4 de outubro de 2024

Cannabis Use and Earlier Onset of Psychosis A Systematic Meta-analysis

7 de junho de 20114min18

Caros
Vejam esse artigo que acaba de sair no Archives of General Psychiatry que mostra, através de uma metanalise, a relação do uso de maconha e começo precoce de psicose.

Archives on General Psichiatry – Online First

Matthew Large, BSc(Med), MBBS, FRANZCP; Swapnil Sharma, MBBS, FRANZCP; Michael T. Compton, MD, MPH; Tim Slade, PhD; Olav Nielssen, MBBS, MCrim, FRANZCP
Arch Gen Psychiatry. 2011;68(6):555-561. doi:10.1001/archgenpsychiatry.2011.5

Context  A number of studies have found that the use of cannabis and other psychoactive substances is associated with an earlier onset of psychotic illness.

Objective  To establish the extent to which use of cannabis, alcohol, and other psychoactive substances affects the age at onset of psychosis by meta-analysis.

Data Sources  Peer-reviewed publications in English reporting age at onset of psychotic illness in substance-using and non–substance-using groups were located using searches of CINAHL, EMBASE, MEDLINE, PsycINFO, and ISI Web of Science.

Study Selection  Studies in English comparing the age at onset of psychosis in cohorts of patients who use substances with age at onset of psychosis in non–substance-using patients. The searches yielded 443 articles, from which 83 studies met the inclusion criteria.

Data Extraction  Information on study design, study population, and effect size were extracted independently by 2 of us.

Data Synthesis  Meta-analysis found that the age at onset of psychosis for cannabis users was 2.70 years younger (standardized mean difference = –0.414) than for nonusers; for those with broadly defined substance use, the age at onset of psychosis was 2.00 years younger (standardized mean difference = –0.315) than for nonusers. Alcohol use was not associated with a significantly earlier age at onset of psychosis. Differences in the proportion of cannabis users in the substance-using group made a significant contribution to the heterogeneity in the effect sizes between studies, confirming an association between cannabis use and earlier mean age at onset of psychotic illness.

Conclusions  The results of meta-analysis provide evidence for a relationship between cannabis use and earlier onset of psychotic illness, and they support the hypothesis that cannabis use plays a causal role in the development of psychosis in some patients. The results suggest the need for renewed warnings about the potentially harmful effects of cannabis.

Author Affiliations: Mental Health Service, Prince of Wales Hospital (Drs Large and Sharma), and School of Psychiatry (Drs Large and Sharma), Clinical Research Unit for Anxiety and Depression, School of Psychiatry (Dr Nielssen), and National Drug and Alcohol Research Centre (Dr Slade), University of New South Wales, Sydney, Australia; and Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia (Dr Compton). Dr Compton is now with the Department of Psychiatry and Behavioral Sciences, The George Washington University School of Medicine and Health Sciences, Washington, DC.

Metanalise-maco_e_Psicose.pdf


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A Unidade de Pesquisa em álcool e Drogas (UNIAD) foi fundada em 1994 pelo Prof. Dr. Ronaldo Laranjeira e John Dunn, recém-chegados da Inglaterra. A criação contou, na época, com o apoio do Departamento de Psiquiatria da UNIFESP. Inicialmente (1994-1996) funcionou dentro do Complexo Hospital São Paulo, com o objetivo de atender funcionários dependentes.



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