González-Ortega Itxaso, Alberich Susana, Echeburúa Enrique, Aizpuru Felipe, Millán Eduardo, Vieta Eduard, Matute Carlos, González-Pinto Ana
Department of Psychiatry, University Hospital of Alava-Santiago, University of the Basque Country, CIBERSAM, Vitoria, Spain.
Araba Research Unit, Osakidetza, Vitoria, Spain.
PLoS One. 2015 Apr 15;10(4):e0123707. doi: 10.1371/journal.pone.0123707. eCollection 2015.
Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use.
64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a) patients with subclinical depressive symptoms at least once during follow-up (DPG), and (b) patients without subclinical depressive symptoms during follow-up (NDPG). Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms using the Hamilton Depression Rating Scale (HDRS)-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF). A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome.
Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001) and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009).
Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.
尽管首发精神病中的抑郁症状与大麻滥用有关，但它们对滥用大麻的首发精神病（FEP）患者长期功能进程的影响尚不清楚。本研究的目的是检验亚临床抑郁症状对大麻使用者首发精神病患者长期预后的影响，并评估这些亚临床抑郁症状对戒除大麻使用能力的影响。
对64名基线时为大麻使用者的首发精神病患者进行了5年的随访。定义了两组：（a）随访期间至少有一次亚临床抑郁症状的患者（抑郁症状组，DPG），以及（b）随访期间无亚临床抑郁症状的患者（无抑郁症状组，NDPG）。使用阳性和阴性症状量表（PANSS）测量精神病症状，使用汉密尔顿抑郁评定量表（HDRS）-17测量抑郁症状，并使用功能总体评定量表（GAF）评估社会心理功能。采用线性混合效应模型分析大麻使用和亚临床抑郁症状对临床结局的综合影响。
亚临床抑郁症状与随访期间持续滥用大麻有关（β=4.45；95%置信区间[CI]：1.78至11.17；P=.001），且与功能较差有关（β=-5.50；95%CI：-9.02至-0.33；P=.009）。
随访期间的亚临床抑郁症状和持续的大麻滥用可能是首发精神病患者不良结局的预测因素。
