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首页> 外文期刊>Journal of psychopharmacology >Cannabis as a risk factor for psychosis: systematic review.
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Cannabis as a risk factor for psychosis: systematic review.

机译：大麻是精神病的危险因素：系统评价。

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Various lines of evidence suggest an association between cannabis and psychosis. Five years ago, the only significant case-control study addressing this question was the Swedish Conscript Cohort. Within the last few years, other studies have emerged, allowing the evidence for cannabis as a risk factor to be more systematically reviewed and assessed. Using specific search criteria on Embase, PsychINFO and Medline, all studies examining cannabis as an independent risk factor for schizophrenia, psychosis or psychotic symptoms, published between January 1966 and January 2004, were examined. Additional studies were also reviewed from references found in retrieved articles, reviews, and a cited reference search (ISI-Web of Science). Studies selected for meta-analysis included: (i) case-control studies where exposure to cannabis preceded the onset of schizophrenia or schizophrenia-like psychosis and (ii) cohort studies of healthy individuals recruited before the median age of illness onset, with cannabis exposure determined prospectively and blind to eventual diagnosis. Studies of psychotic symptoms were also tabulated for further discussion. Eleven studies were identified examining the relationship between cannabis use and psychosis. Seven were included in the meta-analysis, with a derived odds ratio (fixed effects) of 2-9 (95 % confidence interval = 2.4-3.6). No evidence of publication bias or heterogeneity was found. Early use of cannabis did appear to increase the risk of psychosis. For psychotic symptoms, a dose-related effect of cannabis use was seen, with vulnerable groups including individuals who used cannabis during adolescence, those who had previously experienced psychotic symptoms, and those at high genetic risk of developing schizophrenia. In conclusion, the available evidence supports the hypothesis that cannabis is an independent risk factor, both for psychosis and the development of psychotic symptoms. Addressing cannabis use, particularly in vulnerable populations, is likely to have beneficial effects on psychiatric morbidity.
机译：各种证据表明大麻与精神病之间存在关联。五年前，唯一解决这个问题的重要病例对照研究是瑞典应征队列。在过去的几年中，出现了其他研究，可以更系统地审查和评估大麻作为危险因素的证据。使用Embase，PsychINFO和Medline上的特定搜索标准，检查了1966年1月至2004年1月发布的所有将大麻作为精神分裂症，精神病或精神病性症状的独立危险因素的研究。还从检索到的文章中找到的参考文献，评论和引用的参考文献检索（ISI-Web of Science）对其他研究进行了综述。选择进行荟萃分析的研究包括：（i）病例对照研究，其中在精神分裂症或精神分裂症样精神病发作之前先接触大麻，以及（ii）在中位发病年龄之前招募的健康个体的队列研究，并进行大麻暴露前瞻性确定，对最终诊断不知情。精神病症状的研究也被列入表格以供进一步讨论。确定了11项研究，研究了大麻使用与精神病之间的关系。荟萃分析中包括七个，衍生比值比（固定效应）为2-9（95％置信区间= 2.4-3.6）。没有发现出版物偏倚或异质性的证据。尽早使用大麻似乎增加了精神病的风险。对于精神病症状，可以看到大麻使用与剂量有关的作用，其中包括易受伤害的人群，包括在青春期期间使用过大麻的人，以前曾经历过精神病症状的人以及有发展为精神分裂症的高遗传风险的人。总之，现有证据支持以下假设：大麻是精神病和精神病症状发展的独立危险因素。解决大麻的使用问题，特别是在脆弱人群中的使用，可能对精神病发病率产生有益的影响。

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