Arendt Mikkel, Rosenberg Raben, Fjordback Lone, Brandholdt Jack, Foldager Leslie, Sher Leo, Munk-Jørgensen Povl
Center for Basic Psychiatric Research, Aarhus University Hospital, Risskov, Denmark.
Psychol Med. 2007 Jul;37(7):935-45. doi: 10.1017/S0033291706009688. Epub 2007 Jan 4.
A self-medication hypothesis has been proposed to explain the association between cannabis use and psychiatric and behavioral problems. However, little is known about the reasons for use and reactions while intoxicated in cannabis users who suffer from depression or problems controlling violent behavior.
We assessed 119 cannabis-dependent subjects using the Schedules of Clinical Assessment in Neuropsychiatry (SCAN), parts of the Addiction Severity Index (ASI), and questionnaires on reasons for cannabis use and reactions to cannabis use while intoxicated. Participants with lifetime depression and problems controlling violent behavior were compared to subjects without such problems. Validity of the groupings was corroborated by use of a psychiatric treatment register, previous use of psychotropic medication and convictions for violence.
Subjects with lifetime depression used cannabis for the same reasons as others. While under the influence of cannabis, they more often experienced depression, sadness, anxiety and paranoia, and they were less likely to report happiness or euphoria. Participants reporting problems controlling violent behavior more often used cannabis to decrease aggression, decrease suspiciousness, and for relaxation; while intoxicated they more often reacted with aggression.
Subjects with prior depression do not use cannabis as a mean of self-medication. They are more likely to experience specific increases of adverse symptoms while under the influence of cannabis, and are less likely to experience specific symptom relief. There is some evidence that cannabis is used as a means of self-medication for problems controlling aggression.
一种自我用药假说已被提出，用于解释大麻使用与精神和行为问题之间的关联。然而，对于患有抑郁症或存在暴力行为控制问题的大麻使用者，在使用大麻时的用药原因及反应却知之甚少。
我们使用神经精神病学临床评估量表（SCAN）、成瘾严重程度指数（ASI）的部分内容以及关于大麻使用原因和大麻使用时中毒反应的问卷，对119名大麻依赖者进行了评估。将有终生抑郁史和暴力行为控制问题的参与者与没有此类问题的受试者进行比较。通过使用精神病治疗登记册、先前使用精神药物的情况以及暴力犯罪记录来证实分组的有效性。
有终生抑郁史的受试者使用大麻的原因与其他人相同。在大麻的影响下，他们更常出现抑郁、悲伤、焦虑和偏执，且较少报告快乐或欣快感。报告有暴力行为控制问题的参与者更常使用大麻来减少攻击性、减少猜疑以及放松；在中毒时，他们更常出现攻击性反应。
有既往抑郁症史的受试者不会将大麻用作自我用药的手段。他们在大麻影响下更有可能出现特定不良症状的增加，且不太可能出现特定症状的缓解。有一些证据表明，大麻被用作控制攻击性问题的自我用药手段。
