Dervaux Alain
Service de psychiatrie et d'addictologie de liaison, CHU sud d'Amiens, groupe de recherche sur l'alcool et les pharmacodépendances (GRAP, unité Inserm 1247), Amiens, France.
Laboratoire de physiopathologie des maladies psychiatriques, centre psychiatrie et neurosciences, Inserm U894 (Pr M.-O. Krebs), université Paris-Descartes, Paris, France.
Rev Prat. 2018 Jun;68(6):670-674.
Cannabis use disorders and psychiatric comorbidities. Psychiatric disorders and personality disorders are common among patients with cannabis use disorders. Symptoms of cannabis intoxication or withdrawal need to be disentangled from symptoms of psychiatric disorders. Cannabis use disorders and psychiatric disorders worsen each other. Cannabis use disorders could induce psychiatric disorders, in particular depressive disorders and anxiety disorders. Cannabis withdrawal anxiety typically begins after cannabis use has been stopped or reduced. Patients with cannabis use disorder experience, on a daily basis, subthreshold withdrawal anxiety symptoms, characterized by irritability associated with craving for cannabis. By contrast, individuals with primary anxiety disorders have different features. Integrated approaches to treatment for patients presenting with co-occurring cannabis use disorders and psychiatric disorders are recommended, including simultaneous treatments.
大麻使用障碍与精神共病。精神障碍和人格障碍在大麻使用障碍患者中很常见。需要将大麻中毒或戒断症状与精神障碍症状区分开来。大麻使用障碍和精神障碍会相互恶化。大麻使用障碍可能诱发精神障碍，尤其是抑郁症和焦虑症。大麻戒断焦虑通常在停止或减少大麻使用后开始。大麻使用障碍患者每天都会经历阈下戒断焦虑症状，其特征是与渴望大麻相关的易怒。相比之下，原发性焦虑症患者有不同的特征。建议对同时患有大麻使用障碍和精神障碍的患者采用综合治疗方法，包括同时进行治疗。
