Moguće poveznice kanabisa i shizofrenije

master's thesis

• Title (english): Possible association of cannabis and schizophrenia
• Author: Matea Škrilac
• Mentor: Marina Šagud (mentor)
• Committee member: Vesna Medved (predsjednik povjerenstva)
• Committee member: Dražen Begić (član povjerenstva)
• Committee member: Marina Šagud (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Psychiatry and Psychological Medicine); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Psychiatry

Abstract

U egzogene kanabionide se ubrajaju spojevi iz biljke Cannabis sativa, tu ubrajamo nekoliko farmakološki aktivnih tvari poput ∆9- tetrahidrokanabinola (THC) , kanabidiol i kanabinol koji su snažne psihoaktivne tvari te se vežu za CB1 i CB2 receptore u mozgu i djeluju preko dopaminskog sustava. Kanabinoidi mogu uz druge blaže simptome stvoriti disforiju i, u rijetkim slučajevima nakon uporabe visokih doza, mogu uzrokovati vizualne halucinacije, depersonalizaciju i prave psihotične epizode. Shizofrenija je neurorazvojni poremećaj karakteriziran poremećenom povezanošću komponenti moždane neuronske mreže. Shizofrenija je posljedica zajedničkog djelovanja genetske predispozicije i okolišnih čimbenika, a novija istraživanja ukazuju na tri osnovna patofiziološka mehanizma u shizofreniji: dopaminsku disfunkciju, poremećenu transmisiju u glutamatnom sustavu, te upalni proces u mozgu. Prevalencija korištenja kanabisa u shizofrenih pacijenata je veća od 50% što znači da je deset puta veća nego u općoj populaciji. U najnovijim studijama je dokazano kako korištenje kanabisa ubrzava pojavljivanje prve psihoze u shizofrenih pacijenata za tri godine, početak konzumacije kanabisa u adolescenciji povećava broj rehospitalizacija, količinu pozitivnih simptoma i učestalost relapsa. Postoji entitet koji se naziva „shizofrenija inducirana kanabisom“ koji je još uvijek tema mnogih rasprava. Razlozi visoke stope komorbidne upotrebe kanabisa u shizofreniji nisu u potpunosti razumljivi, niti su jednoznačni. Neke od najčešćih hipoteza učestalog korištenja kanabisa u shizofrenih pacijenata jesu: „self medikacija- samoliječenje“, povećan pozitivan i smanjen negativan učinak psihoaktivnih tvari, rizični faktori okoline i disfunkcija sustava nagrada. Neuropsihološka povezanost kanabisa i shizofrenije temelji se na produkciji dopamina i modeliranju strukture mozga konzumacijom kanabisa. Svakako je ovakav komorbiditet specifična klinička slika koju treba dijagnosticirati i liječiti s velikim oprezom.

Abstract (english)

The exogenous cannabinoides include pharmacologically active compounds of the Cannabis sativa, such as Δ9- tetrahydrocannabinol (THC), cannabidiol and cannabinol. Those molecules are strong psychoactive substances that bind to CB1 and CB2 receptors in the brain and consequently influence dopaminergic system. Cannabinoids may along with other milder symptoms induce a dysphoric state and, in rare cases after the use of high doses, cause visual hallucinations, depersonalization and psychotic episodes. Schizophrenia is a neurodevelopmental disorder characterized by an abnormal connections inside brain's neural network. In schizophrenia there is a joint action of genetic predisposition and environmental factors and some recent research reveals three main pathophysiological mechanisms of schizophrenia: dopamine dysfunction, disturbed transmission in the glutamate system and inflammatory process in the brain. The prevalence od cannabis use in schizophrenic patients is higher than 50% being as high as ten times greater than in general population. Recent studies suggest that cannabis use accelerates the onset of first psycho for three years. In addition- cannabis use in adolescence increases the number of rehospitalizations, positive symptoms and frequencies of relapse. An entity „schizophrenia induced by cannabis“ is still a topic of many discussions. Reasons of such high rates of cannabis use in schizophrenia are not well understood. Some hypotheses include: „ self medication- self healing“, increased positive and decreased negative affect of psychoactive substances in those patients, environmental risk factors and dysfunctional reward system. The relationship between cannabis and schizophrenia is based on interaction of dopamine and brain structure modeling. This comorbidity requires specific approach in order to provide comprehensive care for this highly vulnerable population.

• Keywords: kanabis; shizofrenija; dopamin; komorbiditet
• Keywords (english): cannabis; schizophrenia; dopamine; comorbidity
• Language: croatian
• URN:NBN: urn:nbn:hr:105:262466
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-06-23 12:41:21