Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis
Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis
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DOI：
10.1093/schbul/sbw003
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发表时间：
2016-09-01
影响因子：
6.6
通讯作者：
Vassos, Evangelos
中科院分区：
文献类型：
--
作者：
Marconi, Arianna;Di Forti, Marta;Vassos, Evangelos
据报告，大麻的使用会诱发长期的精神障碍，并观察到了剂量-反应关系。我们对研究大麻消费程度与精神病之间关系的研究进行了系统回顾，并进行了荟萃分析以量化影响程度。通过检索电子数据库，辅以人工检索参考书目，确定已发表的研究。如果研究使用剂量标准（使用频率/数量）提供了精神病发作前大麻消费的数据并报告了精神病相关结果，则考虑进行研究。我们对原始研究汇总数据中采用模拟方法生成的单个数据点进行随机效应荟萃分析。在571篇参考文献中，18项研究符合系统性综述的纳入标准，10项纳入荟萃分析，共招募66816名个体。在所有纳入的研究中，较高水平的大麻使用与精神病风险增加有关。逻辑回归模型得出的OR为3.90（95%CI 2.84至5.34）的精神分裂症和其他精神病相关的结果之间的风险最重的大麻用户相比，非用户。目前的证据表明，高水平的大麻使用会增加精神病后果的风险，并证实了使用水平与精神病风险之间的剂量反应关系。尽管无法明确建立因果关系，但有足够的证据证明减少伤害预防计划的合理性。
Cannabis use has been reported to induce long-lasting psychotic disorders and a dose-response relationship has been observed. We performed a systematic review of studies that investigate the association between the degree of cannabis consumption and psychosis and a meta-analysis to quantify the magnitude of effect. Published studies were identified through search of electronic databases, supplemented by manual searches of bibliographies. Studies were considered if they provided data on cannabis consumption prior to the onset of psychosis using a dose criterion (frequency/amount used) and reported psychosis-related outcomes. We performed random effects meta-analysis of individual data points generated with a simulation method from the summary data of the original studies. From 571 references, 18 studies fulfilled inclusion criteria for the systematic review and 10 were inserted in the meta-analysis, enrolling a total of 66 816 individuals. Higher levels of cannabis use were associated with increased risk for psychosis in all the included studies. A logistic regression model gave an OR of 3.90 (95% CI 2.84 to 5.34) for the risk of schizophrenia and other psychosis-related outcomes among the heaviest cannabis users compared to the nonusers. Current evidence shows that high levels of cannabis use increase the risk of psychotic outcomes and confirms a dose-response relationship between the level of use and the risk for psychosis. Although a causal link cannot be unequivocally established, there is sufficient evidence to justify harm reduction prevention programs.