1 Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain.
3 Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain.
J Psychopharmacol. 2019 Mar;33(3):284-294. doi: 10.1177/0269881118822173. Epub 2019 Jan 31.
Cannabis smoking is highly prevalent among patients with psychotic disorders. Its use has been found to be related to clinical characteristics and the prognosis of the disorder. Recent evidence indicates a protective effect of cannabis on weight gain and related metabolic alterations. However, there are no previous studies on the long-term longitudinal effects of cannabis on first-episode drug-naïve patients, which would thereby avoid the confounding effects of chronicity and previous treatment exposure. We aimed to explore the effect of cannabis smoking on weight and lipid/glycaemic metabolic measures in a sample of first-episode non-affective psychosis patients.
Anthropometric measurements and glycaemic and lipid parameters were obtained at baseline and three years after initiation of treatment. Patients self-reported their cannabis use at both time points. To explore the longitudinal effect of cannabis, patients were divided into three groups: continuers, discontinuers and non-users.
Cannabis users at baseline presented a lower weight ( F=14.85, p<0.001), body mass index ( F=13.14, p<0.001), total cholesterol ( F=4.85, p=0.028) and low-density lipoprotein-cholesterol ( F=6.26, p=0.013) compared to non-users. These differences were also observed after three years: weight ( F=8.07, p=0.005), body mass index ( F=4.66, p=0.032) and low-density lipoprotein-cholesterol ( F=3.91, p=0.049). Moreover, those patients discontinuing cannabis use presented a higher increase in weight ( F=2.98, p=0.052), body mass index ( F=2.73, p=0.067) and triglyceride-high-density lipoprotein ratio ( F=2.72, p=0.067) than the 'non-users' and 'continuers'.
The study suggests that cannabis use may produce a protective effect against weight gain and related metabolic alterations in psychosis. However, these results need to be replicated in a larger sample size.
精神障碍患者中，大麻吸食非常普遍。其使用与疾病的临床特征和预后有关。最近的证据表明，大麻对体重增加和相关代谢改变有保护作用。然而，以前没有关于大麻对初发、未经药物治疗的精神病患者的长期纵向影响的研究，这将避免慢性和先前治疗暴露的混杂影响。我们旨在探讨大麻吸食对首发非情感性精神病患者体重和血脂/血糖代谢指标的影响。
在开始治疗时和三年后，测量人体测量学指标以及血糖和血脂参数。患者在两个时间点都报告了自己的大麻使用情况。为了探讨大麻的纵向作用，患者被分为三组：持续使用者、非持续使用者和非使用者。
基线时大麻使用者体重（ F=14.85，p<0.001）、体质指数（ F=13.14，p<0.001）、总胆固醇（ F=4.85，p=0.028）和低密度脂蛋白胆固醇（ F=6.26，p=0.013）均低于非使用者。三年后仍观察到这些差异：体重（ F=8.07，p=0.005）、体质指数（ F=4.66，p=0.032）和低密度脂蛋白胆固醇（ F=3.91，p=0.049）。此外，与“非使用者”和“持续使用者”相比，停止使用大麻的患者体重（ F=2.98，p=0.052）、体质指数（ F=2.73，p=0.067）和甘油三酯/高密度脂蛋白比值（ F=2.72，p=0.067）的增加更高。
研究表明，大麻的使用可能对精神病患者的体重增加和相关代谢改变有保护作用。然而，这些结果需要在更大的样本量中进行复制。
