Kvitland Levi R, Melle Ingrid, Aminoff Sofie R, Lagerberg Trine V, Andreassen Ole A, Ringen Petter A
NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo.
Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.
Early Interv Psychiatry. 2016 Feb;10(1):36-44. doi: 10.1111/eip.12138. Epub 2014 Apr 17.
The aim of this study was to investigate the associations between recent cannabis use, current symptomatology and age at onset of first manic, depressive and psychotic episodes in a large sample with first-treatment bipolar I disorder (BD I).
One hundred one patients with first-treatment Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) bipolar I disorder were included as part of the Thematically Organized Psychosis study. The Structural Clinical Interview for DSM-IV was used for DSM-IV diagnosis and identification of episodes of illness. Earlier suicide attempts were recorded. Manic, depressive and psychotic symptoms were rated using the Young Mania Rating Scale, Inventory of Depressive Symptoms and Positive and Negative Syndrome Scale correspondingly. Cannabis use within the six last months was recorded.
After controlling for confounders, recent cannabis use was significantly associated with lower age at onset of first manic and psychotic episode, but not with onset of first depressive episode (both P < 0.05). Recent use was also associated with more lifetime suicide attempts (P < 0.01). No group differences were found on symptom levels.
The present study confirms earlier findings of an association between cannabis use and a lower age at onset. Recent cannabis use was also associated with more lifetime suicide attempts. The current findings suggest that recent cannabis use is associated with a more severe course of illness in the early phase of BD I.
本研究旨在调查在一大群首次接受治疗的I型双相情感障碍（BD I）患者中，近期使用大麻、当前症状学与首次躁狂、抑郁和精神病性发作的发病年龄之间的关联。
作为主题性组织精神病研究的一部分，纳入了101例首次接受治疗的《精神疾病诊断与统计手册》第四版（DSM-IV）I型双相情感障碍患者。使用DSM-IV结构性临床访谈进行DSM-IV诊断和疾病发作的识别。记录早期自杀未遂情况。分别使用杨氏躁狂评定量表、抑郁症状量表和阳性与阴性症状量表对躁狂、抑郁和精神病性症状进行评分。记录过去六个月内的大麻使用情况。
在控制混杂因素后，近期使用大麻与首次躁狂和精神病性发作的较低发病年龄显著相关，但与首次抑郁发作的发病年龄无关（P均<0.05）。近期使用大麻还与更多的终身自杀未遂相关（P<0.01）。在症状水平上未发现组间差异。
本研究证实了早期关于大麻使用与较低发病年龄之间关联的发现。近期使用大麻还与更多的终身自杀未遂相关。目前的研究结果表明，近期使用大麻与BD I早期更严重的病程相关。
