Objectives: The principal objective of our study was to document the short-term impact of the legalization of recreational cannabis on active cannabis use, cannabis use disorder, and various psychotic disorders. Methods: We carried out a retrospective observational study of patients who were at least 12 years old and who had visited a psychiatrist in the emergency unit of the Centre hospitalier universitaire de Sherbrooke (CHUS). We included all the consultations of this type over a 5-month period, immediately following the legalization of recreational cannabis in Canada. We then divided our population into an adult (over 18) and teenager group (12 to 17) compared the data to the data from consultations made 2 years earlier, using a generalized linear mixed model. Results: We examined consultations in patients over 18 years old in prelegalization ( n = 1,247) and postlegalization ( n = 1,368) groups. We observed a statistically significant increase in the use of cannabis (28.0% to 37.1%; odds ratio [ OR] = 1.81 [1.34 to 2.44], P = 0.00011) as well as an increase in diagnoses of active cannabis use disorder (17.7% to 24.3%; OR = 1.53 [1.13 to 2.08], P = 0.0064). The increase in cannabis use disorder was more prominent among patients between 18 and 24 years old (17.3% to 25.9%; OR = 2.27 [1.17 to 4.40], P = 0.015). We observed no statistically significant difference in terms of psychotic disorder diagnoses (27.4% to 29.2%; OR = 1.17 [0.84 to 1.63], P = 0.35)]. Conversely, we identified a greater proportion of patients who had a personality disorder diagnosis in the postlegalization period (39.6% to 44.9%; OR = 1.35 [1.02 to 1.80], P = 0.038). Examination of pediatric (under 18 years old) consultations revealed no statistically significant differences. Conclusion: Although an affirmative conclusion is tentative, the current findings suggest a first link between the legalization of cannabis in Canada and increased diagnoses of cannabis use disorder, as well as cannabis use in general among patients in a university hospital psychiatric emergency department.
Juvenile xanthogranuloma (JXG) is the most frequent form of non-Langerhans cell histiocytosis. We present a case of giant congenital JXG in a 7-week-old boy, who had a firm and incompressible lesion, measuring 3 × 4 cm in diameter, on his right flank. The clinical appearance of the lesion and the ultrasound results suggested a vascular tumor, such as a hemangioma. Histology confirmed a JXG, although there was an absence of Touton cells, which are usually pathognomonic of JXG. In light of these findings, it would be important to include JXG in the differential diagnosis of congenital tumours, particularly vascular lesions.
Méthode Cette recension a été effectuée dans la base de données PubMed en utilisant la combinaison de termes associés au cannabis, à la légalisation et à la santé mentale. Deux évaluateurs indépendants ont ensuite examiné 272 titres et résumés, puis ont conservé 11 articles.Résultats À la suite de la révision des articles, nous constatons que la plupart des études ciblant la consommation de cannabis décrivent une prévalence croissante d'utilisateurs. Il est à noter qu'aucune étude n'a démontré une diminution de la consommation du cannabis après la légalisation. Parmi les 11 articles retenus, trois évaluent la perception des risques associés au cannabis (avant et après la légalisation). Deux d'entre eux montrent une diminution des risques perçus après la légalisation, alors que le troisième décrit l'inverse. Quelques études ont également analysé l'impact de la légalisation du cannabis sur le nombre de visites à l'urgence générale et elles montrent toutes une augmentation du nombre de visites associées au cannabis. Cela dit, ces résultats sont simplement observationnels et sont à mettre en perspective avec les tendances qui prévalaient déjà avant la légalisation du cannabis. ConclusionCette recension des écrits montre qu'il existe un nombre limité d'études concernant l'impact de la légalisation du cannabis récréatif sur les troubles en santé mentale. Il serait donc intéressant de poursuivre les recherches sur ce sujet.
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