在接受大麻在人群中精神分裂症的病因学中起重要作用之前,需要更有力的证据。

F1000 medicine reports Pub Date : 2013-01-01 Epub Date: 2013-01-11 DOI:10.3410/M5-2
Suzanne H Gage, Stanley Zammit, Matthew Hickman
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引用次数: 51

摘要

精神分裂症是一种使人衰弱但人们知之甚少的疾病,已知的可改变的危险因素很少。大麻的使用可以急性诱发精神病,但其与精神分裂症的因果关系尚不清楚。纵向队列研究表明,大麻和精神病预后之间的联系不是偶然的或反向的因果关系。然而,这种关联可能是由于偏倚或残留混淆。需要能够更深入地检验不同解释的方法。这一点尤其重要,因为生态学研究发现,近几十年来大麻使用量的增加与精神病发病率之间几乎没有联系;公共卫生模型表明,为了预防一例精神分裂症,可能需要对成千上万的大麻使用者进行治疗和预防。我们认为,尽管存在这种不确定性,但仍有科学责任继续调查大麻在精神分裂症病因学中的作用,并且尚未制定将大麻暴露作为预防精神分裂症的关键目标的政策案例。然而,由于有其他证据表明使用大麻有害,这不应影响公众健康信息,即大麻可能有害,应预防大麻依赖。
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Stronger evidence is needed before accepting that cannabis plays an important role in the aetiology of schizophrenia in the population.

Schizophrenia is a debilitating but poorly understood condition with very few known modifiable risk factors. Cannabis use can acutely induce psychotic experiences, but its causal relationship to schizophrenia is less well understood. Longitudinal cohort studies suggest that the association between cannabis and psychotic outcomes is not due to chance or reverse causation. However, the association could be due to bias or residual confounding. Methods that can test alternative explanations in greater depth are required. This is especially important as ecological studies have found little association between the increase in cannabis use over recent decades and incidence of psychotic disorders; public health models suggest that cannabis use may need to be treated and prevented in many thousands of users in order to prevent one case of schizophrenia. We believe that, while such uncertainty exists, there is a scientific duty to continue to investigate the role of cannabis in the aetiology of schizophrenia and that the policy case for considering cannabis exposure as a critical target for preventing schizophrenia is yet to be made. However, due to other evidence of the harms of cannabis use, this should not affect the public health message that cannabis can be harmful and that cannabis dependence should be prevented.

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Cannabis and psychosis: what causes what? Stronger evidence is needed before accepting that cannabis plays an important role in the aetiology of schizophrenia in the population. Advances in lens implant technology. Polyclonal free light chains: a biomarker of inflammatory disease or treatment target? CORRIGENDUM TO: Neuromodulation for treatment-resistant depression
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