Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
Departments of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, United States of America.
Schizophr Res. 2022 Oct;248:114-121. doi: 10.1016/j.schres.2022.08.005. Epub 2022 Aug 26.
Cannabis use is more prevalent among youth at clinical high-risk (CHR) for psychosis than healthy controls (HC). There is mixed evidence as to whether cannabis use is associated with increased severity of attenuated psychotic symptoms (APS) or whether current cannabis use is associated with the transition to psychosis. This study aims to assess cannabis use differences between CHR youth and HC and the impact of cannabis use on APS, clinical status, and transition to psychosis. Participants were from the North American Prodrome Longitudinal Study-3, a prospective longitudinal study including 710 individuals, age 12-30, meeting criteria for a psychosis risk syndrome based on the Structured Interview for Psychosis-Risk Syndromes, and 96 HC. Cannabis use, frequency, and severity of use were assessed with the Alcohol Use Scale/Drug Use Scale. Current and past cannabis use disorders were assessed with the Structured Clinical Interview for DSM-5. Compared to HC, CHR individuals reported significantly increased lifetime cannabis use, during the past six months, and at baseline; greater frequency and severity of cannabis use; and increased prevalence of cannabis use disorder. Relative to CHR youth without cannabis use, CHR cannabis users had significantly higher ratings on baseline grandiosity and lower 12-months social anhedonia. Severity of cannabis was unrelated to clinical status at 2-years, and it did not differentiate CHR individuals who transitioned to psychosis from those who did not. However, a major limitation was that the current number of CHR cannabis users was small, and survival analyses resulted in a smaller power than the 80 % recommended.
大麻使用在有精神病高危临床特征（CHR）的青年中比健康对照组（HC）更为普遍。关于大麻使用是否与加重的精神病前驱症状（APS）的严重程度相关，或者当前的大麻使用是否与精神病发作相关，目前证据不一。本研究旨在评估 CHR 青年和 HC 之间的大麻使用差异，以及大麻使用对 APS、临床状况和向精神病发作的转变的影响。参与者来自北美前驱期纵向研究-3，这是一项前瞻性纵向研究，包括 710 名年龄在 12-30 岁之间的个体，基于精神病风险综合征结构化访谈符合精神病风险综合征标准，以及 96 名 HC。使用酒精使用量表/药物使用量表评估大麻使用、使用频率和使用严重程度。使用 DSM-5 结构化临床访谈评估当前和过去的大麻使用障碍。与 HC 相比，CHR 个体报告了显著增加的终生大麻使用，包括过去六个月和基线时的使用；更高的大麻使用频率和严重程度；以及更高的大麻使用障碍患病率。与没有大麻使用的 CHR 青年相比，CHR 大麻使用者在基线时的夸大妄想评分显著更高，12 个月时的社交快感缺失评分显著更低。大麻使用的严重程度与 2 年时的临床状况无关，也不能区分向精神病发作转变的 CHR 个体与没有转变的个体。然而，一个主要的局限性是当前的 CHR 大麻使用者数量较少，生存分析的效力低于建议的 80%。
