Daily Use, Especially of High-Potency Cannabis, Drives the Earlier Onset of Psychosis in Cannabis Users
Daily Use, Especially of High-Potency Cannabis, Drives the Earlier Onset of Psychosis in Cannabis Users
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DOI：
10.1093/schbul/sbt181
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发表时间：
2014-11-01
影响因子：
6.6
通讯作者：
Murray, Robin M.
中科院分区：
文献类型：
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作者：
Di Forti, Marta;Sallis, Hannah;Murray, Robin M.
大麻的使用与精神病发病年龄（AOP）较早有关。然而，其原因仍有争议。研究方法：我们应用考克斯比例风险模型对410例首发精神病患者进行研究，以探讨性别、大麻使用模式和AOP之间的关系。结果如下：有大麻使用史的患者在年轻时首次出现精神病发作（平均年数= 28.2，SD = 8.0;中位年数= 27.1）（平均年数= 31.4，标准差= 9.9;中位年数= 30.0;风险比[HR] = 1.42; 95%CI：1.16-1.74; P < .001）。在控制性别后，这种关联仍然显著（HR = 1.39; 95%CI：1.11-1.68; P <0.001）。那些在15岁或以下开始大麻的人比那些在15年后开始大麻的人（平均年数= 29.1，SD = 8.5;中位数年数= 27.8; HR = 1.40; 95%CI：1.06-1.84; P = 0.050）更早发生精神病（平均年数= 27.0，SD = 6.2;中位数年数= 26.9）。重要的是，使用高效大麻的受试者（臭鼬型）每天都有最早的发病（平均年数= 25.2，SD = 6.3;中位年数= 24.6）与所有受试组中从未使用者相比（HR = 1.99; 95%CI：1.50-2.65; P < .0001）;这些每日使用高效大麻的人比非大麻使用者平均早6年发病。结论：日常使用，特别是高效能大麻，促使大麻使用者精神病的早期发作。
Cannabis use is associated with an earlier age of onset of psychosis (AOP). However, the reasons for this remain debated. Methods: We applied a Cox proportional hazards model to 410 first-episode psychosis patients to investigate the association between gender, patterns of cannabis use, and AOP. Results: Patients with a history of cannabis use presented with their first episode of psychosis at a younger age (mean years = 28.2, SD = 8.0; median years = 27.1) than those who never used cannabis (mean years = 31.4, SD = 9.9; median years = 30.0; hazard ratio [HR] = 1.42; 95% CI: 1.16-1.74; P < .001). This association remained significant after controlling for gender (HR = 1.39; 95% CI: 1.11-1.68; P < .001). Those who had started cannabis at age 15 or younger had an earlier onset of psychosis (mean years = 27.0, SD = 6.2; median years = 26.9) than those who had started after 15 years (mean years = 29.1, SD = 8.5; median years = 27.8; HR = 1.40; 95% CI: 1.06-1.84; P = .050). Importantly, subjects who had been using high-potency cannabis (skunk-type) every day had the earliest onset (mean years = 25.2, SD = 6.3; median years = 24.6) compared to never users among all the groups tested (HR = 1.99; 95% CI: 1.50-2.65; P < .0001); these daily users of high-potency cannabis had an onset an average of 6 years earlier than that of non-cannabis users. Conclusions: Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users.