Abstract

Objective: Cannabis use is increasingly normalized; psychosis is a major adverse health outcome. We reviewed evidence on cannabis use-related risk factors for psychosis outcomes at different stages toward recommendations for risk reduction by individuals involved in cannabis use. Methods: We searched primary databases for pertinent literature/data 2016 onward, principally relying on reviews and high-quality studies which were narratively summarized and quality-graded; recommendations were developed by international expert consensus. Results: Genetic risks, and mental health/substance use problem histories elevate the risks for cannabis-related psychosis. Early age-of-use-onset, frequency-of-use, product composition (i.e., THC potency), use mode and other substance co-use all influence psychosis risks; the protective effects of CBD are uncertain. Continuous cannabis use may adversely affect psychosis-related treatment and medication effects. Risk factor combinations further amplify the odds of adverse psychosis outcomes. Conclusions: Reductions in the identified cannabis-related risks factors—short of abstinence—may decrease risks of related adverse psychosis outcomes, and thereby protect cannabis users’ health.

摘要

目标：大麻的使用日益正常化；精神病是一种主要的不良健康后果。我们审查了不同阶段与大麻使用相关的精神病结果风险因素的证据，以提出有关大麻使用个人降低风险的建议。方法：我们在主要数据库中检索了 2016 年以来的相关文献/数据，主要依靠评论和高质量的研究，这些研究经过叙述性总结和质量分级；建议是由国际专家共识制定的。结果：遗传风险和心理健康/药物使用问题史会增加大麻相关精神病的风险。早期使用年龄、使用频率、产品成分（即 THC 效力）、使用模式和其他物质的共同使用都会影响精神病风险；CBD 的保护作用尚不确定。持续使用大麻可能会对精神病相关的治疗和药物效果产生不利影响。危险因素组合进一步放大了不良精神病结果的可能性。结论：减少已确定的大麻相关风险因素（不包括戒烟）可能会降低相关不良精神病结果的风险，从而保护大麻使用者的健康。