Madero S, Oliveras C, Pons M T, Sague M, López-Pelayo H, Gual A, Balcells M
Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Research Group on Addictions, Barcelona, Spain; Addictions Research Group, Institut D'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain.
Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Research Group on Addictions, Barcelona, Spain; Addictions Research Group, Institut D'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain.
J Psychiatr Res. 2020 Oct;129:40-46. doi: 10.1016/j.jpsychires.2020.05.028. Epub 2020 May 29.
To evaluate if cannabis dose recorded as standard joint unit (SJU) consumed before admission and other related factors have an influence on psychiatric inpatient's symptom severity and clinical outcomes.
Cross-sectional study in an acute psychiatric inpatient unit including 106 individuals. Quantity of cannabis was measured as SJU and symptoms severity through the Brief Psychiatric Rating Scale (BPRS). Secondary outcomes (e.g. length of stay) were also assessed. Bivariate analyses and multivariate analyses were performed to determine the effect of SJU consumed before admission on measures of clinical severity.
Point prevalence of cannabis use before admission was 25.5%. Mean BPRS score was 55.8 (SD = 16.1); and 62.9 (SD = 11.1) among cannabis users. A low degree positive correlation between SJU consumed the week before admission and BPRS score (r = 0.28, p = 0.03) was found. In the multivariate analyses both main diagnostic group, Schizophrenia and other psychotic disorders vs. others (Bipolar and Unipolar Affective Disorders and Addictive disorders) (B = 8.327; 95% CI 4.976-11.677) and need of PRN ("pre re nata" or when necessary) administration of antipsychotics and benzodiazepines (B = 12.13; 95% CI 6.868-17.393) were significant predictors, both increasing BPRS score.
The study did not find a correlation between SJU consumed last week and psychiatric severity. On the other hand, individuals with psychotic disorders reported a higher prevalence of cannabis use the week before admission and displayed higher BPRS scores, which points to the need for the development of tailored interventions for high-risk groups. The SJU is a useful quantification tool suitable for further clinical research.
评估入院前记录的以标准关节单位（SJU）计量的大麻使用剂量及其他相关因素是否会对精神科住院患者的症状严重程度和临床结局产生影响。
在一个急性精神科住院单元对106名个体进行横断面研究。大麻使用量以SJU计量，症状严重程度通过简明精神病评定量表（BPRS）进行评估。还评估了次要结局（如住院时间）。进行双变量分析和多变量分析以确定入院前使用的SJU对临床严重程度指标的影响。
入院前大麻使用的时点患病率为25.5%。平均BPRS评分为55.8（标准差=16.1）；大麻使用者中的评分为62.9（标准差=11.1）。发现入院前一周使用的SJU与BPRS评分之间存在低度正相关（r=0.28，p=0.03）。在多变量分析中，主要诊断组，即精神分裂症和其他精神病性障碍与其他组（双相和单相情感障碍及成瘾性障碍）（B=8.327；95%置信区间4.976-11.677）以及需要按需（“必要时”）给予抗精神病药物和苯二氮䓬类药物（B=12.13；95%置信区间6.868-17.393）均为显著预测因素，两者均使BPRS评分升高。
该研究未发现上周使用的SJU与精神疾病严重程度之间存在相关性。另一方面，患有精神病性障碍的个体入院前一周大麻使用的患病率较高且BPRS评分较高，这表明需要为高危人群制定针对性的干预措施。SJU是一种适用于进一步临床研究的有用量化工具。
