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首页> 外文期刊>The journal of clinical psychiatry >Cannabis and Neuropsychiatry, 2: The Longitudinal Risk of Psychosis as an Adverse Outcome
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Cannabis and Neuropsychiatry, 2: The Longitudinal Risk of Psychosis as an Adverse Outcome

机译：大麻和神经精神病学，2：不良反应导致精神病的纵向风险

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Psychosis is one of the most serious among the adverse effects associated with cannabis use. The association between cannabis use and psychosis has been variously explored in a series of recent meta-analyses. The results of these meta-analyses show that persons who develop psychosis experience onset of psychosis about 2-3 years earlier if they are cannabis users; this effect is not observed with alcohol or other substance use. Higher levels of cannabis use are associated with greater risk of psychosis. Current cannabis abuse or dependence ( but not past use or lower levels of current use) increases the risk of transition into psychosis in persons at ultrahigh risk of psychosis. About a third of patients with first-episode psychosis are cannabis users, and, at follow-up, about half of these users are found to continue their cannabis use. Continued cannabis use ( in those who are treated after developing psychosis) is associated with higher risk of relapse into psychosis, and discontinuation of cannabis use reduces the risk of relapse to that in cannabis nonusers. Finally, persons with psychosis who continue to use cannabis have more severe positive symptoms and poorer levels of functioning. Because experimental studies in humans show that cannabinoids and cannabis can induce psychotic symptoms, it is reasonable to assume that the epidemiologic data indicate a causal effect of cannabis in anticipating, triggering, or exacerbating psychosis in vulnerable individuals and in worsening the course and outcome of the illness in those who continue to use the substance. Given the public health implications of these findings, the trend to legalize medical marijuana must be viewed with concern, and efforts are necessary to educate patients and the public about the serious mental and physical health risks associated with cannabis use and abuse. (C) Copyright 2016 Physicians Postgraduate Press, Inc.
机译：精神病是与使用大麻有关的最严重副作用之一。最近一系列的荟萃分析对大麻使用与精神病之间的关联进行了各种探讨。这些荟萃分析的结果表明，患有精神病的人如果是大麻使用者，大约会在2-3年之前开始精神病。使用酒精或其他物质不会观察到这种效果。大麻使用量增加与精神病风险增加有关。当前的大麻滥用或依赖（但不是过去的使用或当前使用水平的降低）会增加患有精神病的超高风险者转变为精神病的风险。约有三分之一的首发性精神病患者是大麻使用者，在随访中，发现这些使用者中约有一半继续使用大麻。继续使用大麻（在患有精神病后接受治疗的人中）会增加精神病复发的风险，而停止使用大麻会使非使用大麻者复发的风险降低。最后，继续使用大麻的精神病患者有更严重的积极症状和较差的机能水平。由于在人体进行的实验研究表明，大麻素和大麻可诱发精神病症状，因此可以合理地假设流行病学数据表明大麻对易感个体的精神病有预期，触发或加重的致病作用，并且会使大麻的病程和结果恶化那些继续使用该物质的人患有疾病。考虑到这些发现对公共卫生的影响，必须关注使医用大麻合法化的趋势，并且必须努力教育患者和公众有关与大麻使用和滥用相关的严重精神和身体健康风险。 （C）版权所有2016 Physicians Postgraduate Press，Inc.

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