D'Souza Deepak Cyril, DiForti Marta, Ganesh Suhas, George Tony P, Hall Wayne, Hjorthøj Carsten, Howes Oliver, Keshavan Matcheri, Murray Robin M, Nguyen Timothy B, Pearlson Godfrey D, Ranganathan Mohini, Selloni Alex, Solowij Nadia, Spinazzola Edoardo
Psychiatry Service, VA Connecticut Healthcare System, West Haven, CT, USA.
Abraham Ribicoff Research Facilities, Connecticut Mental Health Center, New Haven, CT, USA.
World J Biol Psychiatry. 2022 Dec;23(10):719-742. doi: 10.1080/15622975.2022.2038797. Epub 2022 Mar 22.
The liberalisation of cannabis laws, the increasing availability and potency of cannabis has renewed concern about the risk of psychosis with cannabis.
The objective of the WFSBP task force was to review the literature about this relationship.
Converging lines of evidence suggest that exposure to cannabis increases the risk for psychoses ranging from transient psychotic states to chronic recurrent psychosis. The greater the dose, and the earlier the age of exposure, the greater the risk. For some psychosis outcomes, the evidence supports some of the criteria of causality. However, alternate explanations including reverse causality and confounders cannot be conclusively excluded. Furthermore, cannabis is neither necessary nor sufficient to cause psychosis. More likely it is one of the multiple causal components. In those with established psychosis, cannabis has a negative impact on the course and expression of the illness. Emerging evidence also suggests alterations in the endocannabinoid system in psychotic disorders.
Given that exposure to cannabis and cannabinoids is modifiable, delaying or eliminating exposure to cannabis or cannabinoids, could potentially impact the rates of psychosis related to cannabis, especially in those who are at high risk for developing the disorder.
大麻法律的放宽、大麻获取的日益容易以及效力的增强，重新引发了人们对大麻导致精神病风险的担忧。
世界生物精神病学协会联合会（WFSBP）特别工作组的目标是回顾关于这种关系的文献。
越来越多的证据表明，接触大麻会增加患精神病的风险，范围从短暂性精神病状态到慢性复发性精神病。剂量越大，接触年龄越早，风险就越大。对于某些精神病结果，证据支持因果关系的一些标准。然而，包括反向因果关系和混杂因素在内的其他解释不能被确凿排除。此外，大麻既不是导致精神病的必要条件也不是充分条件。更有可能的是，它是多个因果因素之一。在已患有精神病的患者中，大麻会对疾病的病程和表现产生负面影响。新出现的证据还表明，精神病性障碍患者的内源性大麻素系统存在改变。
鉴于接触大麻和大麻素是可以改变的，延迟或消除对大麻或大麻素的接触，可能会对与大麻相关的精神病发病率产生影响，尤其是在那些有患该疾病高风险的人群中。
