Cannabis Use, Cannabis Use Disorder, and Comorbid Psychiatric Illness: A Narrative Review.
Cannabis Use, Cannabis Use Disorder, and Comorbid Psychiatric Illness: A Narrative Review.
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DOI：
10.3390/jcm10010015
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发表时间：
2020-12-23
影响因子：
3.9
通讯作者：
Walsh C
中科院分区：
文献类型：
--
作者：
Hasin D;Walsh C
背景：在美国和其他地方，大麻的态度、法律地位和使用模式正在迅速发生变化。因此，本叙述性审查的主要目的是简明扼要地概述关于大麻使用和大麻使用障碍与其他物质使用和精神障碍并存的文献，并利用这些信息准确地指导该领域的未来方向。方法：对PubMed中有关大麻使用、CUD和一种共生精神障碍的研究进行文献综述。为了提供代表性数据的概述，文献综述侧重于全国酒精及相关疾病流行病学调查(NESARC)和全国药物使用与健康调查(NSDUH)调查所开展的以人口为基础的国家级工作。考虑到迅速变化的大麻法律，讨论了最近(过去五年)的研究。结果：大量文献表明，大麻使用和CUD与其他药物使用、精神病、情绪障碍、焦虑症和人格障碍之间存在关联。大麻使用和精神障碍之间存在潜在因果关系的最有力证据。虽然一些证据表明大麻使用与情绪和焦虑症之间存在潜在的方向性，但结果并不一致。研究已经证实，人格障碍患者的CUD发生率较高，但对这种关系的细节了解甚少。结论：尽管美国的普通民众越来越多地认为大麻是一种无害的物质，但经验证据表明，大麻的使用与CUD和共病精神疾病都有关。然而，关于大麻在所有类别的精神障碍的共生障碍的病因、病程和预后中的作用，有混合的证据。未来的研究应该在现有文献的基础上扩展，提供具有代表性的纵向数据，以便更好地了解大麻对并存精神疾病的急性和长期影响。
Background: The landscape of attitudes, legal status and patterns of use of cannabis is rapidly changing in the United States and elsewhere. Therefore, the primary aim of this narrative review is to provide a concise overview of the literature on the comorbidity of cannabis use and cannabis use disorder (CUD) with other substance use and psychiatric disorders, and to use this information to accurately guide future directions for the field. Methods: A literature review of PubMed was conducted for studies relating to cannabis use, CUD, and a co-occurring psychiatric disorder. To provide an overview of representative data, the literature review focused on national-level, population-based work from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and National Survey on Drug Use and Health (NSDUH) surveys. Considering rapidly changing cannabis laws, recent (past five-year) studies were addressed. Results: A strong body of literature shows associations between cannabis use and CUD with other drug use, psychosis, mood disorders, anxiety disorders, and personality disorders. The strongest evidence of a potential causal relationship exists between cannabis use and psychotic disorders. While some evidence shows potential directionality between cannabis use and mood and anxiety disorders, results are inconsistent. Studies have established higher rates of CUD among those with personality disorders, but little about the specifics of this relationship is understood. Conclusions: Although the general population in the United States increasingly perceives cannabis to be a harmless substance, empirical evidence shows that cannabis use is associated both with CUD and comorbid psychiatric illness. However, there is mixed evidence regarding the role of cannabis in the etiology, course, and prognosis of a co-occurring disorder across all categories of psychiatric disorders. Future research should expand on the existing body of literature with representative, longitudinal data, in order to better understand the acute and long-term effects of cannabis on comorbid psychiatric illness.
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