Sideli Lucia, Fisher Helen L, Murray Robin M, Sallis Hannah, Russo Manuela, Stilo Simona A, Paparelli Alessandra, Wiffen Benjamin D R, O'Connor Jennifer A, Pintore Sonia, Ferraro Laura, La Cascia Caterina, La Barbera Daniele, Morgan Craig, Di Forti Marta
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.
Early Interv Psychiatry. 2018 Apr;12(2):135-142. doi: 10.1111/eip.12285. Epub 2015 Nov 12.
Several studies have suggested that lifetime cannabis consumption and childhood abuse synergistically contribute to the risk for psychotic disorders. This study aimed to extend existing findings regarding an additive interaction between childhood abuse and lifetime cannabis use by investigating the moderating role of type and frequency of cannabis use.
Up to 231 individuals presenting for the first time to mental health services with psychotic disorders and 214 unaffected population controls from South London, United Kingdom, were recruited as part of the Genetics and Psychosis study. Information about history of cannabis use was collected using the Cannabis Experiences Questionnaire. Childhood physical and sexual abuse was assessed using the Childhood Experience of Care and Abuse Questionnaire.
Neither lifetime cannabis use nor reported exposure to childhood abuse was associated with psychotic disorder when the other environmental variable was taken into account. Although the combination of the two risk factors raised the odds for psychosis by nearly three times (adjusted OR = 2.94, 95% CI: 1.44-6.02, P = 0.003), no evidence of interaction was found (adjusted OR = 1.46, 95% CI: -0.54 to 3.46, P = 0.152). Furthermore, the association of high-potency cannabis and daily consumption with psychosis was at least partially independent of the effect of childhood abuse.
The heavy use of high-potency cannabis increases the risk of psychosis but, in addition, smoking of traditional resin (hash) and less than daily cannabis use may increase the risk for psychosis when combined with exposure to severe childhood abuse.
多项研究表明，终生吸食大麻与童年期受虐会协同增加患精神障碍的风险。本研究旨在通过调查大麻使用类型和频率的调节作用，扩展关于童年期受虐与终生吸食大麻之间相加交互作用的现有研究结果。
作为“遗传学与精神病”研究的一部分，招募了英国伦敦南部首次因精神障碍前往心理健康服务机构就诊的多达231名个体，以及214名未受影响的人群作为对照。使用《大麻使用经历问卷》收集大麻使用史信息。使用《童年期关爱与虐待经历问卷》评估童年期身体虐待和性虐待情况。
当考虑到另一个环境变量时，终生吸食大麻和报告的童年期受虐经历均与精神障碍无关。尽管这两种风险因素的组合使患精神病的几率增加了近三倍（校正比值比=2.94，95%置信区间：1.44 - 6.02，P = 0.003），但未发现交互作用的证据（校正比值比=1.46，95%置信区间：-0.54至3.46，P = 0.152）。此外，高效能大麻和每日吸食与精神病之间的关联至少部分独立于童年期受虐的影响。
大量使用高效能大麻会增加患精神病的风险，但此外，吸食传统树脂大麻（哈希）以及非每日吸食大麻，与童年期遭受严重虐待相结合时，可能会增加患精神病的风险。
