Kvitland Levi Roestad, Melle Ingrid, Aminoff Sofie Ragnhild, Demmo Christine, Lagerberg Trine Vik, Andreassen Ole Andreas, Ringen Petter Andreas
NORMENT, KG Jebsen Center for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway TOP Study, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956 Nydalen, 0424, Oslo, Norway.
Division of Mental Health Services, Department of Specialized Inpatient Treatment, Akershus University Hospital, Akershus, Norway.
BMC Psychiatry. 2015 Feb 5;15:11. doi: 10.1186/s12888-015-0389-x.
There is limited knowledge about how environmental factors affect the course of bipolar disorder (BD). Cannabis has been proposed as a potential risk factor for poorer course of illness, but the role of cannabis use has not been studied in a first treatment BD I sample.
The present study examines the associations between course of illness in first treatment BD I and continued cannabis use, from baseline to one year follow up. Patients (N = 62) with first treatment DSM-IV BD I were included as part of the Thematically Organized Psychosis study (TOP), and completed interviews and self-report questionnaires at both baseline and follow up. Cannabis use within the last six months at baseline and use between baseline and follow up ("continued use") was recorded.
After controlling for confounders, continued cannabis use was significantly associated with elevated mood (YMRS) and inferior global functioning (GAF-F) at follow up. Elevated mood mediated the effect of cannabis use on global functioning.
These results suggest that cannabis use has clinical implications for the early course of BD by increasing mood level. More focus on reducing cannabis use in clinical settings seems to be useful for improving outcome in early phase of the disorder.
关于环境因素如何影响双相情感障碍（BD）病程的了解有限。大麻已被认为是导致病情转差的一个潜在风险因素，但尚未在首次接受治疗的双相I型障碍样本中研究大麻使用的作用。
本研究考察了首次接受治疗的双相I型障碍患者从基线到一年随访期间病情发展与持续使用大麻之间的关联。作为主题性组织精神病研究（TOP）的一部分，纳入了首次接受治疗的DSM-IV双相I型障碍患者（N = 62），这些患者在基线和随访时均完成了访谈及自我报告问卷。记录了基线时过去六个月内的大麻使用情况以及基线与随访期间的使用情况（“持续使用”）。
在控制混杂因素后，持续使用大麻与随访时的情绪高涨（杨氏躁狂量表[YMRS]）及整体功能较差（全球功能评估-随访[GAF-F]）显著相关。情绪高涨介导了大麻使用对整体功能的影响。
这些结果表明，大麻使用通过提高情绪水平对双相情感障碍的早期病程具有临床意义。在临床环境中更加注重减少大麻使用似乎有助于改善该疾病早期阶段的预后。
