Bersani Giuseppe, Prevete Elisabeth
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
Hum Psychopharmacol. 2017 May;32(3). doi: 10.1002/hup.2591. Epub 2017 May 18.
Literature is quite poor about the clinical effects of novel psychoactive substances (NPS) and the long-term consequences of NPS use in psychiatric patients. Consequently, it is of the greatest interest to examine which effects NPS can exert in patients with previous severe mental illness (SMI), such as psychotic patients. The aim of this work was a comprehensive review about NPS use in patients with SMI.
We searched Medline or PubMed for relevant English-language citations and reviews describing relationships between NPS use and mental disorders, as well as for the main groups of substances and associated psychiatric manifestations. All studies reporting single case or case series of patients were selected.
The NPS use in patients with SMI is probably underestimated. The one existing systematic review considers only 14 studies, 12 of which are case reports. Most clinical results report acute symptom exacerbation of preexisting psychosis. Paranoid, mood, and aggression symptoms occur more frequently.
NPS use could modify clinical features of SMI, but these conclusions cannot be generalizable. More evidence is needed to establish the causal and effective connection between NPS use and course of illness, type of psychiatric symptoms, and outcome of treatment in terms of adherence or response.
关于新型精神活性物质（NPS）的临床效果以及NPS在精神科患者中使用的长期后果的文献相当匮乏。因此，研究NPS对既往患有严重精神疾病（SMI）的患者（如精神病患者）会产生何种影响，具有极大的研究价值。本研究的目的是对SMI患者使用NPS的情况进行全面综述。
我们在Medline或PubMed中检索了相关的英文文献引用和综述，这些文献描述了NPS使用与精神障碍之间的关系，以及主要的物质类别和相关的精神症状表现。所有报告单个病例或病例系列的研究均被纳入。
SMI患者中NPS的使用情况可能被低估了。现有的一项系统综述仅纳入了14项研究，其中12项为病例报告。大多数临床结果报告了既往精神病症状的急性加重。偏执、情绪和攻击症状更为常见。
使用NPS可能会改变SMI的临床特征，但这些结论无法推广。需要更多证据来确立NPS使用与疾病进程、精神症状类型以及治疗依从性或反应方面的治疗结果之间的因果和有效联系。
