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{"title":"Cannabis and Cannabinoids in Mood and Anxiety Disorders: Impact on Illness Onset and Course, and Assessment of Therapeutic Potential.","authors":"Sabrina L Botsford, Sharon Yang, Tony P George","doi":"10.1176/appi.focus.25023010","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and objectives: </strong>Cannabis use is common in people with and mood and anxiety disorders (ADs), and rates of problematic use are higher than in the general population. Given recent policy changes in favor of cannabis legalization, it is important to understand how cannabis and cannabinoids may impact people with these disorders. We aimed to assess the effects of cannabis on the onset and course of depression, bipolar disorder, ADs, and post-traumatic stress disorder (PTSD), and also to explore the therapeutic potential of cannabis and cannabinoids for these disorders.</p><p><strong>Methods: </strong>A systematic review of the literature was completed. The PubMed® database from January 1990 to May 2018 was searched. We included longitudinal cohort studies, and also all studies using cannabis or a cannabinoid as an active intervention, regardless of the study design.</p><p><strong>Results: </strong>Forty-seven studies were included: 32 reported on illness onset, nine on illness course, and six on cannabinoid therapeutics. Cohort studies varied significantly in design and quality. The literature suggests that cannabis use is linked to the onset and poorer clinical course in bipolar disorder and PTSD, but this finding is not as clear in depression and anxiety disorders (ADs). There have been few high-quality studies of cannabinoid pharmaceuticals in clinical settings.</p><p><strong>Conclusions and scientific significance: </strong>These conclusions are limited by a lack of well-controlled longitudinal studies. We suggest that future research be directed toward high-quality, prospective studies of cannabis in clinical populations with mood and ADs, in addition to controlled studies of cannabinoid constituents and pharmaceuticals in these populations.Reprinted from <i>Am J Addict 2020; 29:9-26</i>, with permission from American Academy of Addiction Psychiatry. Copyright © 2019.</p>","PeriodicalId":73036,"journal":{"name":"Focus (American Psychiatric Publishing)","volume":"23 2","pages":"239-256"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995907/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Focus (American Psychiatric Publishing)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1176/appi.focus.25023010","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/15 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Background and objectives: Cannabis use is common in people with and mood and anxiety disorders (ADs), and rates of problematic use are higher than in the general population. Given recent policy changes in favor of cannabis legalization, it is important to understand how cannabis and cannabinoids may impact people with these disorders. We aimed to assess the effects of cannabis on the onset and course of depression, bipolar disorder, ADs, and post-traumatic stress disorder (PTSD), and also to explore the therapeutic potential of cannabis and cannabinoids for these disorders.
Methods: A systematic review of the literature was completed. The PubMed® database from January 1990 to May 2018 was searched. We included longitudinal cohort studies, and also all studies using cannabis or a cannabinoid as an active intervention, regardless of the study design.
Results: Forty-seven studies were included: 32 reported on illness onset, nine on illness course, and six on cannabinoid therapeutics. Cohort studies varied significantly in design and quality. The literature suggests that cannabis use is linked to the onset and poorer clinical course in bipolar disorder and PTSD, but this finding is not as clear in depression and anxiety disorders (ADs). There have been few high-quality studies of cannabinoid pharmaceuticals in clinical settings.
Conclusions and scientific significance: These conclusions are limited by a lack of well-controlled longitudinal studies. We suggest that future research be directed toward high-quality, prospective studies of cannabis in clinical populations with mood and ADs, in addition to controlled studies of cannabinoid constituents and pharmaceuticals in these populations.Reprinted from Am J Addict 2020; 29:9-26 , with permission from American Academy of Addiction Psychiatry. Copyright © 2019.
大麻和大麻素在情绪和焦虑障碍:对疾病发病和病程的影响,以及治疗潜力的评估。
背景和目的:大麻使用在患有情绪和焦虑障碍(ad)的人群中很常见,并且有问题的使用率高于一般人群。鉴于最近有利于大麻合法化的政策变化,了解大麻和大麻素如何影响这些疾病患者是很重要的。我们的目的是评估大麻对抑郁症、双相情感障碍、ad和创伤后应激障碍(PTSD)的发病和病程的影响,并探索大麻和大麻素对这些疾病的治疗潜力。方法:对相关文献进行系统回顾。检索1990年1月至2018年5月的PubMed®数据库。我们纳入了纵向队列研究,以及所有使用大麻或大麻素作为积极干预的研究,无论研究设计如何。结果:纳入47项研究:32项关于发病,9项关于病程,6项关于大麻素治疗。队列研究在设计和质量上存在显著差异。文献表明,大麻的使用与双相情感障碍和创伤后应激障碍的发病和较差的临床病程有关,但这一发现在抑郁症和焦虑症(ADs)中并不明显。在临床环境中,大麻素药物的高质量研究很少。结论和科学意义:这些结论受到缺乏良好控制的纵向研究的限制。我们建议,除了大麻素成分和药物在这些人群中的对照研究外,未来的研究还应针对大麻在患有情绪和ad的临床人群中的高质量、前瞻性研究。转载自Am J Addict 2020;29:9-26,得到了美国成瘾精神病学学会的许可。版权所有©2019。
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