Kann Cannabis das Risiko für schizophrene Psychosen erhöhen?

H. Bugra; C. Rapp; E. Studerus; J. Aston; S. Borgwardt; A. Riecher-Rössler

doi:10.1055/s-0032-1325415

Fortschritte der Neurologie · Psychiatrie, Table of Contents

Fortschr Neurol Psychiatr 2012; 80(11): 635-643
DOI: 10.1055/s-0032-1325415

Übersicht

Kann Cannabis das Risiko für schizophrene Psychosen erhöhen?

Can Cannabis Use Increase the Risk for Schizophrenic Psychoses?

H. Bugra

¹Zentrum für Gender Research und Früherkennung, Universitäre Psychiatrische Kliniken, Universitätsspital Basel, Schweiz

,

C. Rapp

¹Zentrum für Gender Research und Früherkennung, Universitäre Psychiatrische Kliniken, Universitätsspital Basel, Schweiz

,

E. Studerus

¹Zentrum für Gender Research und Früherkennung, Universitäre Psychiatrische Kliniken, Universitätsspital Basel, Schweiz

,

J. Aston

¹Zentrum für Gender Research und Früherkennung, Universitäre Psychiatrische Kliniken, Universitätsspital Basel, Schweiz

,

S. Borgwardt

²Zentrum für Diagnostik und Krisenintervention, Universitäre Psychiatrische Kliniken, Universitätsspital Basel, Schweiz

,

A. Riecher-Rössler

¹Zentrum für Gender Research und Früherkennung, Universitäre Psychiatrische Kliniken, Universitätsspital Basel, Schweiz

› Author Affiliations

Abstract

Zusammenfassung

Hintergrund: Cannabis wurde in den letzten Jahren zunehmend als einer der wichtigsten umweltbezogenen Risikofaktoren für die Entstehung von schizophrenen Psychosen diskutiert. Dies ist hauptsächlich auf folgende Beobachtungen zurückzuführen: 1. Bei hohen Dosen kann Cannabis auch bei gesunden Personen vorübergehend akute psychotische Symptome auslösen. 2. Patienten mit schizophrenen Psychosen missbrauchen Cannabis deutlich häufiger als altersvergleichbare gesunde Kontrollpersonen.

Fragestellung: Es ist weiterhin umstritten, ob Cannabis kausal an der Entstehung von schizophrenen Psychosen beteiligt ist. In der vorliegenden Arbeit wurden deshalb die wichtigsten Evidenzen, die für oder gegen einen kausalen Zusammenhang zwischen Cannabiskonsum und Auslösung schizophrener Psychosen sprechen, gesichtet und kritisch überprüft.

Methodik: Systematische Literaturrecherche in den Datenbanken PubMed, ISI Web of Science und PsycINFO zu den Schlüsselwörtern cannabis, marijuana, THC, hashish, psychosis, schizophrenia.

Schlussfolgerungen: Es zeigte sich, dass ein kausaler Zusammenhang zwar nicht eindeutig belegbar, aber doch zumindest plausibel ist. Die Ergebnisse wiesen auch darauf hin, dass der Konsum von Cannabis insbesondere bei einem niedrigen Einstiegsalter das Risiko für schizophrene Psychosen erhöht.

Abstract

Background: In recent years, cannabis has been increasingly discussed as one of the most important environmental risk factors for developing schizophrenic psychoses. This is mainly due to the following observations. (i) Cannabis at high doses can cause acute transient psychotic symptoms even in healthy individuals. (ii) Patients with schizophrenia abuse cannabis more often than age-matched healthy controls.

Objectives: It is still controversial whether cannabis use can cause schizophrenic psychoses that would not have occurred otherwise. In our review, we have critically evaluated the evidence for a causal link between cannabis use and schizophrenic psychoses.

Methods: A systematic literature review in PubMed, ISI Web of Science and PsycINFO was carried out using the following keywords: cannabis, marijuana, THC, hashish, psychosis, schizophrenia.

Conclusions: We have concluded that although a causal relationship between cannabis use and schizophrenic psychoses cannot be definitely proven, the available evidence strongly supports its plausibility. Furthermore, the results of the review indicate that cannabis might cause psychosis especially in individuals with a predisposition for schizophrenia and in adolescents with an early onset of cannabis use.

Schlüsselwörter

Cannabis - Schizophrenie - Psychose - Kausalität - Review

Key words

cannabis - schizophrenia - psychosis - causal inference - review

Full Text

References

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