对英国国家医疗服务体系（NHS）首个针对同时患有大麻使用障碍和精神疾病的年轻人的诊所的数据进行的概念验证分析。

A proof-of-concept analysis of data from the first NHS clinic for young adults with comorbid cannabis use and psychotic disorders.

作者信息

Di Forti Marta, Bond Benjamin W, Spinazzola Edoardo, Trotta Giulia, Lynn Jodie, Malkin Richard, Kamran Siddiqui Naba, Demir Sultan, Opadokun Titilayomi, Leung Perry B M, Li Zhikun, Quattrone Andrea, Baxter Gabriella, Appiah-Kusi Elizabeth, Freeman Tom P, Walsh Hannah, Squeri Tommaso, Semikina Daria, Amberson-Jones Felicity, Austin-Zimmerman Isabelle, Meynen Tim, Quattrone Diego, Murray Robin M

机构信息

Department of Social Genetics and Developmental Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.

South London and Maudsley NHS Foundation Mental Health Trust, London, UK.

出版信息

BJPsych Open. 2024 Dec 12;11(1):e1. doi: 10.1192/bjo.2024.782.

DOI:10.1192/bjo.2024.782

PMID:39663754

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11733490/

Abstract

BACKGROUND

Cannabis use severely affects the outcome of people with psychotic disorders, yet there is a lack of treatments. To address this, in 2019 the National Health Service (NHS) Cannabis Clinic for Psychosis (CCP) was developed to support adults suffering from psychosis to reduce and/or stop their cannabis use.

AIMS

Examine outcome data from the first 46 individuals to complete the CCP's intervention.

METHOD

The sample ( = 46) consisted of adults (aged ≥ 18) with psychosis under the care of the South London and Maudsley NHS Foundation Trust, referred to the CCP between January 2020 and February 2023, who completed their intervention by September 2023. Clinical and functional measures were collected before (T0) and after (T1) the CCP intervention (one-to-one sessions and peer group attendance). Primary outcomes were changes in the Cannabis Use Disorders Identification Test-Revised (CUDIT-R) score and pattern of cannabis use. Secondary outcomes included T0-T1 changes in measures of delusions, paranoia, depression, anxiety and functioning.

RESULTS

A reduction in the mean CUDIT-R score was observed between T0 (mean difference = 17.10, 95% CI = 15.54-18.67) and T1, with 73.91% of participants achieving abstinence and 26.09% reducing the frequency and potency of their use. Significant improvements in all clinical and functional outcomes were observed, with 90.70% being in work or education at T1 compared with 8.70% at T0. The variance in CUDIT-R scores explained between 34 and 64% of the variance in our secondary measures.

CONCLUSIONS

The CCP intervention is a feasible strategy to support cannabis use cessation/reduction and improve clinical and functional outcomes of people with psychotic disorders.

摘要

背景

大麻使用严重影响精神病患者的预后，但目前缺乏相关治疗方法。为解决这一问题，2019年英国国家医疗服务体系（NHS）设立了精神病大麻诊所（CCP），以帮助患有精神病的成年人减少和/或停止使用大麻。

目的

研究前46名完成CCP干预的个体的预后数据。

方法

样本（n = 46）由年龄≥18岁、在南伦敦和莫兹利NHS基金会信托基金照料下患有精神病的成年人组成，他们于2020年1月至2023年2月被转介至CCP，并于2023年9月前完成干预。在CCP干预前（T0）和干预后（T1）（一对一治疗和参加同伴小组）收集临床和功能指标。主要结局指标为大麻使用障碍识别测试修订版（CUDIT-R）得分及大麻使用模式的变化。次要结局指标包括T0至T1期间妄想、偏执、抑郁、焦虑及功能指标的变化。

结果

T0（平均差值 = 17.10，95%可信区间 = 15.54 - 18.67）至T1期间，CUDIT-R平均得分降低，73.91%的参与者实现了戒断，26.09%的参与者减少了使用频率和用量。所有临床和功能结局均有显著改善，T1时90.70%的参与者就业或接受教育，而T0时这一比例为8.70%。CUDIT-R得分的方差解释了次要指标方差的34%至64%。