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早期使用大麻与精神病患者的暴力行为。

Early onset of cannabis use and violent behavior in psychosis.

机构信息

Department of Psychiatry, Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.

Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

出版信息

Eur Psychiatry. 2020 Jul 16;63(1):e78. doi: 10.1192/j.eurpsy.2020.71.

Abstract

BACKGROUND

Although evidence from psychosis patients demonstrates the adverse effects of cannabis use (CU) at a young age and that the rate of CU is high in subgroups of young violent patients with psychotic disorders, little is known about the possible effect of the age of onset of CU on later violent behaviors (VB). So, we aimed to explore the impact of age at onset of CU on the risk of displaying VB in a cohort of early psychosis patients.

METHOD

Data were collected prospectively over a 36-month period in the context of an early psychosis cohort study. A total of 265 patients, aged 18-35 years, were included in the study. Logistic regression was performed to assess the link between age of onset of substance use and VB.

RESULTS

Among the 265 patients, 72 had displayed VB and 193 had not. While violent patients began using cannabis on average at age 15.29 (0.45), nonviolent patients had started on average at age 16.97 (0.35) (p = 0.004). Early-onset CU (up to age 15) was a risk factor for VB (odds ratio = 4.47, confidence interval [CI]: 1.13-20.06) when the model was adjusted for age group, other types of substance use, being a user or a nonuser and various violence risk factors and covariates. History of violence and early CU (until 15) were the two main risk factors for VB.

CONCLUSIONS

Our results suggest that early-onset CU may play a role in the emergence of VB in early psychosis.

摘要

背景

尽管来自精神病患者的证据表明年轻时使用大麻(CU)会产生不良影响,而且在有精神病障碍的年轻暴力患者亚组中 CU 的发生率很高,但对于 CU 的发病年龄对以后暴力行为(VB)的可能影响知之甚少。因此,我们旨在探讨在一组早期精神病患者中,CU 的发病年龄对表现 VB 的风险的影响。

方法

在一项早期精神病队列研究的背景下,在 36 个月的时间内进行了前瞻性数据收集。共有 265 名年龄在 18-35 岁的患者纳入研究。采用逻辑回归评估物质使用的发病年龄与 VB 之间的联系。

结果

在 265 名患者中,72 名表现出 VB,193 名没有。虽然暴力患者平均在 15.29 岁(0.45)开始使用大麻,而非暴力患者平均在 16.97 岁(0.35)开始使用大麻(p=0.004)。早期 CU(直至 15 岁)是 VB 的危险因素(优势比=4.47,置信区间[CI]:1.13-20.06),当模型调整为年龄组、其他类型的物质使用、使用者或非使用者以及各种暴力风险因素和协变量时。暴力史和早期 CU(直至 15 岁)是 VB 的两个主要危险因素。

结论

我们的结果表明,早期 CU 可能在早期精神病中 VB 的出现中起作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f18/7503178/e5fb0415e336/S0924933820000711_fig1.jpg

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