Centre for Biomedical Research in the Mental Health Network (CIBERSAM), 28029 Madrid, Spain.
Bioaraba Research Institute, Department of Psychiatry, Araba University Hospital, 01004 Vitoria, Spain.
Int J Environ Res Public Health. 2022 Jun 15;19(12):7325. doi: 10.3390/ijerph19127325.
Despite the negative influence of cannabis use on the development and prognosis of first-episode psychosis (FEP), there is little evidence on effective specific interventions for cannabis use cessation in FEP. The aim of this study was to compare the efficacy of a specific cognitive behavioral therapy (CBT) for cannabis cessation (CBT-CC) with treatment as usual (TAU) in FEP cannabis users. In this single-blind, 1-year randomized controlled trial, 65 participants were randomly assigned to CBT-CC or TAU. The primary outcome was the reduction in cannabis use severity. The CBT-CC group had a greater decrease in cannabis use severity and positive psychotic symptoms over time, and a greater improvement in functioning at post-treatment than TAU. The treatment response was also faster in the CBT-CC group, reducing cannabis use, anxiety, positive and general psychotic symptoms, and improving functioning earlier than TAU in the follow-up. Moreover, patients who stopped and/or reduced cannabis use during the follow-up, decreased psychotic symptoms and increased awareness of disease compared to those who continued using cannabis. Early intervention based on a specific CBT for cannabis cessation, may be effective in reducing cannabis use severity, in addition to improving clinical and functional outcomes of FEP cannabis users.
尽管大麻使用会对首发精神病（FEP）的发展和预后产生负面影响，但针对 FEP 患者大麻戒除的有效特定干预措施的证据很少。本研究旨在比较针对大麻戒除的特定认知行为疗法（CBT-CC）与常规治疗（TAU）在 FEP 大麻使用者中的疗效。在这项为期 1 年的单盲随机对照试验中，65 名参与者被随机分配至 CBT-CC 组或 TAU 组。主要结局是大麻使用严重程度的降低。随着时间的推移，CBT-CC 组的大麻使用严重程度和阳性精神病症状下降更大，治疗后功能改善更大。CBT-CC 组的治疗反应也更快，在随访中比 TAU 更早地减少大麻使用、焦虑、阳性和一般精神病症状，并改善功能。此外，与继续使用大麻的患者相比，在随访期间停止和/或减少大麻使用的患者，其精神病症状减少，对疾病的认识增加。基于针对大麻戒除的特定 CBT 的早期干预，可能有助于降低大麻使用严重程度，同时改善 FEP 大麻使用者的临床和功能结局。
