Harvard Medical School, Department of Psychiatry, USA; Beth Israel Deaconess Medical Center, Department of Psychiatry, USA; Boston University School of Medicine, Department of Psychiatry, USA; Boston Medical Center, USA.
Yale University School of Medicine, Department of Psychiatry, USA.
J Psychiatr Res. 2022 Mar;147:248-253. doi: 10.1016/j.jpsychires.2022.01.039. Epub 2022 Jan 16.
Cannabis has been implicated as both a potential cause and adverse prognostic factor in psychotic disorders. Investigating the contributory role of cannabis toward the overall burden of psychotic illnesses may represent an important step toward psychosis prevention and treatment. The current study samples consecutive admissions (N = 246) to two community based first-episode psychosis services to characterize timing of cannabis use relative to psychosis and attenuated symptom onset, differences between those with and without cannabis exposure, and the association of age at first cannabis exposure with clinical and demographic variables. Both cannabis exposure (78%) and cannabis use disorders (47%) were highly prevalent at admission. In 94% of participants, cannabis use preceded the onset of both attenuated and full-threshold psychosis symptoms by several years. Earlier age at first exposure to cannabis was associated with younger age at prodrome and psychosis onset, worse premorbid functioning, and greater severity of cannabis use disorder at admission. The timing of first exposure to cannabis may have individual prognostic as well as public health significance. Documenting the prevalence and impact of cannabis use in early psychosis samples, as well as the overall incidence of psychotic disorders, will be of vital public health significance as the United States enacts cannabis legalization and cannabis products become more widely available.
大麻被认为是精神障碍的潜在病因和不良预后因素。研究大麻对精神疾病整体负担的促成作用，可能是预防和治疗精神疾病的重要一步。本研究对两个基于社区的首发精神病服务机构的连续入院患者（N=246）进行采样，以描述大麻使用与精神病和症状缓解发作的时间关系、有和无大麻暴露者之间的差异，以及首次大麻暴露的年龄与临床和人口统计学变量的关联。大麻暴露（78%）和大麻使用障碍（47%）在入院时都高度普遍存在。在 94%的参与者中，大麻使用在症状缓解和全阈值精神病发作前数年就已经开始。首次接触大麻的年龄越早，前驱期和精神病发作的年龄越小，病前功能越差，入院时大麻使用障碍的严重程度越大。首次接触大麻的时间可能具有个体预后和公共卫生意义。在美国实施大麻合法化和大麻产品更广泛获得的情况下，记录早期精神病样本中大麻使用的流行率和影响，以及精神障碍的总体发病率，将具有至关重要的公共卫生意义。
