Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults.

McGrath J; Welham J; Scott JVarghese DDegenhardt LHayatbakhsh MRAlati RWilliams GMBor WNajman JM

摘要

CONTEXT: Prospective cohort studies have identified an association between cannabis use and later psychosis-related outcomes, but concerns remain about unmeasured confounding variables. The use of sibling pair analysis reduces the influence of unmeasured residual confounding. OBJECTIVE: To explore the association between cannabis use and psychosis-related outcomes. DESIGN: A sibling pair analysis nested within a prospective birth cohort. SETTING: Births at a Brisbane, Australia, hospital. PARTICIPANTS: Three thousand eight hundred one young adults born between 1981 and 1984 as part of the Mater-University Study of Pregnancy. MAIN OUTCOME MEASURES: Cannabis use and 3 psychosis-related outcomes (nonaffective psychosis, hallucinations, and Peters et al Delusions Inventory score) were assessed at the 21-year follow-up. Associations between duration since first cannabis use and psychosis-related outcomes were examined using logistic regression adjusted for sex, age, parental mental illness, and hallucinations at the 14-year follow-up. Within 228 sibling pairs, the association between within-pair differences in duration since first cannabis use and Peters et al Delusions Inventory score was examined with general linear modeling. The potential impact of attrition was examined. RESULTS: Duration since first cannabis use was associated with all 3 psychosis-related outcomes. For those with duration since first cannabis use of 6 or more years, there was a significantly increased risk of (1) nonaffective psychosis (adjusted odds ratio, 2.2; 95% confidence interval, 1.1-4.5), (2) being in the highest quartile of Peters et al Delusions Inventory score (adjusted odds ratio, 4.2; 95% confidence interval, 4.2-5.8), and (3) hallucinations (adjusted odds ratio, 2.8; 95% confidence interval, 1.9-4.1). Within sibling pairs, duration since first cannabis use and higher scores on the Peters et al Delusions Inventory remained significantly associated. CONCLUSIONS: Early cannabis use is associated with psychosis-related outcomes in young adults. The use of sibling pairs reduces the likelihood that unmeasured confounding explains these findings. This study provides further support for the hypothesis that early cannabis use is a risk-modifying factor for psychosis-related outcomes in young adults.

机译：背景:前瞻性群组研究确定一个大麻使用之间的联系后来psychosis-related结果,但是关注于无边无际的混淆变量。减少了无边无际的残留的影响混淆。吸食大麻和之间的联系psychosis-related结果。对分析嵌套在一个潜在的诞生队列。医院。数百年至1981年间出生的一个年轻人1984年Mater-University研究的一部分怀孕。和3 psychosis-related结果(非情感性精神病,幻觉,Peters等人妄想库存分数)进行评估21年的随访。因为第一次吸食大麻和psychosis-related使用逻辑回归结果检查调整性别、年龄、父母的精神疾病,在14年的随访和幻觉。在228同胞对之间的关系自第一次within-pair持续时间的差异Peters等人吸食大麻和错觉库存分数与一般线性建模研究。的潜在影响磨损检查。结果:持续时间以来第一次吸食大麻与所有3 psychosis-related结果有关。对于那些时间以来第一次吸食大麻6年或以上,明显(1)非情感性精神病的风险增加(调整后的优势比,2.2;区间,1.1 - -4.5),(2)最高Peters等人的四分位数妄想库存分数(调整比值比,4.2;区间,4.2 - -5.8),(3)幻觉(调整后的优势比,2.8;区间,1.9 - -4.1)。时间以来第一次吸食大麻和更高Peters等人妄想库存的成绩仍然显著相关。吸食大麻与早期psychosis-related结果在年轻的成年人。使用的兄弟姐妹对减少的可能性无边无际的混杂解释这些发现。这项研究提供了进一步的支持早期吸食大麻是一种假设psychosis-related risk-modifying因素结果在年轻的成年人。

Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults.

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