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Yıl:2023; Cilt: 60; Sayı: 4>> Özet
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Nöropsikiyatri Arşivi; 2023;60(4):363-369
İlk Atak Akut Psikotik Hastalarda Kannabis Kullanımının Klinik Etkileri
B Akdöner , U Baklacı , Ö Kuman Tunçel , E Aldemir , H Elbi
Yakın Doğu Üniversitesi, Lefkoşa, KKTC
Amaç: Kannabis, dünyada en yaygın kullanılan yasa dışı psikoaktif maddedir. Literatürde, kannabis kullanan kişilerdeki psikotik bozukluk ile kannabis kullanmayan kişilerdeki psikotik bozukluk arasındaki klinik farklılıkları inceleyen çalışmaların sayısının yetersiz olduğu düşünülmektedir. Bu çalışmada kannabis kullanımının psikotik belirtiler üzerine etkilerinin ve kannabis kullanan ve kullanmayan grup arasındaki bilişsel işlevler açısından olası farkların incelenmesi amaçlanmıştır. Yöntem: İlk atak psikotik bozukluk hastaları, kannabis kullananlar ve kannabis kullanmayanlar olarak iki gruba ayrıldı. Gruplar kendi arasında sosyodemografik faktörler, psikotik belirtiler, bilişsel işlevler ve çocukluk çağı travmaları açısından karşılaştırıldı. Çalışmaya katılan tüm hastalar psikotik belirtiler açısından tedavi öncesinde ve sonrasında olmak üzere iki defa değerlendirildi. Bulgular: Çalışmaya kannabis kullanan 18, kullanmayan 20 kişi olacak şekilde toplamda 38 ilk atak psikotik bozukluk hastası katıldı. Ailede madde kullanım öyküsü ve yalnız yaşama, kannabis kullanan grupta daha yüksek oranda saptandı. Negatif psikotik belirtiler kannabis kullanmayan grupta daha yüksek oranda saptandı. Tedavi sonrasında negatif psikotik belirtilerdeki değişim kannabis kullanmayan grupta daha fazlaydı. Kannabis kullanımı ile Stroop test puanları arasında anlamlı ilişki saptandı. Sonuç: Çalışmamızdan edindiğimiz bulgular, psikotik bozukluğun kannabis kullanımı olan ve olmayan gruplarda farklı özellikler gösterebileceğine işaret etmektedir. Bu iki klinik durum arasında fenomenolojik farklılıklar olabileceği ve önleyici çalışmaların, farklı tedavi planlamalarının, hastaların iyilik halinin sağlanması ve sürdürülmesi açısından önemli olabileceği düşünülmektedir
Clinical Effects of Cannabis Use in First-Episode Acute Psychotic Patients
Introduction: Cannabis is the most widely used illegal psychoactive substance worldwide. Although there are clinical studies examining the differences between psychotic symptoms emerging after cannabis use and non-cannabis-related psychotic symptoms, data are limited in the scientific literature. We aimed to investigate the effects of cannabis use on psychotic symptoms and compare the cognitive function differences between the cannabis-user and non-user groups. Methods: First-episode psychotic patients were included in the study and divided into two groups based on cannabis use. Participants with cannabis use and without cannabis use were compared in terms of sociodemographic factors, psychotic symptoms, cognitive functions, and childhood trauma. All patients were assessed twice, during recruitment and after treatment for psychotic symptoms. Results: A total of 38 patients comprising of 18 patients with a history of cannabis use and 20 patients without a history of cannabis use were included. There were significant correlations between cannabis use, and living apart from family and family history of substance abuse. Negative psychotic symptoms were higher in the non-user group. The negative psychotic symptoms improved more significantly after treatment in the non-user group. There was a significant correlation between cannabis use and Stroop Color-Word Test scores. Conclusion: Our results give us a chance to argue that psychosis has different features in people with and without a history of cannabis use. These two phenomena could differ in many ways, so different prevention strategies and treatment options should be considered.

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