Sagar Kelly A, Gruber Staci A
Cognitive and Clinical Neuroimaging Core, McLean Hospital, McLean Imaging Center, Belmont, MA, USA.
Marijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital, Belmont, MA, USA.
CNS Drugs. 2025 Feb;39(2):113-125. doi: 10.1007/s40263-024-01148-2. Epub 2025 Jan 4.
The relationship between cannabis use and mental health is complex, as studies often report seemingly contradictory findings regarding whether cannabis use results in more positive or negative treatment outcomes. With an increasing number of individuals using cannabis for both recreational (i.e., non-medical) and medical purposes, it is critical to gain a deeper understanding of the ways in which cannabis may be helpful or harmful for those diagnosed with psychiatric disorders. Although cannabis is composed of hundreds of compounds, studies assessing the effects of "cannabis" most often report the impact of delta-9-tetrahydrocannabinol (d9-THC), the primary intoxicating constituent of the plant. While d9-THC has documented therapeutic properties, negative clinical outcomes commonly associated with cannabis are generally related to d9-THC exposure. In contrast, non-intoxicating cannabinoids such as cannabidiol (CBD) show promise as potential treatment options for psychiatric symptoms. In this article, findings from studies and reviews examining the relationship between mental health conditions (mood, anxiety, psychosis, and post-traumatic stress disorder [PTSD]) and cannabis use are summarized to highlight critical variables that are often overlooked, including those associated with cannabis use patterns (e.g., frequency of use, amount used, cannabinoid exposure, product choice, and route of administration). Further, this article explores individual factors (e.g., age, sex, genetics/family history) that likely impact cannabis-related outcomes. Research to date suggests that youth and those with a family history or genetic liability for psychiatric disorders are at higher risk for negative outcomes, while more research is needed to fully understand unique effects related to sex and older age.
大麻使用与心理健康之间的关系很复杂，因为研究常常报告关于大麻使用会导致更积极还是更消极的治疗结果的看似矛盾的发现。随着越来越多的人将大麻用于娱乐（即非医疗）和医疗目的，深入了解大麻对那些被诊断患有精神疾病的人可能有益或有害的方式至关重要。尽管大麻由数百种化合物组成，但评估“大麻”影响的研究最常报告的是δ-9-四氢大麻酚（d9-THC）的影响，它是这种植物的主要致醉成分。虽然d9-THC具有已记录的治疗特性，但通常与大麻相关的负面临床结果一般与接触d9-THC有关。相比之下，诸如大麻二酚（CBD）等无致醉作用的大麻素显示出有望成为治疗精神症状的潜在选择。在本文中，对研究和综述中关于心理健康状况（情绪、焦虑、精神病和创伤后应激障碍[PTSD]）与大麻使用之间关系的研究结果进行了总结，以突出那些经常被忽视的关键变量，包括与大麻使用模式相关的变量（例如使用频率、使用量、大麻素暴露、产品选择和给药途径）。此外，本文探讨了可能影响与大麻相关结果的个体因素（例如年龄、性别、遗传/家族史）。迄今为止的研究表明，青少年以及有精神疾病家族史或遗传易感性的人出现负面结果的风险更高，而需要更多研究来全面了解与性别和老年相关的独特影响。
