Hudson Amanda, Hudson Pamela
Mental Health and Addictions, Health PEI , Charlottetown, Canada.
Department of Health Management, University of Prince Edward Island , Charlottetown, Canada.
Clin Gerontol. 2021 Jan-Feb;44(1):3-15. doi: 10.1080/07317115.2020.1808134. Epub 2020 Aug 29.
This paper reviews research on the topic of cannabis use and mental health harms in older adults and illustrates potential contributing factors and special clinical considerations for working with this population. Known risk factors for cannabis-related mental disorders and mental health problems are outlined, first for the general population and then specifically for older adults. Studies were identified through online databases using a variety of search words. Articles were included in the review if they were peer-reviewed or published by a reputable national organization, published in English, and were pertinent to the topic of mental health harms of cannabis use. Risk factors that emerged from the literature review aligned with the following categories: (1) patterns of use (i.e., potency of product, frequency of use), (2) personal characteristics (i.e., age, sex, social demographics), (3) psychosocial constructs (motivations, perceptions), and (4) morbidities (mental health, medication interactions). Frequent use was associated with increased risk for mental health consequences related to cannabis use. Certain motives for use (i.e., using to cope, using as a sleep aid) may increase susceptibility to cannabis-related harms, although more empirical work is required. Mental health conditions may predispose to cannabis-related harms through a variety of mechanisms, including increased vulnerability for cannabis-related psychiatric disorders, poorer prognosis for preexisting psychiatric disorders, and possibility of cannabis-medication interactions. Personal characteristics (younger age, being male, lower socioeconomic status) predict more frequent cannabis use, which may dispose to adverse outcomes. Predictors of cannabis-related harms hold relevance for public health messaging, as well as clinical interventions. Understanding how cannabis interacts with sociodemographic factors, mental health morbidities, and medications is crucial in providing accurate guidance to patients about their recreational cannabis use and in informing prescriber decisions about medicinal cannabis.
本文回顾了关于老年人使用大麻及其对心理健康危害这一主题的研究，并阐述了潜在的促成因素以及针对该人群开展工作时的特殊临床考量。文中首先概述了大麻相关精神障碍和心理健康问题在普通人群中的已知风险因素，然后具体阐述了老年人的风险因素。通过在线数据库，使用多种搜索词来识别相关研究。如果文章经过同行评审或由知名国家组织发表、以英文发表且与大麻使用对心理健康的危害这一主题相关，则纳入本综述。文献综述中出现的风险因素可归为以下几类：（1）使用模式（即产品效力、使用频率），（2）个人特征（即年龄、性别、社会人口统计学特征），（3）心理社会因素（动机、认知），以及（4）疾病（心理健康、药物相互作用）。频繁使用大麻与使用大麻相关的心理健康后果风险增加有关。某些使用动机（如为了应对、助眠而使用）可能会增加对大麻相关危害的易感性，不过还需要更多实证研究。心理健康状况可能通过多种机制导致大麻相关危害，包括患大麻相关精神障碍的易感性增加、既有精神障碍的预后较差以及大麻与药物相互作用的可能性。个人特征（年龄较小、男性、社会经济地位较低）预示着更频繁的大麻使用，这可能导致不良后果。大麻相关危害的预测因素对公共卫生宣传以及临床干预都具有重要意义。了解大麻如何与社会人口统计学因素、心理健康疾病以及药物相互作用，对于向患者提供关于其娱乐性大麻使用的准确指导以及为开具医用大麻处方的医生提供决策依据至关重要。
