Adolescent Clinic, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Meibergdreef 5, Amsterdam, The Netherlands.
Aust N Z J Psychiatry. 2009 Dec;43(12):1155-62. doi: 10.3109/00048670903179095.
The aim of the present study was to gain more insight into the positive and negative effects of cannabis in the prodromal phase of schizophrenia and in the ultra-high-risk (UHR) state for psychosis.
A theory-driven questionnaire was used to examine subjective effects in the prodromal phase in male subjects with a recent onset of schizophrenia or related disorder (n = 52) and in the UHR state in help-seeking male subjects screened for being at UHR for psychosis (n = 17); both groups were compared to cannabis-using controls from the general population (n=52).
Recent-onset patients and UHR subjects reported feeling more anxious, depressed and suspicious immediately after cannabis use. Some patients also reported feeling less depressed after cannabis use. Recent-onset patients reported increased visual and acoustic hallucinations, and confusion after cannabis use. Of the recent-onset patients 37% reported that their very first psychotic symptoms occurred during cannabis intoxication. Long-term effects of cannabis reported more often by both patient groups were depression, less control over thoughts and social problems.
These results suggest that schizophrenia patients in the prodromal phase and subjects at UHR for psychosis are more sensitive to some negative effects of cannabis, in particular psychotic effects, compared to cannabis users from the general population. Although limited by the retrospective design in the recent-onset patients, the present study adds qualitative evidence to longitudinal studies that suggest that cannabis is a component cause in the onset of the first psychotic episode. Further studies are needed on the objective and subjective effects of cannabis in UHR subjects.
本研究旨在更深入地了解大麻在精神分裂症前驱期和精神病超高危（UHR）状态中的积极和消极影响。
使用一种基于理论的问卷，研究了近期首发精神分裂症或相关障碍男性患者（n=52）前驱期的主观效应，以及寻求帮助的男性精神病 UHR 筛查对象（n=17）的 UHR 状态下的主观效应；这两组都与来自普通人群的大麻使用者对照组（n=52）进行了比较。
近期发病患者和 UHR 受试者报告说，在使用大麻后立即感到更焦虑、抑郁和多疑。一些患者还报告说，使用大麻后抑郁感减轻。近期发病患者报告说，在使用大麻后出现幻觉和意识混乱增加。在近期发病患者中，有 37%的患者报告说，他们的首次精神病症状发生在大麻中毒期间。两组患者报告的大麻的长期影响更多的是抑郁、思维控制减弱和社会问题。
这些结果表明，与普通人群中的大麻使用者相比，精神分裂症前驱期患者和精神病 UHR 受试者对大麻的一些负面效应更为敏感，特别是精神病效应。尽管近期发病患者的研究设计存在回顾性限制，但本研究为纵向研究提供了定性证据，表明大麻是首发精神病发作的一个促成因素。需要进一步研究 UHR 受试者中大麻的客观和主观效应。
