Sorkhou Maryam, Bedder Rachel H, George Tony P
Addictions Division, Centre for Addiction and Mental Health (CAMH), University of Toronto, Toronto, ON, Canada.
Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.
Front Psychiatry. 2021 Feb 16;12:630247. doi: 10.3389/fpsyt.2021.630247. eCollection 2021.
Cannabis is known to have a broad range of effects on behavior, including experiencing a "high" and tranquility/relaxation. However, there are several adverse behavioral sequalae that can arise from cannabis use, depending on frequency of use, potency (e.g., THC content), age of onset, and cumulative exposure. This systematic review examined evidence for cannabis-related adverse behavioral sequalae in otherwise healthy human subjects. Following PRISMA guidelines, we conducted a systematic review of cross-sectional and longitudinal studies from 1990 to 2020 that identified cannabis-related adverse behavioral outcomes in subjects without psychiatric and medical co-morbidities from PubMed and PsychInfo searches. Key search terms included "cannabis" OR "tetrahydrocannabinol" OR "cannabidiol" OR "marijuana" AND "anxiety" OR "depression" OR "psychosis" OR "schizophrenia" "OR "IQ" OR "memory" OR "attention" OR "impulsivity" OR "cognition" OR "education" OR "occupation". Our search detected a total of 2,870 studies, from which we extracted 124 relevant studies from the literature on cannabis effects in the non-clinical population. Effects of cannabis on several behavioral sequelae including cognition, motivation, impulsivity, mood, anxiety, psychosis intelligence, and psychosocial functioning were identified. The preponderance of the evidence suggests that frequency of cannabis use, THC (but not CBD) content, age of onset, and cumulative cannabis exposure can all contribute to these adverse outcomes in individuals without a pre-existing medical condition or psychiatric disorder. The strongest evidence for the negative effects of cannabis are for psychosis and psychosocial functioning. Although more research is needed to determine risk factors for development of adverse behavioral sequelae of cannabis use, these findings underline the importance of understanding vulnerability to the adverse effects of cannabis, which has implications for prevention and treatment of problematic cannabis use.
众所周知,大麻对行为有广泛影响,包括产生“兴奋感”以及使人平静/放松。然而,根据使用频率、效力(如四氢大麻酚含量)、开始使用的年龄和累积接触量的不同,使用大麻可能会引发一些不良行为后果。本系统综述研究了在其他方面健康的人类受试者中与大麻相关的不良行为后果的证据。遵循PRISMA指南,我们对1990年至2020年的横断面和纵向研究进行了系统综述,这些研究通过PubMed和PsychInfo搜索,确定了无精神疾病和其他疾病共病的受试者中与大麻相关的不良行为结果。关键搜索词包括“大麻”或“四氢大麻酚”或“大麻二酚”或“大麻”以及“焦虑”或“抑郁”或“精神病”或“精神分裂症”“或”智商“或”记忆“或”注意力“或”冲动性“或”认知“或”教育“或”职业“。我们的搜索共检测到2870项研究,从中我们从关于大麻对非临床人群影响的文献中提取了124项相关研究。确定了大麻对包括认知、动机、冲动性、情绪、焦虑、精神病、智力和心理社会功能在内的几种行为后果的影响。大量证据表明,大麻使用频率、四氢大麻酚(而非大麻二酚)含量、开始使用的年龄和大麻累积接触量都可能导致没有既往疾病或精神障碍的个体出现这些不良后果。大麻负面影响的最有力证据是对精神病和心理社会功能的影响。虽然需要更多研究来确定大麻使用不良行为后果发展的风险因素,但这些发现强调了了解大麻不良反应易感性的重要性,这对有问题的大麻使用的预防和治疗具有重要意义。