Psychiatric Center Bispebjerg, Faculty of Health Sciences, Copenhagen University: Bispebjerg Bakke 23, building 13A, DK-2400 Copenhagen NV, Denmark.
Addict Behav. 2009 Jun-Jul;34(6-7):520-5. doi: 10.1016/j.addbeh.2009.02.001. Epub 2009 Feb 25.
Cannabis use disorders (CUD) are prevalent among people with schizophrenia spectrum disorders (SSD), with a range of detrimental effects, e.g. reduced compliance to medication and psychosocial interventions, and increased level of psychotic-dimension symptoms. The aim of this study was to review literature on treatments of CUD in SSD-patients.
PubMed, PsycINFO, EMBASE, and The Cochrane Central Register of Controlled Trials were searched.
41 articles were selected, 11 treating cannabis as a separate outcome. Contingency management was only effective while active. Pharmacological interventions appeared effective, but lacked randomized controlled trials (RCTs). Psychosocial interventions, e.g. motivational interviewing and cognitive behavior therapy (CBT), were ineffective in most studies with cannabis as a separate outcome, but effective in studies that grouped cannabis together with other substance use disorders.
Insufficient evidence exists on treating this form of dual-diagnosis patients. Studies grouping several types of substances as a single outcome may overlook differential effects. Future RCTs should investigate combinations of psychosocial, pharmacological, and contingency management.
大麻使用障碍（CUD）在精神分裂症谱系障碍（SSD）患者中较为常见，具有多种不良影响，例如降低对药物和心理社会干预的依从性，以及增加精神病维度症状的水平。本研究旨在综述 SSD 患者中 CUD 的治疗方法。
检索了 PubMed、PsycINFO、EMBASE 和 The Cochrane Central Register of Controlled Trials。
共选择了 41 篇文章，其中 11 篇将大麻作为单独的结局进行了治疗。当治疗处于活跃状态时，控制管理才有效。药物干预似乎有效，但缺乏随机对照试验（RCT）。心理社会干预，如动机访谈和认知行为疗法（CBT），在大多数将大麻作为单独结局的研究中无效，但在将大麻与其他物质使用障碍一起分组的研究中有效。
针对这种双重诊断患者的治疗方法证据不足。将几种物质分组作为单一结局的研究可能会忽略不同的效果。未来的 RCT 应研究心理社会、药理学和控制管理的组合。
