Quantifying the clinical significance of cannabis withdrawal.
Quantifying the clinical significance of cannabis withdrawal.
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DOI：
10.1371/journal.pone.0044864
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Budney AJ
中科院分区：
文献类型：
--
作者：
Allsop DJ;Copeland J;Norberg MM;Fu S;Molnar A;Lewis J;Budney AJ
对大麻戒断临床意义的质疑阻碍了其作为一种独立的大麻引起的精神疾病被纳入《精神疾病诊断和统计手册》（DSM IV）。本研究旨在量化大麻戒断对正常日常活动的功能损害，并研究预测功能损害的因素。此外，该研究还测试了大麻戒断造成的功能障碍对戒断尝试期间和之后使用大麻的影响。符合 DSM-IV 依赖标准的 49 名未寻求治疗的大麻使用者的志愿者样本提供了一周基线阶段和两周监测戒除大麻以及一个月随访期间每日与戒断相关的功能障碍评分。戒断症状引起的功能障碍与症状严重程度密切相关 (p = 0.0001)。在尝试戒断之前对大麻依赖较严重的参与者报告称，大麻戒断导致的功能障碍更大（p = 0.03）。在戒断期间再次吸食大麻与高度依赖使用者的部分戒断症状造成的更大的功能障碍有关。戒断尝试期间较高水平的功能障碍预示着一个月随访时大麻使用水平较高 (p = 0.001)。大麻戒断具有临床意义，因为它与正常日常活动的功能障碍以及大麻使用的复发有关。复发组的样本量很小，并且使用未寻求治疗的人群需要在临床样本中重复研究结果。针对在尝试戒烟期间导致功能障碍的戒断症状量身定制治疗方案可能会改善治疗结果。
Questions over the clinical significance of cannabis withdrawal have hindered its inclusion as a discrete cannabis induced psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). This study aims to quantify functional impairment to normal daily activities from cannabis withdrawal, and looks at the factors predicting functional impairment. In addition the study tests the influence of functional impairment from cannabis withdrawal on cannabis use during and after an abstinence attempt. A volunteer sample of 49 non-treatment seeking cannabis users who met DSM-IV criteria for dependence provided daily withdrawal-related functional impairment scores during a one-week baseline phase and two weeks of monitored abstinence from cannabis with a one month follow up. Functional impairment from withdrawal symptoms was strongly associated with symptom severity (p = 0.0001). Participants with more severe cannabis dependence before the abstinence attempt reported greater functional impairment from cannabis withdrawal (p = 0.03). Relapse to cannabis use during the abstinence period was associated with greater functional impairment from a subset of withdrawal symptoms in high dependence users. Higher levels of functional impairment during the abstinence attempt predicted higher levels of cannabis use at one month follow up (p = 0.001). Cannabis withdrawal is clinically significant because it is associated with functional impairment to normal daily activities, as well as relapse to cannabis use. Sample size in the relapse group was small and the use of a non-treatment seeking population requires findings to be replicated in clinical samples. Tailoring treatments to target withdrawal symptoms contributing to functional impairment during a quit attempt may improve treatment outcomes.
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