Absetzen von Cannabis nach Erstpsychose verbessert das funktionelle Langzeitoutcome und reduziert Negativsymptome, während fortgesetzter Konsum mit schlechterem Verlauf assoziiert ist.
Zusammenfassung
Prospektive 8-Jahres-Kohorte (n=92) nach erster Psychoseepisode; Patienten die Cannabis aufhörten (CUS, n=27) zeigten besseres funktionelles Langzeitergebnis vs. Weiterkonsumenten (CU, n=25): Effektgröße=1.26 (95% CI 0.65-1.86) und weniger Negativsymptome (Effektgröße=-0.72, 95% CI -1.27 bis -0.14). Cannabis-Stopp nach Erstpsychose → klar verbesserter Langzeitverlauf.
P
PopulationPatienten mit erstmaliger Psychose-Hospitalisation, n=92; unterteilt in: kontinuierliche Cannabisnutzer (CU, n=25), ehemalige Cannabisnutzer die aufhörten (CUS, n=27) und Nie-Nutzer (NU, n=40)
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InterventionFortgeführter Cannabiskonsum (CU) vs. Abbruch des Cannabiskonsums nach erster Psychose (CUS)
C
KontrollePatienten ohne Cannabiskonsum (NU) sowie Vergleich CU vs. CUS untereinander
O
OutcomeCUS-Gruppe zeigte signifikant besseres funktionelles Langzeitoutcome vs. CU und NU (Effektstärke 1,26; 95%-KI 0,65–1,86) sowie weniger Negativsymptome vs. CU (Effektstärke −0,72; 95%-KI −1,27 bis −0,14)
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Autoren
González-Pinto A, Alberich S, Barbeito S, Gutierrez M, Vega P, Ibáñez B, Haidar MK, Vieta E, Arango C.
<h4>Objective</h4>To examine the influence of cannabis use on long-term outcome in patients with a first psychotic episode, comparing patients who have never used cannabis with (a) those who used cannabis before the first episode but stopped using it during follow-up and (b) those who used cannabis both before the first episode and during follow-up.<h4>Methods</h4>Patients were studied following their first admission for psychosis. They were interviewed at years 1, 3, and 5. At follow-up after 8 years, functional outcome and alcohol and drug abuse were recorded. Patients were classified according to cannabis use: 25 had cannabis use before their first psychotic episode and continuous use during follow-up (CU), 27 had cannabis use before their first episode but stopped its use during follow-up (CUS), and 40 never used cannabis (NU).<h4>Results</h4>The 3 groups did not differ significantly in symptoms or functional outcome at baseline or during short-term follow-up. The CUS group exhibited better long-term functional outcome compared with the other 2 groups and had fewer negative symptoms than the CU group, after adjusting for potential confounders. For the CUS group, the effect size was 1.26 (95% confidence interval [CI]=0.65 to 1.86) for functional outcome and -0.72 (95% CI=-1.27 to -0.14) for negative symptoms. All patients experienced improvements in positive symptoms during long-term follow-up.<h4>Conclusion</h4>Cannabis has a deleterious effect, but stopping use after the first psychotic episode contributes to a clear improvement in outcome. The positive effects of stopping cannabis use can be seen more clearly in the long term.