David Ayelet, Stolar Orit, Berkovitch Matitiahu, Kohn Elkana, Hazan Ariela, Waissengreen Danel, Gal Eynat
Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel.
Child Development Division, Sharon District-Maccabi Healthcare Services, Tel Aviv, Israel.
Cannabis Cannabinoid Res. 2024 Jul 24. doi: 10.1089/can.2024.0001.
The literature supports the benefits of medical cannabis for core and comorbid symptoms in autistic individuals and anxiety-related symptoms in individuals without autism. However, no study has specifically investigated how cannabidiol (CBD)-rich cannabis affects anxiety subtypes in autistic children or its relationship with restricted and repetitive behaviors and interests (RRBI). Understanding the effects of CBD-rich cannabis treatment on anxiety subtypes and RRBI could offer more precise treatment approaches to managing anxiety symptoms and reducing RRBI frequency in autistic children. To examine (1) the impact of CBD-rich cannabis treatment on autistic children's (1a) anxiety levels and subtypes and (1 b) RRBI and subtypes and (2) whether changes in anxiety explain changes in RRBI following cannabis treatment. In this open-label study, we analyzed data from 65 autistic children (5-12 years) who had participated in research on the effects of CBD-rich cannabis on children with autism. Their parents completed the Repetitive Behavior Scale-revised to assess the frequency and severity of six subgroups of their children's recurrent behaviors and the Screen for Child Anxiety-Related Emotional Disorders for symptoms related to five types of anxiety disorders. They completed these assessments at three time points: (T1) before treatment, (T2) after 3 months, and (T3) after 6 months of treatment. The results indicated reduced RRBI and symptoms related to various anxiety subtypes in autistic children following 6 months of CBD-rich cannabis treatment. Specifically, we observed significant differences in the autistic children's overall anxiety and in some anxiety subtypes (i.e., general, social, panic, and separation anxieties). Significant improvements were observed in RRBI, including the total score, and specifically in compulsive, ritualistic, and sameness behaviors. Our findings revealed that reduced anxiety, particularly within the panic- and separation-related subtypes, predicted a subsequent decrease in RRBI, specifically sameness behaviors, following cannabis treatment. The findings of the cannabis treatment's potential benefits for alleviating anxiety symptoms, leading to reduced RRBI, may provide evidence for the meaningful relationship between these variables and for the potential benefits of cannabis treatment for autistic children. We strongly recommend further double-blind, placebo-controlled studies using standardized assessments to validate these findings.
文献支持医用大麻对自闭症个体的核心症状和共病症状以及非自闭症个体的焦虑相关症状有益。然而，尚无研究专门调查富含大麻二酚（CBD）的大麻如何影响自闭症儿童的焦虑亚型，或其与受限及重复行为和兴趣（RRBI）的关系。了解富含CBD的大麻治疗对焦虑亚型和RRBI的影响，可为管理自闭症儿童的焦虑症状和降低RRBI频率提供更精确的治疗方法。为了研究（1）富含CBD的大麻治疗对自闭症儿童的（1a）焦虑水平和亚型以及（1b）RRBI和亚型的影响，以及（2）大麻治疗后焦虑的变化是否能解释RRBI的变化。在这项开放标签研究中，我们分析了65名5至12岁自闭症儿童的数据，这些儿童参与了关于富含CBD的大麻对自闭症儿童影响的研究。他们的父母完成了修订后的重复行为量表，以评估孩子六种复发性行为亚组的频率和严重程度，以及儿童焦虑相关情绪障碍筛查量表，以评估与五种焦虑症相关的症状。他们在三个时间点完成了这些评估：（T1）治疗前、（T2）治疗3个月后和（T3）治疗6个月后。结果表明，经过6个月富含CBD的大麻治疗后，自闭症儿童的RRBI以及与各种焦虑亚型相关的症状有所减轻。具体而言，我们观察到自闭症儿童的总体焦虑以及某些焦虑亚型（即一般性、社交性、惊恐性和分离性焦虑）存在显著差异。RRBI包括总分，特别是强迫性、仪式性和同一性行为有显著改善。我们的研究结果显示，焦虑减轻，尤其是惊恐和分离相关亚型内的焦虑减轻，预示着大麻治疗后RRBI会随之下降，特别是同一性行为。大麻治疗对减轻焦虑症状从而降低RRBI具有潜在益处的研究结果，可能为这些变量之间的有意义关系以及大麻治疗对自闭症儿童的潜在益处提供证据。我们强烈建议进一步开展双盲、安慰剂对照研究，使用标准化评估来验证这些发现。
