发病前频繁使用大麻的精神病患者比不使用的患者更容易患上精神分裂症，这与遗传易感性有关。
Psychotic patients who used cannabis frequently before illness onset have higher genetic predisposition to schizophrenia than those who did not.
机构信息
NORMENT,KG Jebsen Centre for Psychosis Research,Institute of Clinical Medicine,University of Oslo,and Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway.
NORMENT,KG Jebsen Centre for Psychosis Research,Department of Clinical Science,University of Bergen,Bergen,Norway.
出版信息
Psychol Med. 2018 Jan;48(1):43-49. doi: 10.1017/S0033291717001209. Epub 2017 Oct 2.
BACKGROUND
Schizophrenia (SZ) and bipolar disorder (BD) are heritable, polygenic disorders with shared clinical and genetic components, suggesting a psychosis continuum. Cannabis use is a well-documented environmental risk factor in psychotic disorders. In the current study, we investigated the relationship between SZ genetic load and cannabis use before illness onset in SZ and BD spectrums. Since frequent early cannabis use (age <18 years) is believed to increase the risk of developing psychosis more than later use, follow-up analyses were conducted comparing early use to later use and no use.
METHODS
We assigned a SZ-polygenic risk score (PGRS) to each individual in our independent sample (N = 381 SZ spectrum cases, 220 BD spectrum cases and 415 healthy controls), calculated from the results of the Psychiatric Genomics Consortium (PGC) SZ case-control study (N = 81 535). SZ-PGRS in patients who used cannabis weekly to daily in the period before first illness episode was compared with that of those who never or infrequently used cannabis.
RESULTS
Patients with weekly to daily cannabis use before illness onset had the highest SZ-PGRS (p = 0.02, Cohen's d = 0.33). The largest difference was found between patients with daily or weekly cannabis use before illness onset <18 years of age and patients with no or infrequent use of cannabis (p = 0.003, Cohen's d = 0.42).
CONCLUSIONS
Our study supports an association between high SZ-PGRS and frequent cannabis use before illness onset in psychosis continuum disorders.
背景
精神分裂症（SZ）和双相情感障碍（BD）是具有遗传多基因特征的疾病，具有共同的临床和遗传成分，提示存在精神病谱。大麻使用是精神障碍的一个有充分记录的环境风险因素。在目前的研究中，我们调查了 SZ 和 BD 谱中，SZ 遗传负荷与发病前大麻使用之间的关系。由于频繁的早期大麻使用（<18 岁）被认为比后期使用增加了发展为精神病的风险，因此进行了后续分析，比较了早期使用与后期使用和无使用。
方法
我们为独立样本中的每个个体分配了 SZ 多基因风险评分（PGRS）（381 名 SZ 谱系病例、220 名 BD 谱系病例和 415 名健康对照者），该评分是从精神病基因组学联合会（PGC）SZ 病例对照研究（81535 名患者）的结果计算得出的。比较发病前每周至每日使用大麻的患者的 SZ-PGRS 与从未或很少使用大麻的患者。
结果
发病前每周至每日使用大麻的患者 SZ-PGRS 最高（p = 0.02，Cohen's d = 0.33）。在发病前 <18 岁时每日或每周使用大麻和从未或很少使用大麻的患者之间，差异最大（p = 0.003，Cohen's d = 0.42）。
结论
我们的研究支持 SZ-PGRS 与精神病谱障碍发病前频繁大麻使用之间的关联。
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