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大麻对创伤后应激障碍的长期、前瞻性、治疗影响。

The Long-Term, Prospective, Therapeutic Impact of Cannabis on Post-Traumatic Stress Disorder.

机构信息

Perelman School of Medicine, The University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Denver Research Institute, Denver, Colorado, USA.

出版信息

Cannabis Cannabinoid Res. 2022 Apr;7(2):214-223. doi: 10.1089/can.2020.0056. Epub 2020 Dec 9.

Abstract

Given the increasing availability and use of cannabis among individuals with post-traumatic stress disorder (PTSD) and the addition of PTSD as an eligible diagnosis in several U.S. medical cannabis programs, the efficacy of dispensary-obtained cannabis needs to be thoroughly examined. This prospective study assessed PTSD symptoms and functioning every 3 months over the course of a year in two samples of participants diagnosed with PTSD: (1) those with PTSD using dispensary-obtained cannabis (cannabis users) and (2) those with PTSD, who do not use cannabis (controls). Linear mixed-effects models and generalized estimating equations tested whether trajectories of symptoms differed between the two subsamples. A total of 150 participants (mean [standard deviation] age, 50.67 [15.26] years; 73% male) were enrolled in the study. Over the course of 1 year, the cannabis users reported a greater decrease in PTSD symptom severity over time compared to controls [group×time interaction=-0.32 (95% confidence interval [CI]=-0.59 to -0.05, =0.13; =-2.35, =0.02). Participants who used cannabis were 2.57 times more likely to no longer meet DSM-5 criteria for PTSD at the end of the study observation period compared to participants who did not use cannabis (95% CI=1.12-6.07; =0.03). This study provides evidence that the types of cannabis available in recreational and medical cannabis dispensaries might hold promise as an alternative treatment for PTSD. Randomized placebo-controlled trials are needed to assess safety and determine how different preparations of cannabis impact PTSD and functioning.

摘要

鉴于创伤后应激障碍(PTSD)患者中大麻的使用越来越多,并且美国多个医疗大麻项目将 PTSD 添加为合格诊断,因此需要彻底检查获得的大麻的疗效。本前瞻性研究在两个 PTSD 患者样本中每 3 个月评估一次 PTSD 症状和功能,持续一年:(1)使用获得的大麻(大麻使用者)的 PTSD 患者和(2)不使用大麻的 PTSD 患者(对照组)。线性混合效应模型和广义估计方程测试了这两个亚组之间的症状轨迹是否存在差异。共有 150 名参与者(平均[标准差]年龄,50.67[15.26]岁;73%为男性)入组该研究。在 1 年的时间里,与对照组相比,大麻使用者报告 PTSD 症状严重程度随时间的下降幅度更大[组×时间交互作用=-0.32(95%置信区间[CI]=-0.59 至-0.05,=0.13;= -2.35,=0.02)]。与未使用大麻的参与者相比,在研究观察期结束时,使用大麻的参与者不再符合 DSM-5 PTSD 标准的可能性高 2.57 倍(95%CI=1.12-6.07;=0.03)。这项研究提供了证据,表明娱乐和医疗大麻药房中提供的大麻类型可能有望成为 PTSD 的替代治疗方法。需要进行随机安慰剂对照试验来评估安全性,并确定不同的大麻制剂如何影响 PTSD 和功能。

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