Cannabis use in first episode psychosis: Meta-analysis of prevalence, and the time course of initiation and continued use.
Myles et al.·The Australian and New Zealand journal of psychiatryImpact 2.7
UnklarGRADEHoch150 Zitate
Stichprobek = 37 Studien
DauerOktober 2014…
EndpunktPrävalenz Cannabis-Konsum bei…
Verblindungunklar
DesignMeta-Analyse
”Kernaussage
Meta-Analyse zeigt: Cannabis-Initiation durchschnittlich 6,3 Jahre vor Psychose-Onset; Prävalenz bei First Episode Psychosis 33,7%; nach Behandlung reduziertes Risiko für fortgesetzte Cannabis-Nutzung (OR 0,56).
Zusammenfassung
Meta-Analyse über k=37 Beobachtungsstudien zu Cannabis-Konsum bei Erstmanifestation von Psychose. Intervall zwischen Beginn regelmäßigen Cannabis-Konsums und Psychose-Onset: 6,3 Jahre (SMD=1,56; 95% CI: 1,40–1,72). Prävalenz aktuellen Cannabis-Konsums bei Erstmanifestation: 33,7% (95% CI: 31–39%). Odds für anhaltenden Konsum 6 Monate bis 10 Jahre nach Erstmanifestation: OR=0,56 (95% CI: 0,40–0,79).
P
PopulationPersonen mit erstmaliger Psychose (First Episode Psychosis), gepoolte Stichprobe aus 37 Samples
I
InterventionCannabiskonsum (Prävalenz, Beginn und Fortführung des Konsums)
O
OutcomeGepooltes Intervall zwischen Beginn des Cannabiskonsums und Psychosebeginn: 6,3 Jahre (SMD=1,56; 95% KI [1,40–1,72]); Prävalenz des Cannabiskonsums bei Erstpsychose: 33,7% (95% KI [31%–39%]); Odds der Konsumfortführung nach Behandlung: OR=0,56 (95% KI [0,40–0,79])
Vertrauen in die Evidenz
Sehr niedrigNiedrigModeratHoch
Hoch
Höchste von vier GRADE-Stufen, die Effektschätzung ist sehr verlässlich.
Objectives: Cannabis use is prevalent among people with first episode psychosis and the epidemiology of its use in early psychosis is unclear. We performed a meta-analysis of observational studies to determine; (1) the interval between age at initiation of cannabis use and age at onset of first episode psychosis, (2) the prevalence of cannabis use at time of first episode psychosis, and (3) the odds of continuing cannabis following treatment for first episode psychosis.
Data Sources: Search of electronic databases MEDLINE, EMBASE, PsycINFO, Web of Science and CINAHL for English-language papers using search terms (psychosis OR schizophrenia) AND (cannabis OR Cannabis) IN (title OR keyword OR abstract), current to October 2014.
Study Selection: Studies were included if they reported on prevalence of current cannabis use in first episode psychosis cohorts. A total of 37 samples were included for meta-analysis.
Data Extraction: Rates of cannabis use in each sample were extracted to determine prevalence estimates. The age at initiation of regular cannabis and age at onset of psychosis were used to determine the length of cannabis use preceding psychosis. Prevalence estimates at first episode psychosis and various time points of follow-up following first episode psychosis were analysed to determine odds ratio of continuing cannabis use. Data synthesis was performed using random-effects meta-analyses.
Results: The pooled estimate for the interval between initiation of regular cannabis use and age at onset of psychosis was 6.3 years (10 samples, standardised mean difference = 1.56, 95% confidence interval = [1.40, 1.72]). The estimated prevalence of cannabis use at first episode psychosis was 33.7% (35 samples, 95% confidence interval = [31%, 39%]). Odds of continued cannabis use between 6 months and 10 years following first episode psychosis was 0.56 (19 samples, 95% confidence interval = [0.40, 0.79]).