INSERM, Laboratoire de Physiopathologie des Maladies Psychiatriques, Centre de Psychiatrie et Neurosciences, U894, Université Paris Descartes, Paris, France.
Int J Neuropsychopharmacol. 2010 Oct;13(9):1145-54. doi: 10.1017/S1461145710000647. Epub 2010 Jun 9.
There is now compelling evidence that cannabis consumption might precipitate psychosis onset. The objective of the present study was to assess the role of individual sensitivity to the psychotogenic effect of cannabis in male patients with schizophrenia. The lifetime diagnosis, disease and substance-use history were determined using a standardized interview in 190 patients with schizophrenia. Of patients with lifetime cannabis use (n=121), 44 were characterized as Cannabis-sensitive (CS) patients if the onset of psychotic symptoms occurred within 1 month following the initiation of cannabis consumption, or following a marked rise of cannabis consumption, or marked aggravation of psychotic symptoms each time the subject used cannabis. Age at onset of psychosis was not different in patients with lifetime cannabis use compared to non-users. By contrast, the first psychotic episode occurred 2.6 yr earlier in CS compared to Non-cannabis-sensitive (NCS) patients (p=0.006). Moreover, a specific excess of family history of psychotic disorder was found in CS patients, but not of any other psychiatric disorder, as well as an earlier age at exposure to cannabis (16.7+/-2.5 yr, p=0.03). Sensitivity to psychotogenic effects of cannabis in schizophrenia patients could be related to both genetic vulnerability to schizophrenia and the influence of cannabis on brain maturation and could modulate the influence of cannabis on the onset of schizophrenia.
现在有确凿的证据表明，大麻的使用可能会引发精神病的发作。本研究的目的是评估个体对大麻致精神病作用的敏感性在男性精神分裂症患者中的作用。通过标准化访谈，在 190 名精神分裂症患者中确定了他们的终身诊断、疾病和物质使用史。在有终生大麻使用史的患者中（n=121），如果在开始使用大麻后 1 个月内、或在大麻摄入量显著增加后、或每次使用大麻时精神病症状明显加重，出现精神病症状，将其定为大麻敏感（CS）患者。与非使用者相比，有终生大麻使用史的患者的精神病发病年龄并无差异。相比之下，CS 患者的首次精神病发作比非大麻敏感（NCS）患者早 2.6 年（p=0.006）。此外，CS 患者中存在精神障碍家族史的特定过多，而不是任何其他精神障碍，并且接触大麻的年龄更早（16.7+/-2.5 岁，p=0.03）。精神分裂症患者对大麻致精神病作用的敏感性可能与精神分裂症的遗传易感性以及大麻对大脑成熟的影响有关，并可能调节大麻对精神分裂症发病的影响。
