简介:最近的纵向研究指出,严重精神障碍(SMD)患者使用大麻与暴力之间存在正相关关系。然而,很少研究大麻使用频率/严重程度与暴力之间存在剂量-反应关系.因此,这项研究旨在确定这种关系是否存在于精神病人群中。方法:为此,共有98名门诊病人(男81名,女17名,年龄在18岁以上)的SMD被蒙特利尔大学研究所招募(蒙特利尔,加拿大)并包括在分析中。临床评价每3个月进行1年。物质使用,暴力行为,和潜在的协变量通过自我报告的评估,尿检,以及临床,罪犯,和警察记录。使用广义估计方程,大麻使用频率(非使用者,偶尔,常规,和频繁的用户)和暴力被调查,以及大麻使用的严重程度和暴力行为之间的联系。结果:发现大麻使用频率和严重程度是暴力行为的重要预测因素。调整时间后,年龄,性别,种族,诊断,冲动,使用酒精和兴奋剂,每个频率分布的比值比为1.91(p<0.001),大麻使用严重程度评分每增加1分(范围从0到79)为1.040(p<0.001).结论:尽管流失率很高,这些发现可能对临床医生有重要意义,因为大麻的使用可能会对精神病患者造成严重后果.然而,这种关联的潜在机制仍不清楚.
Introduction: Recent longitudinal studies point toward the existence of a positive relationship between cannabis use and violence in people with severe mental disorders (SMD). However, the existence of a dose-response relationship between the frequency/severity of cannabis use and violence has seldom been investigated. Therefore, this
study aims to determine if such a relationship exists in a psychiatric population. Methods: To do so, a total of 98 outpatients (81 males and 17 females, all over 18 years of age) with SMD were recruited at the Institut universitaire de santé mentale de Montréal (Montréal, Canada) and included in the analyses. Clinical evaluations were conducted every 3 months for a year. Substance use, violent behaviors, and potential covariables were assessed through self-reported assessments, urinary testing, as well as clinical, criminal, and police records. Using generalized estimating equations, the association between cannabis use frequency (nonusers, occasional, regular, and frequent users) and violence was investigated, as well as the association between the severity of cannabis use and violent behaviors. Results: It was found that cannabis use frequency and severity were significant predictors of violent behaviors. After adjustment for time, age, sex, ethnicity, diagnoses, impulsivity, and use of alcohol and stimulants, odds ratios were of 1.91 (p<0.001) between each frequency profile and 1.040 (p<0.001) for each increase of one point of the severity of cannabis use score (ranging from 0 to 79). Conclusions: Despite the high attrition rate, these findings may have important implications for clinicians as cannabis use may have serious consequences in psychiatric populations. Nevertheless, the mechanisms underlying this association remain unclear.