Vaddiparti Krishna, Liu Yiyang, Bottari Sarah, Boullosa Carly Crump, Zhou Zhi, Wang Yan, Williamson John, Cook Robert L
Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
Department of Clinical and Health Psychology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
Med Cannabis Cannabinoids. 2023 Nov 13;6(1):160-169. doi: 10.1159/000534710. eCollection 2023 Jan-Dec.
Post-traumatic stress disorder (PTSD) is a debilitating disorder experienced by a subgroup of individuals following a life-threatening trauma. Several US states have passed laws permitting the medical use of marijuana (MMJ) by individuals with PTSD, despite very little scientific indication on the appropriateness of marijuana as a therapy for PTSD. This prospective pilot study of adults with confirmed PTSD in Florida (FL) investigated whether PTSD symptoms, sleep quality, affect, and general physical and mental health/well-being improved post-initiation of MMJ treatment.
Participants, = 15, were recruited from two MMJ clinics in Gainesville and Jacksonville, FL. To be eligible, participants had to be 18 years of age or older, not currently on MMJ, and willing to abstain from recreational marijuana, if using any, until the State Medical Cannabis Card was obtained, screen positive for PTSD. Participants were assessed at baseline (pre-MMJ initiation) and 30 and 70 days post-MMJ initiation using the Pittsburgh Sleep Quality Index (PSQI), PTSD Checklist for DSM-5 (PCL-5), Positive and Negative Affect Schedule (PANAS), PROMIS Global Health V1.2, and semi-structured marijuana and other substance use assessment.
PTSD symptom severity as measured by total PCL-5 score improved significantly at 30- and 70-day follow-ups. Similarly, statistically significant reductions in nightmares were reported at 30- and 70-day follow-ups. Corresponding improvements in sleep were noticed with participants reporting increased duration of sleep hours, sleep quality, sleep efficiency, and total PSQI score. Likewise, negative affect and global mental health improved significantly at follow-up. According to the post hoc analyses, the most statistically significant changes occurred between baseline and 30-day follow-up. The exception to this pattern was nightmares, which did not show significant improvement until day 70.
The findings of this study highlight the potential of MMJ in improving patient outcomes for those with PTSD, particularly concerning sleep disturbances, which often do not respond to currently available treatments.
创伤后应激障碍（PTSD）是一部分经历过危及生命创伤的个体所患的一种使人衰弱的疾病。尽管几乎没有科学依据表明大麻适合作为治疗PTSD的方法，但美国几个州已通过法律，允许患有PTSD的个体医用大麻（MMJ）。这项针对佛罗里达州（FL）确诊患有PTSD的成年人的前瞻性试点研究，调查了MMJ治疗开始后，PTSD症状、睡眠质量、情绪以及总体身心健康状况是否得到改善。
从佛罗里达州盖恩斯维尔和杰克逊维尔的两家MMJ诊所招募了15名参与者。符合条件的参与者必须年满18岁，目前未使用MMJ，并且如果正在使用任何娱乐性大麻，愿意在获得州医用大麻卡之前 abstain from ，PTSD筛查呈阳性。使用匹兹堡睡眠质量指数（PSQI）、DSM-5的PTSD检查表（PCL-5）、正负情绪量表（PANAS）、PROMIS全球健康V1.2以及半结构化的大麻和其他物质使用评估，在基线（MMJ开始前）以及MMJ开始后30天和70天对参与者进行评估。
通过PCL-5总分衡量的PTSD症状严重程度在30天和70天随访时显著改善。同样，在30天和70天随访时报告称噩梦有统计学意义的显著减少。注意到睡眠有相应改善，参与者报告睡眠时间、睡眠质量、睡眠效率增加，PSQI总分提高。同样，随访时消极情绪和总体心理健康状况显著改善。根据事后分析，在统计学上最显著的变化发生在基线和30天随访之间。这种模式的例外是噩梦，直到第70天才显示出显著改善。
本研究结果突出了MMJ在改善PTSD患者预后方面的潜力，特别是在改善睡眠障碍方面，睡眠障碍通常对目前可用治疗无反应。
