Langlois Catherine, Potvin Stéphane, Khullar Atul, Tourjman Smadar Valérie
Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.
Front Psychiatry. 2021 May 14;12:625158. doi: 10.3389/fpsyt.2021.625158. eCollection 2021.
In light of the recent changes in the legal status of cannabis in Canada, the understanding of the potential impact of the use of cannabis by individuals suffering from depression is increasingly considered as being important. It is fundamental that we look into the existing literature to examine the influence of cannabis on psychiatric conditions, including mood disorders. In this article, we will explore the relationship that exists between depression and cannabis. We will examine the impact of cannabis on the onset and course of depression, and its treatment. We have undertaken a wide-ranging review of the literature in order to address these questions. The evidence from longitudinal studies suggest that there is a bidirectional relationship between cannabis use and depression, such that cannabis use increases the risk for depression and vice-versa. This risk is possibly higher in heavy users having initiated their consumption in early adolescence. Clinical evidence also suggests that cannabis use is associated with a worse prognosis in individuals with major depressive disorder. The link with suicide remains controversial. Moreover, there is insufficient data to determine the impact of cannabis use on cognition in individuals with major depression disorder. Preliminary evidence suggesting that the endogenous cannabinoid system is involved in the pathophysiology of depression. This will need to be confirmed in future positron emission tomography studies. Randomized controlled trials are needed to investigate the potential efficacy of motivational interviewing and/or cognitive behavioral therapy for the treatment of cannabis use disorder in individuals with major depressive major disorder. Finally, although there is preclinical evidence suggesting that cannabidiol has antidepressant properties, randomized controlled trials will need to properly investigate this possibility in humans.
鉴于加拿大近期大麻法律地位的变化，了解抑郁症患者使用大麻的潜在影响日益被视为重要之事。我们有必要研究现有文献，以考察大麻对包括情绪障碍在内的精神疾病的影响。在本文中，我们将探讨抑郁症与大麻之间存在的关系。我们将研究大麻对抑郁症发病及病程以及治疗的影响。为解决这些问题，我们对文献进行了广泛的综述。纵向研究的证据表明，大麻使用与抑郁症之间存在双向关系，即使用大麻会增加患抑郁症的风险，反之亦然。对于在青春期早期就开始大量使用大麻的人来说，这种风险可能更高。临床证据还表明，使用大麻与重度抑郁症患者的预后较差有关。与自杀的关联仍存在争议。此外，没有足够的数据来确定使用大麻对重度抑郁症患者认知的影响。初步证据表明内源性大麻素系统参与了抑郁症的病理生理过程。这需要在未来的正电子发射断层扫描研究中得到证实。需要进行随机对照试验，以研究动机访谈和/或认知行为疗法对治疗重度抑郁症患者大麻使用障碍的潜在疗效。最后，尽管有临床前证据表明大麻二酚具有抗抑郁特性，但仍需要随机对照试验在人体中对此可能性进行恰当研究。
