Recommendations for Reducing the Risk of Cannabis Use-Related Adverse Psychosis Outcomes: A Public Mental Health-Oriented Evidence Review.

IF 1.5 4区医学 Q3 PSYCHIATRY

Journal of Dual Diagnosis Pub Date : 2023-04-01 Epub Date: 2023-07-14 DOI:10.1080/15504263.2023.2226588

Benedikt Fischer, Wayne Hall, Thiago M Fidalgo, Eva Hoch, Bernard Le Foll, Maria-Elena Medina-Mora, Jens Reimer, Philip G Tibbo, Didier Jutras-Aswad

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引用次数: 1

Abstract

Objective: Cannabis use is increasingly normalized; psychosis is a major adverse health outcome. We reviewed evidence on cannabis use-related risk factors for psychosis outcomes at different stages toward recommendations for risk reduction by individuals involved in cannabis use. Methods: We searched primary databases for pertinent literature/data 2016 onward, principally relying on reviews and high-quality studies which were narratively summarized and quality-graded; recommendations were developed by international expert consensus. Results: Genetic risks, and mental health/substance use problem histories elevate the risks for cannabis-related psychosis. Early age-of-use-onset, frequency-of-use, product composition (i.e., THC potency), use mode and other substance co-use all influence psychosis risks; the protective effects of CBD are uncertain. Continuous cannabis use may adversely affect psychosis-related treatment and medication effects. Risk factor combinations further amplify the odds of adverse psychosis outcomes. Conclusions: Reductions in the identified cannabis-related risks factors-short of abstinence-may decrease risks of related adverse psychosis outcomes, and thereby protect cannabis users' health.

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降低大麻使用相关不良精神病后果风险的建议：以公共心理健康为导向的证据审查。

目标：大麻的使用日益正常化；精神病是一种严重的不良健康后果。我们审查了不同阶段与大麻使用相关的精神病后果风险因素的证据，以建议参与大麻使用的个人降低风险。方法：我们在主要数据库中搜索2016年以后的相关文献/数据，主要依靠叙述性总结和质量分级的综述和高质量研究；建议是由国际专家协商一致提出的。结果：遗传风险和心理健康/药物使用问题史增加了大麻相关精神病的风险。早期使用年龄、使用频率、产品成分（即四氢大麻酚效力）、使用模式和其他物质共同使用都会影响精神病风险；CBD的保护作用尚不确定。持续使用大麻可能对精神病相关治疗和药物效果产生不利影响。危险因素组合进一步增加了不良精神病结果的几率。结论：减少未戒除的已确定的大麻相关风险因素可能会降低相关不良精神病后果的风险，从而保护大麻使用者的健康。

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来源期刊

Journal of Dual Diagnosis Multiple-

CiteScore

4.90

自引率

13.60%

发文量

期刊介绍： Journal of Dual Diagnosis is a quarterly, international publication that focuses on the full spectrum of complexities regarding dual diagnosis. The co-occurrence of mental health and substance use disorders, or “dual diagnosis,” is one of the quintessential issues in behavioral health. Why do such high rates of co-occurrence exist? What does it tell us about risk profiles? How do these linked disorders affect people, their families, and the communities in which they live? What are the natural paths to recovery? What specific treatments are most helpful and how can new ones be developed? How can we enhance the implementation of evidence-based practices at clinical, administrative, and policy levels? How can we help clients to learn active recovery skills and adopt needed supports, clinicians to master new interventions, programs to implement effective services, and communities to foster healthy adjustment? The Journal addresses each of these perplexing challenges.