College of Physicians and Surgeons, Columbia University, and the New York State Psychiatric Institute, New York, NY.
College of Physicians and Surgeons, Columbia University.
J Am Acad Child Adolesc Psychiatry. 2017 Mar;56(3):214-225. doi: 10.1016/j.jaac.2016.12.014. Epub 2016 Dec 29.
This review of the scientific literature examines the potential adult sequelae of exposure to cannabis and related synthetic cannabinoids in adolescence. We examine the four neuropsychiatric outcomes that are likely most vulnerable to alteration by early cannabinoid use, as identified within both the clinical and preclinical research: cognition, emotional functioning, risk for psychosis, and addiction.
A literature search was conducted through PubMed, PsychInfo, and Google Scholar with no publication date restrictions. The search terms used were "adolescent" and "adult," and either "cannabis," "marijuana," "delta-9-tetra-hydrocannabinol," or "cannabinoid," which was then crossed with one or more of the following terms: "deficit," "impairment," "alteration," "long-term," "persistent," "development," "maturation," and "pubescent."
The majority of the clinical and preclinical data point to a strong correlation between adolescent cannabinoid exposure and persistent, adverse neuropsychiatric outcomes in adulthood. Although the literature supports the hypothesis that adolescent cannabis use is connected to impaired cognition and mental health in adults, it does not conclusively demonstrate that cannabis consumption alone is sufficient to cause these deficits in humans. The animal literature, however, clearly indicates that adolescent-onset exposure to cannabinoids can catalyze molecular processes that lead to persistent functional deficits in adulthood, deficits that are not found to follow adult-onset exposure and that model some of the adverse outcomes reported in humans among adult populations of early-onset cannabis users.
Based on the data in the current literature, a strong association is found between early, frequent, and heavy adolescent cannabis exposure and poor cognitive and psychiatric outcomes in adulthood, yet definite conclusions cannot yet be made as to whether cannabis use alone has a negative impact on the human adolescent brain. Future research will require animal models and longitudinal studies to be carefully designed with a focus on integrating assessments of molecular, structural, and behavioral outcomes in order to elucidate the full range of potential adverse and long-term consequences of cannabinoid exposure in adolescence.
本综述文献研究了青少年时期接触大麻和相关合成大麻素后可能出现的成人后遗症。我们研究了四个最容易受到早期大麻使用改变的神经精神后果,这是在临床和临床前研究中确定的:认知、情绪功能、精神病风险和成瘾。
通过 PubMed、PsychInfo 和 Google Scholar 进行文献检索,没有出版日期限制。使用的搜索词是“青少年”和“成人”,以及“大麻”、“大麻”、“Δ-9-四氢大麻酚”或“大麻素”,然后与以下一个或多个术语交叉:“缺陷”、“损害”、“改变”、“长期”、“持续”、“发育”、“成熟”和“青春期”。
大多数临床和临床前数据表明,青少年时期接触大麻素与成年后持续的、不良的神经精神后果之间存在很强的相关性。尽管文献支持青少年大麻使用与成年人认知和心理健康受损有关的假设,但它并没有确凿地证明大麻单独消费足以在人类中造成这些缺陷。然而,动物文献清楚地表明,青少年期开始接触大麻素会引发导致成年后持续功能缺陷的分子过程,这些缺陷不会随着成年期开始接触而出现,并且在一些在早期开始使用大麻的成年人中报告的不良后果中模拟了一些。
根据当前文献中的数据,青少年时期频繁和大量接触大麻与成年后认知和精神不良后果之间存在很强的关联,但尚不能确定大麻单独使用是否对人类青少年大脑有负面影响。未来的研究将需要精心设计动物模型和纵向研究,重点是整合分子、结构和行为结果的评估,以阐明大麻素暴露在青春期的全部潜在不良和长期后果。