PLOS ONE2013-10-29 12:34 AM

Quantifying the Clinical Significance of Cannabis Withdrawal 量化大麻戒断的临床意义

Abstract Background and Aims Questions over the clinical significance of cannabis withdrawal have hindered its inclusion as a discrete cannabis induced psychiatric condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM IV). This study aims to quantify functional impairment to normal daily activities from cannabis withdrawal, and looks at the factors predicting functional impairment. In addition the study tests the influence of functional impairment from cannabis withdrawal on cannabis use during and after an abstinence attempt. 背景和目的 关于大麻戒断的临床意义的争议使它无法作为一个单独由大麻诱发而导致精神疾病的案例而被列入精神疾病诊断和统计手册中(DSMIV)。 本研究旨在量化大麻戒断对正常日常活动的功能性损害,并且探寻那些能预示功能性损害的因素。此外,该研究测试了在一次大麻戒瘾尝试期间和之后,大麻戒断对功能性损害的影响。 Methods and Results A volunteer sample of 49 non-treatment seeking cannabis users who met DSM-IV criteria for dependence provided daily withdrawal-related functional impairment scores during a one-week baseline phase and two weeks of monitored abstinence from cannabis with a one month follow up. Functional impairment from withdrawal symptoms was strongly associated with symptom severity (p = 0.0001). Participants with more severe cannabis dependence before the abstinence attempt reported greater functional impairment from cannabis withdrawal (p = 0.03). Relapse to cannabis use during the abstinence period was associated with greater functional impairment from a subset of withdrawal symptoms in high dependence users. Higher levels of functional impairment during the abstinence attempt predicted higher levels of cannabis use at one month follow up (p = 0.001). 方法和结果 由49个符合DSM-IV标准的非寻求治疗的大麻使用者志愿组成了非独立样本。按一个星期作为基础期和两个星期作为监测中的大麻戒断期这样的实验安排,这些志愿者在接下来的一个月间每天给出一个与大麻隔断相关的功能性损害的分数。戒断症状引起的功能性损害与症状严重程度紧密相关(P=0.0001)。较严重依赖大麻的参与者在戒瘾尝试前汇报有更强烈的大麻戒断的功能性损害(P=0.03)。在戒瘾期间复吸大麻与高依赖吸食者一系列戒断症状中更严重的功能性损害有关。在戒瘾期间更高程度的功能性损害预示了在接下来一个月期间更高程度的大麻使用量。 Conclusions Cannabis withdrawal is clinically significant because it is associated with functional impairment to normal daily activities, as well as relapse to cannabis use. Sample size in the relapse group was small and the use of a non-treatment seeking population requires findings to be replicated in clinical samples. Tailoring treatments to target withdrawal symptoms contributing to functional impairment during a quit attempt may improve treatment outcomes. 结论 大麻戒断的临床意义重大因为它和正常日常活动的功能性损害以及大麻复吸相关。复吸组的样本规模很小且对非治疗需求人口数的使用要求这种发现可以在临床样本中具有复制性。针对在戒瘾尝试中加强功能性损害的目标戒断症状的特定治疗也许能改善治疗效果。

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