Rylander Melanie, Winston Helena R, Medlin Haley, Hull Madelyne, Nussbaum Abraham
a University of Colorado School of Medicine , Department of Psychiatry, Denver Health Medical Center , Denver , CO , USA.
b Department of Psychiatry , University of Colorado School of Medicine , Denver , CO , USA.
Am J Drug Alcohol Abuse. 2018;44(1):73-84. doi: 10.1080/00952990.2017.1329313. Epub 2017 Jun 14.
The associations between cannabis use and psychosis are well documented in numerous studies. There is a need to evaluate the impact of cannabis use on inpatient psychiatric utilization and outcomes.
To evaluate the impact of cannabis use on psychiatric hospital outcomes.
This study was conducted between April 20, 2015 and October 20, 2015. All patients (n = 120) admitted to Denver Health with psychotic symptoms were administered a urine toxicology screening testing for the presence of 11-nor-9-carboxy-Δ-tetrahydrocannabinol (THC-COOH, the active metabolite of cannabis). Patients with positive tests were compared to those with negative tests on several measures, including length of stay, presence or lack of 30-day readmission, Brief Psychotic Rating Scale (BPRS) score, and use of antipsychotics and/or sedatives/anxiolytics.
There were 120 patients. Twenty nine were women and 91 were men. Patients testing positive for THC-COOH had a shorter length of stay compared to patients testing negative for THC-COOH, after adjusting for age, prior psychiatric admissions, history of a psychotic-spectrum disorder, and comorbid additional substance use (p = 0.02). There were no differences in 30-day readmissions, 30-day post-discharge presentation to the Denver Health psychiatric emergency department, BPRS scores, and medication administration.
Patients presenting with psychotic symptoms and cannabis use require shorter inpatient psychiatric hospitalizations. This study is the first to quantify this observation and highlights the need for future clinical decision-making tools that would ideally correlate cannabis use with the degree of potential need for expensive and scarce mental health resources, such as psychiatric hospitalization.
大量研究充分证明了大麻使用与精神病之间的关联。有必要评估大麻使用对住院精神科治疗利用情况及治疗结果的影响。
评估大麻使用对精神科住院治疗结果的影响。
本研究于2015年4月20日至2015年10月20日进行。所有因精神症状入住丹佛健康中心的患者（n = 120）均接受了尿液毒理学筛查，以检测11-去甲-9-羧基-Δ-四氢大麻酚（THC-COOH，大麻的活性代谢物）的存在情况。对检测呈阳性的患者与检测呈阴性的患者在多项指标上进行比较，包括住院时间、是否有30天再入院情况、简明精神病评定量表（BPRS）评分以及抗精神病药物和/或镇静剂/抗焦虑药物的使用情况。
共有120名患者。其中29名女性，91名男性。在对年龄、既往精神科住院史、精神病谱系障碍病史以及合并的其他物质使用情况进行调整后，THC-COOH检测呈阳性的患者住院时间比THC-COOH检测呈阴性的患者短（p = 0.02）。在30天再入院情况、出院后30天内到丹佛健康中心精神科急诊科就诊情况、BPRS评分以及药物使用方面没有差异。
出现精神症状且使用大麻的患者需要较短的精神科住院治疗时间。本研究首次对这一观察结果进行了量化，并强调了未来临床决策工具的必要性，这些工具理想情况下应将大麻使用情况与对昂贵且稀缺的心理健康资源（如精神科住院治疗）的潜在需求程度相关联。
