University Hospital of Child and Adolescent Psychiatry, Bern, Switzerland.
Schizophr Res. 2011 Jun;129(1):52-6. doi: 10.1016/j.schres.2011.03.023. Epub 2011 Apr 17.
Age at onset of psychosis (AAO) may be younger in patients with cannabis use disorders (CUD) compared to those without CUD (NCUD). Previous studies included CUD co-morbid with other substance use disorders (SUD), and many did not control for confounders.
Controlling for relevant confounders, differences in AAO between patients with and without CUD excluding those with any other SUD were analyzed in a large representative file audit of 625 first-episode psychosis (FEP) patients (age 14 to 29years) admitted to the Early Psychosis Prevention and Intervention Centre in Melbourne, Australia.
Three quarters of the 625 FEP patients had a CUD. Cannabis use started before psychosis onset in 87.6% of patients. AAO was not significantly different between CUD (without other SUD, n=201) and NCUD (n=157). However, AAO was younger in those with early CUD (starting age 14 or younger) compared to NCUD (F(1)=5.2; p=0.024; partial η(2)=0.026). Earlier age at onset of cannabis use predicted earlier age at onset of psychosis (β=-0.49, R(2)-change=0.25, p<0.001).
Only CUD starting age 14 or younger was associated with an earlier AAO at a small effect size. These findings suggest that CUD may exert an indirect effect on brain maturation resulting in earlier AAO potentially only in cannabis sensitive subjects.
与无大麻使用障碍（NCUD）的患者相比，患有大麻使用障碍（CUD）的精神病患者发病年龄（AAO）可能更小。之前的研究包括 CUD 与其他物质使用障碍（SUD）共病，并且许多研究没有控制混杂因素。
在对澳大利亚墨尔本早期精神病预防和干预中心收治的 625 名首发精神病（FEP）患者（年龄 14 至 29 岁）的大型代表性文件审计中，控制相关混杂因素后，分析了有和无 CUD 的患者之间 AAO 的差异，排除了任何其他 SUD 的患者。
625 名 FEP 患者中有四分之三患有 CUD。87.6%的患者在精神病发作前开始使用大麻。CUD（无其他 SUD，n=201）和 NCUD（n=157）之间的 AAO 无显著差异。然而，与 NCUD 相比，早期 CUD（起始年龄为 14 岁或更小）的 AAO 更年轻（F(1)=5.2；p=0.024；部分η(2)=0.026）。大麻使用起始年龄较早与精神病发作起始年龄较早相关（β=-0.49，R(2)-变化=0.25，p<0.001）。
只有起始年龄为 14 岁或更小的 CUD 与 AAO 提前较小的效应量相关。这些发现表明，CUD 可能对大脑成熟产生间接影响，从而导致 AAO 提前，可能仅在大麻敏感人群中出现。
