{"title":"成年纯大麻依赖者戒毒期间大麻-戒断综合征轨迹的探索性增长混合模型:两种亚型?","authors":"Benedikt Bernd Claus, Norbert Scherbaum, Michael Specka, Patrik Roser, Udo Bonnet","doi":"10.1080/02791072.2023.2229830","DOIUrl":null,"url":null,"abstract":"<p><p>As clinical studies about subtypes of the cannabis withdrawal syndrome (CWS) are scant, we performed a re-analysis of longitudinal data with German adult cannabis-users seeking inpatient cannabis detoxification-treatment. Sixty-seven cannabis-dependents without active comorbidity were included for growth-mixture-analysis (GMM) of their CWS-severity-trajectories during a scheduled 24-day detox-treatment. As of treatment-day 12, thirty-six (53.7%) of 67 patients were discharged after successful detoxification. This led to artificial imputations for I-GMM. Therefore, we preferred the results of the GMM including raw data-only (R-GMM). By both, I-GMM and R-GMM, we found two classes of CWS severity time-courses. Class one (<i>n</i> = 44, R-GMM) showed a continuously decreasing CWS-severity; class two (<i>n</i> = 23, R-GMM) exhibited a sharp peak (generally between days 2-6 post-cessation). A short inpatient treatment-period and low urinary 11-nor-9-carboxy-Δ<sup>9</sup> -tetrahydrocannabinol-level upon admission predicted the peaking trajectory of R-GMM-class-two-CWS. Withdrawal syndrome medication (PRN), comorbidity, cannabis-history data and gender balance were not significantly different between the CWS-classes. Although possibly confounded by PRN-medication, this exploratory study supports the presence of two CWS-variants in adult cannabis-dependents, characterized by a slowly decreasing (\"protracted\") slope (class one) or a clear crescendo-decrescendo trajectory (class two). The latter was associated with a significantly shorter inpatient detoxification period and lower urinary THC-COOH-levels at admission.</p>","PeriodicalId":16902,"journal":{"name":"Journal of psychoactive drugs","volume":" ","pages":"551-562"},"PeriodicalIF":2.1000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Exploratory Growth Mixture Modeling of Cannabis-Withdrawal Syndrome Trajectories of Adult Pure Cannabis Dependents During Detoxification: Two Subtypes?\",\"authors\":\"Benedikt Bernd Claus, Norbert Scherbaum, Michael Specka, Patrik Roser, Udo Bonnet\",\"doi\":\"10.1080/02791072.2023.2229830\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>As clinical studies about subtypes of the cannabis withdrawal syndrome (CWS) are scant, we performed a re-analysis of longitudinal data with German adult cannabis-users seeking inpatient cannabis detoxification-treatment. Sixty-seven cannabis-dependents without active comorbidity were included for growth-mixture-analysis (GMM) of their CWS-severity-trajectories during a scheduled 24-day detox-treatment. As of treatment-day 12, thirty-six (53.7%) of 67 patients were discharged after successful detoxification. This led to artificial imputations for I-GMM. Therefore, we preferred the results of the GMM including raw data-only (R-GMM). By both, I-GMM and R-GMM, we found two classes of CWS severity time-courses. Class one (<i>n</i> = 44, R-GMM) showed a continuously decreasing CWS-severity; class two (<i>n</i> = 23, R-GMM) exhibited a sharp peak (generally between days 2-6 post-cessation). A short inpatient treatment-period and low urinary 11-nor-9-carboxy-Δ<sup>9</sup> -tetrahydrocannabinol-level upon admission predicted the peaking trajectory of R-GMM-class-two-CWS. Withdrawal syndrome medication (PRN), comorbidity, cannabis-history data and gender balance were not significantly different between the CWS-classes. Although possibly confounded by PRN-medication, this exploratory study supports the presence of two CWS-variants in adult cannabis-dependents, characterized by a slowly decreasing (\\\"protracted\\\") slope (class one) or a clear crescendo-decrescendo trajectory (class two). The latter was associated with a significantly shorter inpatient detoxification period and lower urinary THC-COOH-levels at admission.</p>\",\"PeriodicalId\":16902,\"journal\":{\"name\":\"Journal of psychoactive drugs\",\"volume\":\" \",\"pages\":\"551-562\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of psychoactive drugs\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/02791072.2023.2229830\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/7/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHOLOGY, CLINICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of psychoactive drugs","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/02791072.2023.2229830","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}
Exploratory Growth Mixture Modeling of Cannabis-Withdrawal Syndrome Trajectories of Adult Pure Cannabis Dependents During Detoxification: Two Subtypes?
As clinical studies about subtypes of the cannabis withdrawal syndrome (CWS) are scant, we performed a re-analysis of longitudinal data with German adult cannabis-users seeking inpatient cannabis detoxification-treatment. Sixty-seven cannabis-dependents without active comorbidity were included for growth-mixture-analysis (GMM) of their CWS-severity-trajectories during a scheduled 24-day detox-treatment. As of treatment-day 12, thirty-six (53.7%) of 67 patients were discharged after successful detoxification. This led to artificial imputations for I-GMM. Therefore, we preferred the results of the GMM including raw data-only (R-GMM). By both, I-GMM and R-GMM, we found two classes of CWS severity time-courses. Class one (n = 44, R-GMM) showed a continuously decreasing CWS-severity; class two (n = 23, R-GMM) exhibited a sharp peak (generally between days 2-6 post-cessation). A short inpatient treatment-period and low urinary 11-nor-9-carboxy-Δ9 -tetrahydrocannabinol-level upon admission predicted the peaking trajectory of R-GMM-class-two-CWS. Withdrawal syndrome medication (PRN), comorbidity, cannabis-history data and gender balance were not significantly different between the CWS-classes. Although possibly confounded by PRN-medication, this exploratory study supports the presence of two CWS-variants in adult cannabis-dependents, characterized by a slowly decreasing ("protracted") slope (class one) or a clear crescendo-decrescendo trajectory (class two). The latter was associated with a significantly shorter inpatient detoxification period and lower urinary THC-COOH-levels at admission.