Effects of Extended Cannabis Abstinence in Major Depressive Disorder
Effects of Extended Cannabis Abstinence in Major Depressive Disorder
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DOI：
10.1097/cxa.0000000000000090
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发表时间：
2020-09-01
影响因子：
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通讯作者：
George, Tony P.
中科院分区：
文献类型：
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作者：
Lucatch, Aliya M.;Kloiber, Stefan M.;George, Tony P.
背景：重度抑郁症（MDD）患者使用大麻的比例高于普通人群。最近的荟萃分析发现大麻使用与抑郁症，自杀行为和自杀意念风险增加之间存在联系。到目前为止，很少有研究大麻的使用在诊断为MDD.Objectives的个人的影响：我们研究了大麻戒断对抑郁症的临床症状的影响，在成年人共病大麻使用障碍（CUD）和MDD.Method：共病CUD和MDD（n = 11）的参与者进行了28天的大麻戒断。每周使用汉密尔顿抑郁量表、贝克焦虑量表、斯奈思汉密尔顿快乐量表评估情绪症状。使用每周尿液检测11-nor-9 carboxy-Delta（9）-tetrahydrocannabinol（THC-COOH）（THC的代谢物）的生化方法验证禁欲，如果证实禁欲，参与者将获得或有奖金。在所有参与者中，包括那些复发者，尿THC-COOH在整个研究期间显著减少（P= 0.002）。参与者表现出抑郁症状的显着改善（从基线减少43.7%; P = 0.008），特别是快感缺乏（从基线减少88.7%; P < 0.001）。科学意义：这项研究的结果表明，延长大麻戒断与抑郁症和CUD患者的抑郁症状，特别是快感缺乏的改善有关。我们的研究结果表明，在治疗MDD患者时解决有问题的大麻使用可以改善临床结果。
Background: Individuals with major depressive disorder (MDD) have higher rates of problematic cannabis use than the general population. Recent meta-analyses have found a link between cannabis use and increased risk for depression, suicidal behavior, and suicidal ideation. Few studies to date have examined the effects of cannabis use in individuals diagnosed with MDD.Objectives: We examined the effects of cannabis abstinence on clinical symptoms of depression in adults with comorbid cannabis use disorder (CUD) and MDD.Method: Participants with comorbid CUD and MDD (n = 11) underwent 28 days of cannabis abstinence. Mood symptoms were assessed weekly using the Hamilton Depression Rating Scale, the Beck Anxiety Inventory, the Snaith Hamilton Pleasure scale. Abstinence was biochemically verified using weekly urine assays for 11-nor-9carboxy-Delta(9)-tetrahydrocannnabinol (THC-COOH), a metabolite of THC, and participants were rewarded with a contingent bonus if abstinence was confirmed.Results: 72.7% of study completers achieved abstinence. In all participants, including those who relapsed, urinary THC-COOH was significantly reduced throughout the study (P= 0.002). Participants exhibited significant improvements in depressive symptoms (43.7% reduction from baseline; P = 0.008), especially anhedonia (88.7% reduction from baseline; P < 0.001).Scientific significance: Findings from this study suggest that extended abstinence from cannabis is associated with improvement of depressive symptoms, particularly anhedonia, in individuals with MDD and CUD. Our results indicate that addressing problematic cannabis use in the treatment of individuals with MDD can improve clinical outcomes.