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大麻素与精神病

Cannabinoids and psychosis.

作者信息

Sewell R Andrew, Ranganathan Mohini, D'Souza Deepak Cyril

机构信息

Psychiatry Service, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA.

出版信息

Int Rev Psychiatry. 2009 Apr;21(2):152-62. doi: 10.1080/09540260902782802.

Abstract

Recent advances in knowledge about cannabinoid receptor function have renewed interest in the association between cannabis and psychosis. Case series, autobiographical accounts, and surveys of cannabis users in the general population suggest an association between cannabis and psychosis. Cross-sectional studies document an association between cannabis use and psychotic symptoms, and longitudinal studies suggest that early exposure to cannabis confers a close to two-fold increase in the risk of developing schizophrenia. Pharmacological studies show that cannabinoids can induce a full range of transient positive, negative, and cognitive symptoms in healthy individuals that are similar to those seen in schizophrenia. There is considerable evidence that in individuals with an established psychotic disorder such as schizophrenia, exposure to cannabis can exacerbate symptoms, trigger relapse, and worsen the course of the illness. Only a very small proportion of the general population exposed to cannabis develop a psychotic illness. It is likely that cannabis exposure is a 'component cause' that interacts with other factors to 'cause' schizophrenia or other psychotic disorder, but is neither necessary nor sufficient to do so alone. Further work is necessary to identify the factors that underlie individual vulnerability to cannabinoid-related psychosis and to elucidate the biological mechanisms underlying this risk.

摘要

近年来,关于大麻素受体功能的知识进展重新引发了人们对大麻与精神病之间关联的兴趣。病例系列、自传体记述以及对普通人群中大麻使用者的调查表明大麻与精神病之间存在关联。横断面研究记录了大麻使用与精神病症状之间的关联,纵向研究表明早期接触大麻会使患精神分裂症的风险增加近两倍。药理学研究表明,大麻素可在健康个体中诱发一系列与精神分裂症中所见症状相似的短暂的阳性、阴性和认知症状。有大量证据表明,对于患有精神分裂症等既定精神障碍的个体,接触大麻会加剧症状、引发复发并使病情恶化。在接触大麻的普通人群中,只有极小一部分人会患上精神病性疾病。大麻接触很可能是一种“促成因素”,它与其他因素相互作用以“导致”精神分裂症或其他精神病性障碍,但仅凭其自身既非必要条件也非充分条件。有必要开展进一步研究,以确定个体易患大麻相关精神病的潜在因素,并阐明这种风险背后的生物学机制。

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