Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK.
J Psychopharmacol. 2020 Jun;34(6):648-653. doi: 10.1177/0269881120907973. Epub 2020 Feb 28.
Cannabis use has been associated with psychosis and with poor outcome in patients with mental illness. Synthetic cannabinoids (SCs) have been suggested to pose an even greater risk to mental health, but the effect on clinical outcome has not been directly measured. In this study, we aimed to investigate the demographics and hospitalisation of psychiatric patients who were SC users.
We searched the Biomedical Research Centre Clinical Record Interactive Search register for SC users and age- and sex-matched SC non-users who had been psychiatric patients under the South London and Maudsley NHS Trust. We recorded diagnosis, homelessness, cannabis use and the total number of days admitted as an inpatient to secondary and tertiary mental-health services.
We identified 635 SC users and 635 age- and sex-matched SC non-users. SC users were significantly more likely to be homeless (χ=138.0; <0.0001) and to use cannabis (χ=257.3; <0.0001) than SC non-users. SC users had significantly more inpatient days after their first recorded use of SCs than controls ( ()=85.5 (199.7) vs. 25.4 (92.32); <0.0001). Post hoc tests revealed that SC non-users who used cannabis had fewer inpatient days than SC users (<0.0001), and that non-users of both SC and cannabis had fewer inpatient days than SC non-using cannabis users (=0.02).
SC use may lead to an increase in the number of days spent in hospital in patients with psychiatric illness. This highlights the need for clinicians to ask specifically about SC use.
大麻的使用与精神病患者的精神病和不良预后有关。合成大麻素（SCs）被认为对心理健康构成更大的风险，但对临床结果的影响尚未直接测量。在这项研究中，我们旨在调查 SC 使用者的精神病患者的人口统计学和住院情况。
我们在南伦敦和莫兹利国民保健信托基金会的精神病患者中，搜索生物医学研究中心临床记录互动搜索登记处的 SC 用户和年龄及性别匹配的 SC 非用户。我们记录了诊断、无家可归、大麻使用情况以及作为二级和三级精神卫生服务住院患者的总住院天数。
我们确定了 635 名 SC 用户和 635 名年龄和性别匹配的 SC 非用户。与 SC 非用户相比，SC 用户更有可能无家可归（χ=138.0；<0.0001）和使用大麻（χ=257.3；<0.0001）。与对照组相比，SC 用户在首次记录使用 SC 后的住院天数明显更多（（）=85.5（199.7）与 25.4（92.32）；<0.0001）。事后检验显示，使用大麻的 SC 非使用者的住院天数少于 SC 用户（<0.0001），而不使用 SC 和大麻的非使用者的住院天数少于不使用 SC 但使用大麻的使用者（=0.02）。
SC 使用可能导致精神病患者住院天数增加。这凸显了临床医生需要特别询问 SC 使用情况的必要性。
