Cannabis use and psychotic disorders in diverse settings in the Global South: findings from INTREPID II.
Cannabis use and psychotic disorders in diverse settings in the Global South: findings from INTREPID II.
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全球南部不同环境中的大麻使用和精神障碍：无畏II的研究结果。
DOI：
10.1017/s0033291723000399
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发表时间：
2023-11
影响因子：
6.9
通讯作者：
Hutchinson, Gerard
中科院分区：
文献类型：
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作者：
Pow, Joni Lee;Donald, Casswina;di Forti, Marta;Roberts, Tessa A.;Weiss, Helen;Ayinde, Olatunde;John, Sujit;Olley, Bola;Ojagbemi, Akin;Esponda, Georgina Miguel;Lam, Joseph;Poornachandrika, Paramasivam;Dazzan, Paola;Gaughran, Fiona;Kannan, Palaniyandi Ponnusamy;Sudhakar, Selvaraju;Burns, Jonathan;Chiliza, Bonginkosi;Cohen, Alex;Gureje, Oye M.;Thara, Rangaswamy;Murray, Robin;Morgan, Craig;Hutchinson, Gerard
大麻的使用与精神障碍有关，但这种关联主要在全球北方观察到。本研究调查了三个全球南部（拉丁美洲、亚洲、非洲和大洋洲）环境中大麻使用的模式及其与精神病的关联。在2018年5月至2020年9月期间进行的国际精神疾病研究计划（INTREPID）II中的病例对照研究。在每种情况下，我们招募了200多名未经治疗的精神病患者和个体匹配的对照组（Kancheepuram India; Ibadan，尼日利亚;北方特立尼达）。对照组，没有过去或目前的精神病性障碍，个人匹配的情况下，5岁的年龄组，性别和邻里。使用神经精神病学临床评估时间表评估的精神病性障碍和通过世界卫生组织酒精、吸烟和物质参与筛选试验（ASSIST）测量的大麻暴露。在每种情况下，病例报告的终生使用和频繁使用大麻的情况都高于对照组。在特立尼达，大麻使用与精神障碍的几率增加有关：终身使用大麻（调整OR 1.58，95% CI 0.99-2.53）;频繁使用大麻（调整OR 1.99，95%CI 1.10-3.60）;大麻依赖性（通过高ASSIST评分衡量）（调整OR 4.70，95%CI 1.77-12.47），首次使用年龄较早（调整OR 1.83，95%CI 1.03-3.27）。在其他两种情况下使用大麻的情况太罕见，无法研究相关性。与以前的研究一致，我们发现特立尼达的大麻使用与精神病的发生和发病年龄之间存在关联。这些发现对预防精神病的策略具有影响。
Cannabis use has been linked to psychotic disorders but this association has been primarily observed in the Global North. This study investigates patterns of cannabis use and associations with psychoses in three Global South (regions within Latin America, Asia, Africa and Oceania) settings. Case–control study within the International Programme of Research on Psychotic Disorders (INTREPID) II conducted between May 2018 and September 2020. In each setting, we recruited over 200 individuals with an untreated psychosis and individually-matched controls (Kancheepuram India; Ibadan, Nigeria; northern Trinidad). Controls, with no past or current psychotic disorder, were individually-matched to cases by 5-year age group, sex and neighbourhood. Presence of psychotic disorder assessed using the Schedules for Clinical Assessment in Neuropsychiatry and cannabis exposure measured by the World Health Organisation Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Cases reported higher lifetime and frequent cannabis use than controls in each setting. In Trinidad, cannabis use was associated with increased odds of psychotic disorder: lifetime cannabis use (adj. OR 1.58, 95% CI 0.99–2.53); frequent cannabis use (adj. OR 1.99, 95% CI 1.10–3.60); cannabis dependency (as measured by high ASSIST score) (adj. OR 4.70, 95% CI 1.77–12.47), early age of first use (adj. OR 1.83, 95% CI 1.03–3.27). Cannabis use in the other two settings was too rare to examine associations. In line with previous studies, we found associations between cannabis use and the occurrence and age of onset of psychoses in Trinidad. These findings have implications for strategies for prevention of psychosis.