UNASSIGNED: Critical systematic review of published literature examining the relationship of CU/CUD to AD or state-anxiety, including case reports, literature reviews, observational studies, and preclinical and clinical studies. A systematic MEDline search was conducted of terms including: [anxiety], [anxiogenic], [anxiolytic], [PTSD], [OCD], [GAD], [cannabis], [marijuana], [tetrahydrocannabinol], [THC].
UNASSIGNED: While several case-control and cohort studies have reported no correlation between CU/CUD and AD or state anxiety (N = 5), other cross-sectional, and longitudinal studies report significant relationships (N = 20). Meta-analysis supports anxiety correlating with CU (N = 15 studies, OR = 1.24, 95% CI: 1.06-1.45, p = 0.006) or CUD (N = 13 studies, OR = 1.68, 95% CI: 1.23-2.31, p = 0.001). PATH analysis identifies the self-medication hypothesis (N = 8) as the model that best explains the association between CU/CUD and AD or state-anxiety. Despite the support of multiple large cohort studies, causal interpretations (N = 17) are less plausible, while the common factor theory (N = 5), stress-misattribution hypothesis, and reciprocal feedback theory lack substantial evidential support.
UNASSIGNED: The association between cannabis and anxiety is best explained by anxiety predisposing individuals toward CU as a method of self-medication. A causal relationship in which CU causes AD incidence is less likely despite multiple longitudinal studies suggesting so.
■对已发表文献的批判性系统评价,研究CU/CUD与AD或状态焦虑的关系,包括病例报告,文献综述,观察性研究,以及临床前和临床研究。对术语进行了系统的MEDline搜索,包括:[焦虑],[焦虑],[抗焦虑],[PTSD],[强迫症],[GAD],[大麻],[大麻],[四氢大麻酚],[THC]。
■虽然一些病例对照和队列研究报告CU/CUD与AD或状态焦虑之间没有相关性(N=5),其他横截面,纵向研究报告了显著的关系(N=20)。荟萃分析支持与CU相关的焦虑(N=15项研究,OR=1.24,95%CI:1.06-1.45,p=0.006)或CUD(N=13项研究,OR=1.68,95%CI:1.23-2.31,p=0.001)。PATH分析将自我治疗假设(N=8)确定为最能解释CU/CUD与AD或状态焦虑之间关联的模型。尽管有多个大型队列研究的支持,因果解释(N=17)不太合理,而公因子理论(N=5),压力-错误归因假说,互惠反馈理论缺乏实质性的证据支持。
■大麻与焦虑之间的关联最好的解释是焦虑使个体倾向于CU作为一种自我治疗的方法。尽管多项纵向研究表明,CU引起AD发病率的因果关系不太可能发生。