Psychiatry and Addictology Department, Faculty of Medicine, University of Montreal, Montreal, Canada.
Research Center, Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.
Cannabis Cannabinoid Res. 2024 Feb;9(1):241-251. doi: 10.1089/can.2022.0038. Epub 2023 Feb 14.
Recent longitudinal studies point toward the existence of a positive relationship between cannabis use and violence in people with severe mental disorders (SMD). However, the existence of a dose-response relationship between the frequency/severity of cannabis use and violence has seldom been investigated. Therefore, this study aims to determine if such a relationship exists in a psychiatric population. To do so, a total of 98 outpatients (81 males and 17 females, all over 18 years of age) with SMD were recruited at the Institut universitaire de santé mentale de Montréal (Montréal, Canada) and included in the analyses. Clinical evaluations were conducted every 3 months for a year. Substance use, violent behaviors, and potential covariables were assessed through self-reported assessments, urinary testing, as well as clinical, criminal, and police records. Using generalized estimating equations, the association between cannabis use frequency (nonusers, occasional, regular, and frequent users) and violence was investigated, as well as the association between the severity of cannabis use and violent behaviors. It was found that cannabis use frequency and severity were significant predictors of violent behaviors. After adjustment for time, age, sex, ethnicity, diagnoses, impulsivity, and use of alcohol and stimulants, odds ratios were of 1.91 (<0.001) between each frequency profile and 1.040 (<0.001) for each increase of one point of the severity of cannabis use score (ranging from 0 to 79). Despite the high attrition rate, these findings may have important implications for clinicians as cannabis use may have serious consequences in psychiatric populations. Nevertheless, the mechanisms underlying this association remain unclear.
最近的纵向研究表明，在患有严重精神障碍（SMD）的人群中，大麻使用与暴力之间存在正相关关系。然而，大麻使用的频率/严重程度与暴力之间是否存在剂量反应关系很少被研究。因此，本研究旨在确定在精神科人群中是否存在这种关系。
为此，共招募了 98 名门诊患者（81 名男性和 17 名女性，年龄均在 18 岁以上）患有 SMD，他们均来自加拿大蒙特利尔大学心理健康研究所（Institut universitaire de santé mentale de Montréal），并纳入了分析。临床评估每 3 个月进行一次，为期一年。通过自我报告评估、尿液检测以及临床、犯罪和警察记录评估物质使用、暴力行为和潜在的协变量。使用广义估计方程，研究了大麻使用频率（非使用者、偶尔使用者、常规使用者和频繁使用者）与暴力之间的关联，以及大麻使用严重程度与暴力行为之间的关联。
结果发现，大麻使用频率和严重程度是暴力行为的显著预测因素。在校正时间、年龄、性别、种族、诊断、冲动和酒精及兴奋剂使用后，每种使用频率与 1.040（<0.001）之间的比值为 1.91（<0.001），而大麻使用严重程度评分每增加 1 分（范围为 0 至 79），比值为 1.040（<0.001）。
尽管存在高脱落率，但这些发现可能对临床医生具有重要意义，因为大麻使用可能对精神科人群产生严重后果。然而，这种关联的机制仍不清楚。
