San Luigi Gonzaga University Hospital, Regione Gonzole, 10, 10043, Orbassano, Turin, Italy.
Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Via dei Vestini, 33, 66100, Chieti, Italy.
Drug Alcohol Depend. 2021 Dec 1;229(Pt A):109118. doi: 10.1016/j.drugalcdep.2021.109118. Epub 2021 Oct 10.
Cannabis is the most used recreational drug worldwide. Its use can increase the risk of developing psychotic disorders and exacerbate their course. However, the relationship between cannabis use and dissociative symptoms has been scarcely investigated.
To examine differences in psychotic and dissociative symptoms, and in functioning in first-episode psychotic patients (FEPp) using cannabis compared with those not using cannabis.
Between January 2014 and December 2019, seventy FEPp with cannabis use disorder (N = 35) and without it (N = 35) were recruited in psychiatric inpatient facilities in the Italian regions of Lazio and Piemonte. All subjects were assessed at FEP, after 4 and 8 months, using the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Dissociative Experiences Scale - II (DES-II). Detailed information on the pattern of cannabis and other substance use were collected.
FEP using cannabis showed higher levels of positive symptomatology, dissociative experiences and worse functioning than their non-user counterpart, despite a comparable antipsychotic treatment. At an eight-month prospective evaluation, FEP using cannabis still showed higher levels of positive symptomatology and dissociation. Moreover, global functioning worsened over time in FEPp using cannabis, whereas it improved those not using it.
Our findings suggest that a greater degree of dissociation and positive symptoms at FEPp and their persistence over time may characterise cannabis-associated psychosis. Both these factors might explain the overall functioning worsening over time that we observed in the cannabis-user group compared to the functioning improvement in the non-user group.
大麻是全球使用最广泛的消遣性药物。其使用会增加发展为精神病性障碍的风险，并使疾病进程恶化。然而，大麻使用与分离症状之间的关系尚未得到充分研究。
在首次发作的精神病患者（FEPp）中，比较使用大麻与不使用大麻的患者之间在精神病性和分离症状以及功能方面的差异。
2014 年 1 月至 2019 年 12 月，在意大利拉齐奥和皮埃蒙特大区的精神病住院设施中招募了 70 名患有大麻使用障碍的 FEPp（N=35）和不患有该障碍的 FEPp（N=35）。所有患者在 FEP 时、4 个月和 8 个月时使用阳性和阴性综合征量表（PANSS）、总体功能评估（GAF）量表和分离体验量表-第二版（DES-II）进行评估。收集了关于大麻和其他物质使用模式的详细信息。
尽管接受了类似的抗精神病药物治疗，但使用大麻的 FEP 患者表现出更高水平的阳性症状、分离体验和更差的功能。在 8 个月的前瞻性评估中，使用大麻的 FEP 患者仍表现出更高水平的阳性症状和分离。此外，使用大麻的 FEPp 的总体功能随着时间的推移而恶化，而不使用的患者的功能则有所改善。
我们的发现表明，在 FEPp 中，分离程度更高和阳性症状持续存在可能是与大麻相关的精神病的特征。这两个因素可能解释了我们观察到的在使用大麻的患者中，功能随时间恶化，而在不使用大麻的患者中，功能随时间改善。
