Department of Health Sciences, University of York, Heslington, York, UK.
Addiction. 2017 Sep;112(9):1653-1657. doi: 10.1111/add.13826. Epub 2017 Apr 16.
The relationship between cannabis and psychosis and schizophrenia has tested the field of addiction for decades, and in some ways serves as measure of our ability to provide a credible contribution to public health. As cannabis is used widely, many people are interested in the risks the drug poses to mental health. This paper focuses upon a seminal study examining this, the trajectory of subsequent research findings and what this has meant for understanding and communicating risk factor information. These studies provided evidence of a dose-response relationship between cannabis and psychosis, and that for those individuals with schizophrenia cannabis exacerbated their symptoms. The findings fit with a multi-causal model in which vulnerability interacts with a precipitating agent to produce a disease outcome. Even though this is a common model in epidemiology, it has proved difficult to communicate it in this case. This may be because at a population level the increased risk is weak and the vulnerabilities relatively rare. It may also be because people bring strongly held preconceptions to interpreting a complex multi-causal phenomenon.
大麻与精神病和精神分裂症之间的关系几十年来一直是成瘾领域研究的焦点，在某种程度上可以衡量我们为公共卫生提供可信贡献的能力。由于大麻的广泛使用，许多人对这种药物对心理健康构成的风险感兴趣。本文重点介绍了一项开创性的研究，该研究考察了后续研究结果的轨迹，以及这对理解和传播风险因素信息意味着什么。这些研究提供了大麻与精神病之间存在剂量反应关系的证据，并且对于那些患有精神分裂症的人来说，大麻会加重他们的症状。这些发现符合多因素模型，即易感性与诱发因素相互作用产生疾病结果。尽管这是流行病学中的常见模型，但在这种情况下很难进行沟通。这可能是因为在人群水平上，风险增加幅度较小，而脆弱性相对罕见。也可能是因为人们在解释复杂的多因素现象时带有强烈的先入为主的观念。
