Suresh P N, Menon Vikas, Suresh Rohith, Uvais N A
Department of Psychiatry, IQRAA International Hospital and Research Centre, Calicut, Kerala, India.
Corresponding author: P. N. Suresh Kumar, MD, MRCPsych, PhD, Department of Psychiatry, IQRAA International Hospital and Research Centre, Calicut, Kerala, India (
Prim Care Companion CNS Disord. 2023 Apr 18;25(2):22m03350. doi: 10.4088/PCC.22m03350.
To analyze the psychopathology and pattern of remission in cannabis-induced psychotic disorder with treatment. This was a prospective cohort study of a group of patients admitted with new-onset psychosis, cannabis use, and no evidence of other drug abuse from January 1 to June 31, 2019, to the psychiatry inpatient department of a multispecialty tertiary care hospital in Kerala, India. Patients were evaluated at admission and after 1 week in the hospital and 1 month after discharge using the Structured Clinical Interview for the Positive and Negative Syndrome Scale and the Clinical Global Impressions-Severity of illness scale. Fifty-six male subjects were recruited for the study. The mean age of the subjects was 22.2 years, and the majority were active smokers of nicotine and cannabis. Total duration of abuse and family history of substance use in first-degree relatives correlated with severity of psychosis. Hostility, excitement, and grandiosity were the predominant positive symptoms, and these symptoms showed a steady reduction toward the end of the study. The most frequent negative symptoms were emotional withdrawal, passive or apathetic social withdrawal, and difficulty in abstract thinking, and these symptoms also showed significant improvement ( < .001 for all). For symptoms such as somatic concern and guilt feelings, significant treatment response was noted only in the initial week ( < .001). Cannabis-induced psychosis in the Indian setting presents with predominant positive symptoms and minimal affective symptoms. The steady improvement noted with complete cessation of cannabis indicates a possible contributory role for cannabis in precipitating psychosis.
分析大麻所致精神障碍的精神病理学及治疗缓解模式。这是一项前瞻性队列研究，研究对象为2019年1月1日至6月31日入住印度喀拉拉邦一家多专科三级护理医院精神科住院部的一组新发精神病、使用大麻且无其他药物滥用证据的患者。使用阳性和阴性症状量表的结构化临床访谈以及临床总体印象-疾病严重程度量表在入院时、住院1周后及出院1个月后对患者进行评估。56名男性受试者被纳入研究。受试者的平均年龄为22.2岁，大多数人同时大量吸食尼古丁和大麻。滥用的总时长及一级亲属的物质使用家族史与精神病的严重程度相关。敌意、兴奋和夸大是主要的阳性症状，这些症状在研究结束时呈稳步减轻。最常见的阴性症状是情感退缩、被动或冷漠的社交退缩以及抽象思维困难，这些症状也有显著改善（所有均P<0.001）。对于躯体关注和内疚感等症状，仅在最初一周观察到显著的治疗反应（P<0.001）。在印度背景下，大麻所致精神病以主要的阳性症状和极少的情感症状为表现。随着大麻完全停用而观察到的稳步改善表明大麻在引发精神病方面可能起到了促成作用。
