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DOI: 10.1055/a-2494-3048
Cannabiskonsum und Cannabis-assoziierte psychische Störungen bei Kindern und Jugendlichen
Cannabis Use and Cannabis-Associated Psychiatric Disorders in Children and Adolescents
Zusammenfassung
Cannabis gehört zu den am häufigsten von Jugendlichen konsumierten Suchtmitteln. Vor dem Hintergrund der kürzlich in Deutschland erfolgten Cannabislegalisierung ist auch zukünftig von einer hohen klinischen Relevanz bei Kindern und Jugendlichen auszugehen. In dieser Übersichtsarbeit werden die Grundlagen und klinischen Aspekte des Cannabiskonsums sowie der damit verbundenen psychischen Störungen bei Jugendlichen vorgestellt. Der Übergang vom Jugend- zum Erwachsenenalter geht mit neurobiologischen Prozessen einher, die junge Cannabis-Konsumenten besonders anfällig für die Entwicklung einer Abhängigkeit und anderer psychischer Störungen machen. Diagnostik und Therapie von Cannabisabhängigkeit und -missbrauch werden unter Berücksichtigung der Besonderheiten bei minderjährigen Personen erörtert und anhand von Kasuistiken veranschaulicht.
Abstract
Cannabis is one of the most commonly used substances among adolescents. In light of the recent legalization of cannabis in Germany, its clinical relevance among children and adolescents is expected to remain high in the future. This review presents the basics and clinical aspects of cannabis use and its associated psychiatric disorders in adolescents. The transition from adolescence to adulthood involves neurobiological processes that make young cannabis users particularly susceptible to developing dependency and other psychiatric disorders. The diagnosis and treatment of cannabis dependence and abuse are discussed with a focus on the specific characteristics and challenges during adolescence and are illustrated through case studies.
Publication History
Article published online:
10 February 2025
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Literatur
- 1 Pagliaro LA, Pagliaro AM. Child and Adolescent Drug and Substance Abuse: A Comprehensive Reference Guide. 1. Aufl.. Routledge; 2019
- 2 ElSohly MA, Mehmedic Z, Foster S. et al. Changes in cannabis potency over the last 2 decades (1995–2014): analysis of current data in the United States. Biological psychiatry 2016; 79: 613-619
- 3 Haucap J, Knoke L. Warum und wie die Liberalisierung des Cannabismarktes in Deutschland erfolgen sollte. Wirtschaftsdienst 2022; 102: 32-39
- 4 Bundesgesetzblatt Teil I – Gesetz zum kontrollierten Umgang mit Cannabis und zur Änderung weiterer Vorschriften – Bundesgesetzblatt. Verfügbar unter:: Accessed November 08, 2024 at: https://www.recht.bund.de/bgbl/1/2024/109/VO.html
- 5 Mennis J, McKeon TP, Stahler GJ. Recreational cannabis legalization alters associations among cannabis use, perception of risk, and cannabis use disorder treatment for adolescents and young adults. Addictive behaviors 2023; 138: 107552
- 6 Fischer B, Jutras-Aswad D, Hall W. Outcomes associated with nonmedical cannabis legalization policy in Canada: taking stock at the 5-year mark. CMAJ 2023; 195: E1351-E1353
- 7 Copeland J, Howard J. Cannabis Use Disorders. In: Rosner R. (Hrsg.) Clinical Handbook of Adolescent Addiction. John Wiley & Sons, Ltd; 2013: 202-212
- 8 Perisetti A, Gajendran M, Dasari CS. et al. Cannabis hyperemesis syndrome: an update on the pathophysiology and management. Ann Gastroenterol 2020; 33: 571-578
- 9 Jones RT. Cardiovascular system effects of marijuana. The Journal of Clinical Pharmacology 2002; 42: 58S-63S
- 10 Wang GS, Roosevelt G, Heard K. Pediatric marijuana exposures in a medical marijuana state. JAMA Pediatrics 2013; 167: 630-633
- 11 Roehler DR, Hoots BE, Holland KM. et al. Trends and characteristics of cannabis-associated emergency department visits in the United States, 2006–2018. Drug and Alcohol Dependence 2022; 232: 109288
- 12 Budney AJ, Hughes JR, Moore BA. et al. Review of the Validity and Significance of Cannabis Withdrawal Syndrome. American Journal of Psychiatry 2004; 161: 1967-1977
- 13 Bahji A, Stephenson C, Tyo R. et al. Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of Cannabinoids: A Systematic Review and Meta-analysis. JAMA Network Open 2020; 3: e202370
- 14 Bonnet U, Preuss UW. The cannabis withdrawal syndrome: current insights. Substance Abuse and Rehabilitation 2017; 8: 9-37
- 15 Connor JP, Stjepanović D, Budney AJ. et al. Clinical management of cannabis withdrawal. Addiction 2022; 117: 2075-2095
- 16 Hall W, Degenhardt L. Prevalence and correlates of cannabis use in developed and developing countries. Current Opinion in Psychiatry 2007; 20: 393-397
- 17 European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). European Drug Report 2016: Trends and Developments. Luxembourg: Publications Office of the European Union; 2016
- 18 Orth B, Merkel C. Der Substanzkonsum Jugendlicher und junger Erwachsener in Deutschland. Ergebnisse des Alkoholsurveys 2021 zu Alkohol, Rauchen, Cannabis und Trends. BZgA-Forschungsbericht 2022;
- 19 Arnaud N, Wartberg L, Simon-Kutscher K. et al. Prevalence of substance use disorders and associations with mindfulness, impulsive personality traits and psychopathological symptoms in a representative sample of adolescents in Germany. European Child & Adolescent Psychiatry 2024; ; 33: 451-465
- 20 Thomasius R, Weymann N, Stolle M. et al. Cannabiskonsum und-missbrauch bei Jugendlichen und jungen Erwachsenen. Psychotherapeut 2009; 54: 170-178
- 21 Paus T, Keshavan M, Giedd JN. Why do many psychiatric disorders emerge during adolescence?. Nature reviews neuroscience 2008; 9: 947-957
- 22 Konrad K, Firk C, Uhlhaas PJ. Brain Development During Adolescence. Deutsches Ärzteblatt international 2013;
- 23 Lee FS, Heimer H, Giedd JN. et al. Adolescent mental health – Opportunity and obligation. Science 2014; 346: 547-549
- 24 Jordan CJ, Andersen SL. Sensitive periods of substance abuse: Early risk for the transition to dependence. Developmental Cognitive Neuroscience 2017; 25: 29-44
- 25 Feingold D, Livne O, Rehm J. et al. Probability and correlates of transition from cannabis use to DSM-5 cannabis use disorder: Results from a large-scale nationally representative study. Drug and Alcohol Review 2020; 39: 142-151
- 26 Dilling H, Mombour W, Schmidt MH. et al. (Hrsg.) Internationale Klassifikation psychischer Störungen : ICD-10, Kapitel V (F) klinisch-diagnostische Leitlinien. Bern: Huber; 1991
- 27 Arnaud N, Thomasius R. Störungen durch Substanzgebrauch und abhängige Verhaltensweisen in der ICD-11. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie 2020; 1-8
- 28 Moeller KE, Lee KC, Kissack JC. Urine Drug Screening: Practical Guide for Clinicians. Mayo Clinic Proceedings 2008; 83: 66-76
- 29 Sack P-M, Kristin S, Anneke A. et al. Screening auf Substanz bezogene Störungen mit dem RAFFT bei Jugendlichen und jungen Erwachsenen. SUCHT 2011; 57: 173-181
- 30 Degenhardt L. The link between cannabis use and psychosis: furthering the debate. Psychological Medicine 2003; 33: 3-6
- 31 Smit F, Bolier L, Cuijpers P. Cannabis use and the risk of later schizophrenia: a review. Addiction 2004; 99: 425-430
- 32 Hasan A, von Keller R, Friemel CM. et al. Cannabis use and psychosis: a review of reviews. Eur Arch Psychiatry Clin Neurosci 2020; 270: 403-412
- 33 D’Souza NS DC, DiForti M, Ganesh Suhas. et al. Consensus paper of the WFSBP task force on cannabis, cannabinoids and psychosis. The World Journal of Biological Psychiatry 2022; 23: 719-742
- 34 Schoeler T, Theobald D, Pingault J-B. et al. Developmental sensitivity to cannabis use patterns and risk for major depressive disorder in mid-life: findings from 40 years of follow-up. Psychological Medicine 2018; 48: 2169-2176
- 35 Nielsen SM, Toftdahl NG, Nordentoft M. et al. Association between alcohol, cannabis, and other illicit substance abuse and risk of developing schizophrenia: a nationwide population based register study. Psychological Medicine 2017; 47: 1668-1677
- 36 Hjorthøj C, Posselt CM, Nordentoft M. Development Over Time of the Population-Attributable Risk Fraction for Cannabis Use Disorder in Schizophrenia in Denmark. JAMA Psychiatry 2021; 78: 1013-1019
- 37 Hoch E, Friemel CM, Schneider M. Cannabis: Potenzial und Risiko: Eine wissenschaftliche Bestandsaufnahme. Springer-Verlag; 2018
- 38 Di Forti M, Marconi A, Carra E. et al. Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. The Lancet Psychiatry 2015; 2: 233-238
- 39 Kiburi SK, Molebatsi K, Ntlantsana V. et al. Cannabis use in Adolescence and Risk of Psychosis: Are there Factors that Moderate this Relationship? A Systematic Review and Meta-Analysis. Substance Abuse 2021; 42: 527-542
- 40 Leadbeater BJ, Ames ME, Linden-Carmichael AN. Age-varying effects of cannabis use frequency and disorder on symptoms of psychosis, depression and anxiety in adolescents and adults. Addiction 2019; 114: 278-293
- 41 Sultan RS, Zhang AW, Olfson M. et al. Nondisordered Cannabis Use Among US Adolescents. JAMA Network Open 2023; 6: e2311294
- 42 Lubman DI, Cheetham A, Yucel M. Cannabis and adolescent brain development. Pharmacology & Therapeutics 2015; 148: 1-16
- 43 Meier MH, Caspi A, Ambler A. et al. Persistent cannabis users show neuropsychological decline from childhood to midlife. Proceedings of the National Academy of Sciences 2012; 109: E2657-E2664
- 44 Tanner-Smith EE, Wilson SJ. Family-based approaches to treating adolescent substance use disorders: Evidence and outcomes. Journal of Child Psychology and Psychiatry 2013; 54: 602-612
- 45 Hogue A, Dauber S, Liddle HA. Parental involvement in adolescent substance abuse treatment: Relationship to treatment outcomes. Journal of Child & Adolescent Substance Abuse 2001; 11: 1-26
- 46 Bundeszentrale für gesundheitliche Aufklärung (BZgA). Frühintervention bei erstauffälligen Drogenkonsumenten – FreD. Verfügbar unter: Accessed November 08, 2024 at: https://www.drugcom.de/fred/
- 47 Görgen W, Hartmann R, Oliva H. Frühintervention bei erstauffälligen Drogenkonsumenten – FreD. Abschlussbericht der wissenschaftlichen Begleitung. Bonn: Bundesministerium für Gesundheit und Soziale Sicherung; 2003. Verfügbar unter: Accessed August 14, 2024 at: https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.lwl.org/ks-download/downloads/fred/FOGS_Evaluation_Modell_und_Anhang.pdf&ved=2ahUKEwjgj8Oj24WIAxUO3wIHHZ2VAUkQFnoECBkQAQ&usg=AOvVaw1_bt6NQ1y6s8DIsNYneLH_
- 48 Calomarde-Gómez C, Jiménez-Fernández B, Balcells-Oliveró M. et al. Motivational Interviewing for Cannabis Use Disorders: A Systematic Review and Meta-Analysis. European Addiction Research 2021; 27: 413-427
- 49 Couwenbergh C, van den Brink W, Zwart K. et al. Comorbid psychopathology in adolescents and young adults treated for substance use disorders. Eur Child Adolesc Psychiatry 2006; 15: 319-328
- 50 Scheeringa DS, Zeanah AM, Myers JT. et al. Posttraumatic Stress Disorder and Substance Use Disorder Comorbidity in Youth: Research Findings and Clinical Implications. Journal of Traumatic Stress 2005; 18: 499-509
- 51 Roberts RE, Roberts CR, Xing Y. Comorbidity of substance use disorders and other psychiatric disorders among adolescents: Evidence from an epidemiologic survey. Drug and Alcohol Dependence 2007; 88: S4-S13
- 52 Holtmann M, Thomasius R, Melchers P. et al. Anforderungen an die stationäre medizinische Rehabilitation für Jugendliche mit substanzbedingten Erkrankungen. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie 2018; 46: 173-181
- 53 Steinberg L, Monahan KC. Substance use and adolescent development: A brief overview. Development and Psychopathology 2011; 23: 823-844
- 54 Kölch M, Vogel H. Unterbringung von Kindern und Jugendlichen mit freiheitsentziehenden Maßnahmen. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie 2016; 44: 39-50
- 55 Winters KC, Lee CS. Likelihood of relapse to substance use among adolescents in treatment. Journal of Substance Abuse Treatment 2008; 36: 182-194
- 56 Dennis M, Godley SH, Diamond G. et al. The Cannabis Youth Treatment (CYT) Study: Main findings from two randomized trials. Journal of Substance Abuse Treatment 2004; 27: 197-213
- 57 Henderson CE, Dakof GA, Greenbaum PE. et al. Effectiveness of Multidimensional Family Therapy in reducing adolescent drug abuse: Findings from a randomized controlled trial. Journal of Consulting and Clinical Psychology 2010; 78: 596-607