Cannabis Use Is Associated With Depression Severity and Suicidality in the National Comorbidity Survey-Adolescent Supplement.

Objective: To investigate the association of cannabis use with major depression and suicidal behavior in adolescence. Method: Data are from the National Comorbidity Survey-Adolescent Supplement N=10,123, a nationally representative survey of adolescents aged 13 to 18 years. Weighted logistic regression and ordinal regression analyses of major depression and suicidal behavior outcomes were conducted on cannabis variables, incorporating sociodemographic characteristics. Results: Adolescents with lifetime cannabis use have 2.07 times higher odds of mild/moderate (adjusted odds ratio [aOR]; 95% CI=1.69, 2.53) and 3.32 times higher odds of severe major depressive disorder (MDD; aOR; 95% CI=2.31, 4.75). Cannabis use (aOR 6.90, 95% CI=4.67,10.19), mild/moderate MDD (aOR 4.10, 95% CI=2.82, 5.98), and severe MDD (aOR 13.97, 95% CI = 7.59, 25.70) were associated with higher odds of suicide attempt. Past 12-month cannabis use (aOR 3.70, 95% CI = 2.16, 6.32), mild/moderate major depressive episodes (MDE) (aOR 7.85, 95% CI=3.59, 17.17), and severe MDE (aOR 36.36, 95% CI=13.68,96.64) were associated with higher odds of suicide attempt. The frequency of past 12-month cannabis use was associated with higher odds of suicide attempt and with MDE severity, with higher odds among individuals who use cannabis 3 or more days than among individuals who use cannabis less frequently, suggesting a dose effect. Among cannabis users, older age of onset of cannabis use was associated with lower odds of suicidal behaviors. Conclusion: Cannabis use is associated with higher odds of depression and depression severity in adolescence. Furthermore, depression and cannabis use are independently associated with higher odds of suicide attempt. Diversity & Inclusion Statement: We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group.

Headaches and sleep problems in US adolescents: Findings from the National Comorbidity Survey - Adolescent Supplement (NCS-A).

BACKGROUND: There is limited research on the association of sleep problems with International Classification of Headache Disorders (ICHD-II)-defined headache subtypes in youth, particularly from community-based samples. This cross-sectional study examines the associations of sleep patterns, symptoms and disorders with specific headache subtypes among adolescents from the general population of the United States. METHODS: The sample includes 10,123 adolescents in the National Comorbidity Survey - Adolescent Supplement, a face-to-face survey of adolescents aged 13-18 years in the continental USA. Headache subtype diagnoses were based on modified ICHD-III criteria, and mood and anxiety disorders were based on Diagnostic and Statistical Manual of Mental Disorders criteria. The associations of self-reported sleep patterns and insomnia symptoms and headache status were estimated with multivariate regression models that adjust for demographic characteristics and comorbid anxiety and mood disorders. RESULTS: There was no significant difference in bedtime between youth with and without headache. However, adolescents with migraine headache reported significantly shorter sleep duration (p = .022) and earlier wakeup time (p = .002) than those without headache. Youth with any headache, particularly migraine, had significantly more sleep disturbances than those without headache. With respect to headache subtypes, youth with migraine with aura were more likely to report difficulty maintaining sleep, early morning awakening, daytime fatigue, and persistent insomnia symptoms than those with migraine without aura. However, these associations were largely accounted for by comorbid anxiety and mood disorders. There was a monotonic increase in the number of insomnia symptoms with increasingly restrictive definitions of migraine. CONCLUSION: Pervasive sleep disturbances in adolescents with headache have important implications for the evaluation, treatment and etiology of pediatric headache.

Three dysconnectivity patterns in treatment-resistant schizophrenia patients and their unaffected siblings.

UNLABELLED: Among individuals diagnosed with schizophrenia, approximately 20%-33% are recognized as treatment-resistant schizophrenia (TRS) patients. These TRS patients suffer more severely from the disease but struggle to benefit from existing antipsychotic treatments. A few recent studies suggested that schizophrenia may be caused by impaired synaptic plasticity that manifests as functional dysconnectivity in the brain, however, few of those studies focused on the functional connectivity changes in the brains of TRS groups. In this study, we compared the whole brain connectivity variations in TRS patients, their unaffected siblings, and healthy controls. Connectivity network features between and within the 116 automated anatomical labeling (AAL) brain regions were calculated and compared using maps created with three contrasts: patient vs. control, patient vs. sibling, and sibling vs. CONTROL: To evaluate the predictive power of the selected features, we performed a multivariate classification approach. We also evaluated the influence of six important clinical measures (e.g. age, education level) on the connectivity features. This study identified abnormal significant connectivity changes of three patterns in TRS patients and their unaffected siblings: 1) 69 patient-specific connectivity (PCN); 2) 102 shared connectivity (SCN); and 3) 457 unshared connectivity (UCN). While the first two patterns were widely reported by previous non-TRS specific studies, we were among the first to report widespread significant connectivity differences between TRS patient groups and their healthy sibling groups. Observations of this study may provide new insights for the understanding of the neurophysiological mechanisms of TRS.

Multimorbidity of psychiatric disorders as an indicator of clinical severity.

The present study examines the clinical and research significance of the high frequency of multiple diagnoses emanating from the non-hierarchical descriptive approach to classification in the current psychiatric diagnostic systems. Data from a 15-year prospective cohort study of young adults from the general community were employed to evaluate the frequency of multiple disorders (i. e., multimorbidity), and the extent to which patterns of multiple disorders are associated with indicators of severity of psychopathology. The average number of lifetime disorders in this community-based sample was 2.1 with a range from 0 to 7. Associations within diagnostic spectra were more common than those between diagnostic spectra. The results confirm the link between comorbidity and severity demonstrated in several previous studies and further show that there is a direct increase in nearly all of the indicators of severity by the number of disorders for which the subjects met criteria across 15 years. Each of the major diagnostic categories, particularly depression, contributed to increased severity rather than representing a non-specific effect of the number of disorders. These findings demonstrate the importance of characterization of multiple syndromes rather than applying arbitrary hierarchical distinctions between diagnostic categories.