Burns J K, Jhazbhay K, Emsley R
Department of Psychiatry, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, South Africa.
Afr J Psychiatry (Johannesbg). 2010 Nov;13(5):395-9. doi: 10.4314/ajpsy.v13i5.63106.
Cannabis use/abuse is a common co-morbid problem in patients experiencing a first episode of psychotic illness (FEP). The relationship between the clinical presentation of FEP and cannabis abuse is complex and warrants further investigation, especially within the South African context.
We tested associations between recent/current cannabis use and duration of untreated psychosis (DUP), age of onset (AO), PANSS-rated (Positive and Negative Syndrome Scale) positive, negative and general psychopathology symptoms and depressive symptoms (Calgary Depression Scale for Schizophrenia) in a sample of 54 patients with FEP.
Mean DUP was 34.4 weeks, while mean AO was 24.7 years. Co-morbid cannabis use occurred in 35% of the sample and was significantly associated with shorter DUP (Mann-Whitney U, p=0.026). While not significant, there was also a trend association between cannabis use and lower negative symptoms (Mann-Whitney U, p=0.051).
Current/recent cannabis use was associated with clinical features of psychosis onset that previously have been associated with better outcome. Medium and long-term outcome for cannabis users however, is likely to depend on whether or not cannabis use is ongoing.
大麻使用/滥用是首次发作精神病（FEP）患者中常见的共病问题。FEP的临床表现与大麻滥用之间的关系复杂，值得进一步研究，尤其是在南非背景下。
我们在54例FEP患者样本中测试了近期/当前大麻使用与未治疗精神病持续时间（DUP）、发病年龄（AO）、阳性和阴性症状量表（PANSS）评定的阳性、阴性和一般精神病理学症状以及抑郁症状（精神分裂症卡尔加里抑郁量表）之间的关联。
平均DUP为34.4周，平均AO为24.7岁。35%的样本存在共病大麻使用，且与较短的DUP显著相关（曼-惠特尼U检验，p = 0.026）。虽然不显著，但大麻使用与较低的阴性症状之间也存在趋势关联（曼-惠特尼U检验，p = 0.051）。
当前/近期大麻使用与先前与较好预后相关的精神病发作临床特征有关。然而，大麻使用者的中长期预后可能取决于大麻使用是否持续。
