Cannabis use and suicide attempts among 86,254 adolescents aged 12-15 years from 21 low- and middle-income countries.
Journal: European psychiatry : the journal of the Association of European Psychiatrists
Volume: 56
Issue:
Year of Publication: 2019
Affiliated Institutions:
Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada. Electronic address: andre.carvalho@camh.ca.
South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE AZ, UK; Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, AF, SE , UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, CM SQ, UK.
KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven Department of Neurosciences, UPC KU Leuven, Kortenberg, Belgium.
Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.
IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia; Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
NICM Health Research Institute, School of Science and Health, Western Sydney University, Sydney, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
Health Outcomes and Performance Evaluation (HOPE) Research Unit within the Social and Epidemiological Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry and Institute of Mental Health Policy Research, University of Toronto, Toronto, Ontario, Canada; Mental Health and Addictions Research Program at the Institute for Clinical Evaluative Science (ICES), Toronto, ON, Canada.
Department of Psychiatry and MRC Unit on Risk and Resilience in Mental Disorders, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
Department of Psychiatry and Institute of Mental Health Policy Research, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Str. , , Dresden, Germany; Addiction Policy, Dalla Lana School of Public Health, University of Toronto, College Street, Toronto, ON, MT M, Canada; Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, King's College Circle, Toronto, ON, MS A, Canada.
Research and Development Unit, Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, , Sant Boi de Llobregat, Barcelona, , Spain.
Abstract summary
Evidence suggests that cannabis use may be associated with suicidality in adolescence. Nevertheless, very few studies have assessed this association in low- and middle-income countries (LMICs). In this cross-sectional survey, we investigated the association of cannabis use and suicidal attempts in adolescents from 21 LMICs, adjusting for potential confounders.Data from the Global school-based Student Health Survey was analyzed in 86,254 adolescents from 21 countries [mean (SD) age = 13.7 (0.9) years; 49.0% girls]. Suicide attempts during past year and cannabis during past month and lifetime were assessed. Multivariable logistic regression analyses were conducted.The overall prevalence of past 30-day cannabis use was 2.8% and the age-sex adjusted prevalence varied from 0.5% (Laos) to 37.6% (Samoa), while the overall prevalence of lifetime cannabis use was 3.9% (range 0.5%-44.9%). The overall prevalence of suicide attempts during the past year was 10.5%. Following multivariable adjustment to potential confounding variables, past 30-day cannabis use was significantly associated with suicide attempts (OR = 2.03; 95% CI: 1.42-2.91). Lifetime cannabis use was also independently associated with suicide attempts (OR = 2.30; 95% CI: 1.74-3.04).Our data indicate that cannabis use is associated with a greater likelihood for suicide attempts in adolescents living in LMICs. The causality of this association should be confirmed/refuted in prospective studies to further inform public health policies for suicide prevention in LMICs.
Authors & Co-authors:
Carvalho Andre F AF
Stubbs Brendon B
Vancampfort Davy D
Kloiber Stefan S
Maes Michael M
Firth Joseph J
Kurdyak Paul A PA
Stein Dan J DJ
Rehm Jürgen J
Koyanagi Ai A
Study Outcome
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