Abundant literature suggests the hypothesis that cannabis use leads to the onset of psychotic symptoms. However, the nature of the association and the causal link remain controversial. This review aims to identify the...Abundant literature suggests the hypothesis that cannabis use leads to the onset of psychotic symptoms. However, the nature of the association and the causal link remain controversial. This review aims to identify the risk factors involved in the etiopathogenesis of psychosis or psychotic features. Our electronic search found 1653 studies published until March 1<sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2020. Longitudinal studies and literature reviews were selected if they addressed specifically the issues of the cannabis/psychosis relationship and the eventual risk factors involved. Our systematic review identified six potential risk factors involved in the association. They are, in decreasing importance, the dose-response relationship (quantity, frequency and duration of cannabis use), the early age of cannabis consumption, genetic susceptibility, childhood trauma, cigarette smoking and urban environment. In contrast, a significant inverse relationship exists between cannabidiol (CBD) and psychosis: cannabidiol is associated with less psychotic symptoms and manifests antipsychotic properties. Further studies are needed to establish a clear causal relationship between cannabis and psychosis and to identify the qualitative and quantitative contribution of specific risk factors on its onset and sustainability.</span>展开更多
AIM: To explore the way in which Latin American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication.METHODS: This was a descriptive, cross sectional study that ...AIM: To explore the way in which Latin American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication.METHODS: This was a descriptive, cross sectional study that surveyed Latin-American physicians to evaluate differences between groups divided in three main sections. The first section included demographic and professional data. The second section asked about the available medical resources: weighing scales, sphygmomanometer and measuring tape. Finally, the third section aimed at looking into the attitudes towards car-diovascular prevention. The latter was also divided into two subsections. In the first one, the questions were about weight, blood pressure and waist perimeter. In the second subsection the questions asked about the proportion of patients:(1) that suffered from overweight and/or obesity;(2) whose lipids and glycemia were controlled by the physician;(3) that were questioned by, and received information from the physician about smoking; and(4) that received recommendations from the physician to engage in regular physical activity. The participants were physicians, users of the medical website Intramed. The visitors were recruited by a banner that invited them to voluntarily access an online self-reported structured questionnaire with multiple options. RESULTS: We surveyed 1185 general physicians and 792 psychiatrists. Regarding basic medical resources, a significantly higher proportion of general physicians claimed to have weighing scales(χ2 = 404.9; P < 0.001), sphygmomanometers(χ2 = 419.3; P < 0.001), and measuring tapes(χ2 = 336.5; P < 0.001). While general physicians measured overweight and metabolic indexes in the general population in a higher proportion than in patients treated with antipsychotics(Z =-11.91; P < 0.001), psychiatrists claimed to measure them in patients medicated with antipsychotics in a higher proportion than in the general population(Z =-3.26; P < 0.001). Also general physicians tended to evaluate smoking habits in the general population more than psychiatrists(Z =-7.02; P < 0.001), but psychiatrists evaluated smoking habits in patients medicated with antipsychotics more than general physicians did(Z =-2.25; P = 0.024). General physicians showed a significantly higher tendency to control blood pressure(χ2 = 334.987; P < 0.001), weight(χ2 = 435.636; P < 0.001) and waist perimeter(χ2 = 96.52; P < 0.001) themselves and they did so in all patients. General physicians suggested physical activity to all patients morefrequently(Z =-2.23; P = 0.026), but psychiatrists recommended physical activity to patients medicated with antipsychotics more frequently(Z =-7.53; P < 0.001). CONCLUSION: Psychiatrists usually check vascular risk factors in their patients, especially in those taking antipsychotics. General practitioners check them routinely without paying special attention to this population.展开更多
目的:探讨农村社区中精神分裂症患者犯罪行为的发生率及其相关因素。方法:对成都市新津县农村社区中510例精神分裂症患者的犯罪行为及其临床症状、社会功能、治疗、照管等情况进行了14年(1994-2008年)的随访调查。调查工具包括精神现况...目的:探讨农村社区中精神分裂症患者犯罪行为的发生率及其相关因素。方法:对成都市新津县农村社区中510例精神分裂症患者的犯罪行为及其临床症状、社会功能、治疗、照管等情况进行了14年(1994-2008年)的随访调查。调查工具包括精神现况检查第9版(Present State Examination,PSE-9)、社会功能缺陷筛查表(Social Disability Screening Schedule,SDSS),以及阳性与阴性症状量表(Positive and Negative Syndrome,PANSS)等。结果:在14年的随访调查中有489例患者(95.9%)完成了随访。随访患者终身犯罪行为的发生率为13.5%。犯罪行为在未婚(19.1%)、较年轻[平均年龄(41.2±16.6)岁]、发病年龄较早的精神分裂症患者[平均发病年龄(28.4±10.4)岁]中较常发生。随访资料中,患者家庭经济状况较差(16.6%)、缺乏监护照管人(28.6%)、无家可归(25.0%),及PANSS总分(68.7±28.7)和阳性(14.1±7.4)、阴性(19.3±10.2)分较高的患者中犯罪行为的发生率较高(P<0.05)。结论:精神分裂症患者的犯罪行为在农村社区中较为常见,其影响因素是多方面的。在制定社区精神卫生服务政策、提供精神卫生服务及家庭干预时,应考虑社区中精神分裂症患者的犯罪行为及其危险因素(如患者的婚姻、家庭及监护照管状态、社会支持系统等)。展开更多
文摘Abundant literature suggests the hypothesis that cannabis use leads to the onset of psychotic symptoms. However, the nature of the association and the causal link remain controversial. This review aims to identify the risk factors involved in the etiopathogenesis of psychosis or psychotic features. Our electronic search found 1653 studies published until March 1<sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> 2020. Longitudinal studies and literature reviews were selected if they addressed specifically the issues of the cannabis/psychosis relationship and the eventual risk factors involved. Our systematic review identified six potential risk factors involved in the association. They are, in decreasing importance, the dose-response relationship (quantity, frequency and duration of cannabis use), the early age of cannabis consumption, genetic susceptibility, childhood trauma, cigarette smoking and urban environment. In contrast, a significant inverse relationship exists between cannabidiol (CBD) and psychosis: cannabidiol is associated with less psychotic symptoms and manifests antipsychotic properties. Further studies are needed to establish a clear causal relationship between cannabis and psychosis and to identify the qualitative and quantitative contribution of specific risk factors on its onset and sustainability.</span>
文摘AIM: To explore the way in which Latin American psychiatrists approach the screening of vascular risk factors in patients receiving antipsychotic medication.METHODS: This was a descriptive, cross sectional study that surveyed Latin-American physicians to evaluate differences between groups divided in three main sections. The first section included demographic and professional data. The second section asked about the available medical resources: weighing scales, sphygmomanometer and measuring tape. Finally, the third section aimed at looking into the attitudes towards car-diovascular prevention. The latter was also divided into two subsections. In the first one, the questions were about weight, blood pressure and waist perimeter. In the second subsection the questions asked about the proportion of patients:(1) that suffered from overweight and/or obesity;(2) whose lipids and glycemia were controlled by the physician;(3) that were questioned by, and received information from the physician about smoking; and(4) that received recommendations from the physician to engage in regular physical activity. The participants were physicians, users of the medical website Intramed. The visitors were recruited by a banner that invited them to voluntarily access an online self-reported structured questionnaire with multiple options. RESULTS: We surveyed 1185 general physicians and 792 psychiatrists. Regarding basic medical resources, a significantly higher proportion of general physicians claimed to have weighing scales(χ2 = 404.9; P < 0.001), sphygmomanometers(χ2 = 419.3; P < 0.001), and measuring tapes(χ2 = 336.5; P < 0.001). While general physicians measured overweight and metabolic indexes in the general population in a higher proportion than in patients treated with antipsychotics(Z =-11.91; P < 0.001), psychiatrists claimed to measure them in patients medicated with antipsychotics in a higher proportion than in the general population(Z =-3.26; P < 0.001). Also general physicians tended to evaluate smoking habits in the general population more than psychiatrists(Z =-7.02; P < 0.001), but psychiatrists evaluated smoking habits in patients medicated with antipsychotics more than general physicians did(Z =-2.25; P = 0.024). General physicians showed a significantly higher tendency to control blood pressure(χ2 = 334.987; P < 0.001), weight(χ2 = 435.636; P < 0.001) and waist perimeter(χ2 = 96.52; P < 0.001) themselves and they did so in all patients. General physicians suggested physical activity to all patients morefrequently(Z =-2.23; P = 0.026), but psychiatrists recommended physical activity to patients medicated with antipsychotics more frequently(Z =-7.53; P < 0.001). CONCLUSION: Psychiatrists usually check vascular risk factors in their patients, especially in those taking antipsychotics. General practitioners check them routinely without paying special attention to this population.
文摘目的:探讨农村社区中精神分裂症患者犯罪行为的发生率及其相关因素。方法:对成都市新津县农村社区中510例精神分裂症患者的犯罪行为及其临床症状、社会功能、治疗、照管等情况进行了14年(1994-2008年)的随访调查。调查工具包括精神现况检查第9版(Present State Examination,PSE-9)、社会功能缺陷筛查表(Social Disability Screening Schedule,SDSS),以及阳性与阴性症状量表(Positive and Negative Syndrome,PANSS)等。结果:在14年的随访调查中有489例患者(95.9%)完成了随访。随访患者终身犯罪行为的发生率为13.5%。犯罪行为在未婚(19.1%)、较年轻[平均年龄(41.2±16.6)岁]、发病年龄较早的精神分裂症患者[平均发病年龄(28.4±10.4)岁]中较常发生。随访资料中,患者家庭经济状况较差(16.6%)、缺乏监护照管人(28.6%)、无家可归(25.0%),及PANSS总分(68.7±28.7)和阳性(14.1±7.4)、阴性(19.3±10.2)分较高的患者中犯罪行为的发生率较高(P<0.05)。结论:精神分裂症患者的犯罪行为在农村社区中较为常见,其影响因素是多方面的。在制定社区精神卫生服务政策、提供精神卫生服务及家庭干预时,应考虑社区中精神分裂症患者的犯罪行为及其危险因素(如患者的婚姻、家庭及监护照管状态、社会支持系统等)。
