Di Forti Marta, Morrison Paul D, Butt Alexander, Murray Robin M
Department of Psychological Medicine, Institute of Psychiatry, London, UK.
Curr Opin Psychiatry. 2007 May;20(3):228-34. doi: 10.1097/YCO.0b013e3280fa838e.
Cannabis is the world's most commonly used illicit drug. In this review, we consider the recent literature on the effects of cannabis on mental health and on cognition.
Cannabis use in adolescence increases the risk of later schizophrenia-like psychoses, especially in genetically vulnerable individuals. Not surprisingly, patients already suffering from psychosis who use cannabis have a worse outcome than those who do not. These effects of cannabis may be consequent on its impact on the dopamine system. There is less evidence of cannabis playing an aetiological role in other mental disorders including depression, but there have been far fewer studies. Heavy cannabis use has also been shown to affect memory and learning performance, both in healthy individuals and in patients suffering from psychosis. Combined cognitive-behavioural therapy and motivational interviewing seems a promising psychological intervention to achieve a cessation of cannabis use in patients suffering from schizophrenia.
Further research is needed to understand the biological mechanisms underlying the effects of cannabis on mental health, but intervention strategies to help patients abstain should currently be implemented in psychiatric services, and public education campaigns should be directed at increasing awareness of the health risks of cannabis.
大麻是世界上最常用的非法药物。在本综述中，我们探讨了近期关于大麻对心理健康和认知影响的文献。
青少年使用大麻会增加日后患精神分裂症样精神病的风险，尤其是在有遗传易感性的个体中。不出所料，已患有精神病的患者使用大麻后的预后比不使用者更差。大麻的这些影响可能是其对多巴胺系统作用的结果。关于大麻在包括抑郁症在内的其他精神障碍中起病因学作用的证据较少，但相关研究也少得多。大量使用大麻还被证明会影响健康个体和精神病患者的记忆及学习表现。认知行为疗法和动机访谈相结合似乎是一种有前景的心理干预措施，可帮助精神分裂症患者戒除大麻。
需要进一步研究以了解大麻影响心理健康的生物学机制，但目前应在精神科服务中实施帮助患者戒除大麻的干预策略，并且应开展公众教育活动以提高对大麻健康风险的认识。
