Testing hypotheses about the relationship between cannabis use and psychosis
Testing hypotheses about the relationship between cannabis use and psychosis
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DOI：
10.1016/s0376-8716(03)00064-4
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发表时间：
2003-07-20
影响因子：
4.2
通讯作者：
Lynskey, M
中科院分区：
文献类型：
--
作者：
Degenhardt, L;Hall, W;Lynskey, M
目的：在关于大麻使用与精神病之间关系的四种假设下，模拟大麻使用率上升对精神病发病率和患病率的影响。研究方法：该研究模拟了大麻在8个出生队列中对精神分裂症患病率的影响：1940-1944，1945-1949，1950-1954，1955-1959，1960-1964，1965-1969，1970-1974，1975-1979。它根据以下四个假设，对这些出生队列中观察到的精神分裂症病例数进行了预测：（1）大麻使用与精神分裂症之间存在因果关系;（2）大麻使用使脆弱人群出现精神分裂症;（3）大麻使用使精神分裂症恶化;及（4）精神分裂症患者更容易成为经常吸食大麻的人。结果如下：在过去30年中，澳大利亚大麻吸毒流行率急剧上升，开始使用大麻的年龄相应下降。在过去的30年里，没有证据表明精神分裂症的发病率显著增加。关于精神分裂症发病年龄的趋势数据没有显示出明确的模式。精神分裂症患者使用大麻的情况一直比一般人群更为普遍。结论：大麻的使用似乎与精神分裂症的发病率没有因果关系，但它的使用可能会使易患精神病的人的精神紊乱，并使已患精神病的人的精神紊乱恶化。
Aim: To model the impact of rising rates of cannabis use on the incidence and prevalence of psychosis under four hypotheses about the relationship between cannabis use and psychosis. Methods: The study modelled the effects on the prevalence of schizophrenia over the lifespan of cannabis in eight birth cohorts: 1940-1944, 1945-1949, 1950-1954, 1955-1959, 1960-1964, 1965-1969, 1970-1974, 1975-1979. It derived predictions as to the number of cases of schizophrenia that would be observed in these birth cohorts, given the following four hypotheses: (1) that there is a causal relationship between cannabis use and schizophrenia; (2) that cannabis use precipitates schizophrenia in vulnerable persons; (3) that cannabis use exacerbates schizophrenia; and (4) that persons with schizophrenia are more liable to become regular cannabis users. Results: There was a steep rise in the prevalence of cannabis use in Australia over the past 30 years and a corresponding decrease in the age of initiation of cannabis use. There was no evidence of a significant increase in the incidence of schizophrenia over the past 30 years. Data on trends the age of onset of schizophrenia did not show a clear pattern. Cannabis use among persons with schizophrenia has consistently been found to be more common than in the general population. Conclusions: Cannabis use does not appear to be causally related to the incidence of schizophrenia, but its use may precipitate disorders in persons who are vulnerable to developing psychosis and worsen the course of the disorder among those who have already developed it. (C) 2003 Elsevier Science Ireland Ltd. All rights reserved.