RESUMO
Marijuana is one of the most abused substances in the world. Marijuana is getting legalized around the world. So, it is crucial to understand its effect on our mental health. Its impact on the schizophrenia spectrum needs our special attention. Even though marijuana has been around for a long time, its exact effects are still unknown. Schizophrenia is a chronic illness affecting approximately 20 million people worldwide. Schizophrenia and cannabis seem to have a close relationship, and we want to explore this. We want to know if marijuana is causing, exacerbating, or treating schizophrenia. This systematic review explores this question. We searched online resources like PubMed, PubMed Central, Cochrane Library, and Google Scholar for systematic reviews, traditional reviews, randomized controlled trials, and meta-analysis on cannabis and schizophrenia/ psychosis. We included human studies published in peer-reviewed journals in the English language in the last five years. After reviewing 96 initial results of our search, we excluded 25 duplicates, 29 abstracts, and 18 irrelevant articles. We did a quality assessment for the remaining 24 studies using various quality assessment tools. After the quality assessment, we found 12 articles were of low quality and excluded those. We included the remaining 12 final studies in our systematic review. Out of these 12 studies, five were traditional reviews, two systematic reviews, two meta-analysis, and three observational studies. Six of the articles were on cannabis's effect on just schizophrenia or psychotic disorder. The other six included schizophrenia plus other psychiatric or neurological illnesses. Ten of the studies had data supporting the causative link between cannabis and schizophrenia. Eight records had data supporting the exacerbating effect of marijuana. Six studies had data supporting the therapeutic effect of the cannabidiol (CBD) component of cannabis. From the current data, we can conclude that the tetrahydrocannabinol (THC) component of cannabis can be the main culprit causing psychosis and schizophrenia in the at-risk population. THC can also be the one exacerbating symptoms and causing an adverse prognosis in already diagnosed patients. Even though CBD shows therapeutic effects and THC opposing effects, the data is minimal and low safety and efficacy warrants more research. The relation between cannabis and schizophrenia needs further investigation. We need more case-control studies and clinical trials with a larger population to get conclusive data.
RESUMO
Celiac disease is receiving much attention due to the gluten-free diet trend. Many health-conscious individuals practice a gluten-free diet, even if they do not have celiac disease. As it is an autoimmune disorder, it is associated with many other autoimmune diseases. We were interested in one skin condition, another autoimmune disorder lichen planus as a correlative factor for celiac disease. The following systematic review may give some clues. We searched online resources including PubMed, PubMed Central, Cochrane library, and Google scholar for systematic reviews, traditional reviews, randomized controlled trials, and meta-analysis on celiac disease and lichen planus. We included human studies published in peer-reviewed journals in the English language. After reviewing 2389 initial results of our search, we excluded 1250 duplicates, 1108 abstracts, 42 irrelevant articles. We assessed the remaining 26 articles for their quality using various quality assessment tools. After the quality assessment, we included nine final articles in our systematic review. Out of these nine studies, there were four systematic reviews, one traditional review, two case reports, and two observational studies. Only two articles had exclusively studied the specific association between celiac and lichen planus. The remaining studies included data that gave an overall association between other skin manifestations of celiac disease. From our study, we could not establish the relationship between celiac disease and lichen planus. We need more case-control studies and clinical trials with a larger population to get conclusive data. From current data, we can conclude that both immunological processes correlate but there is no causation. There is also a need for clinical trials to explore the exacerbation of lichen planus due to celiac disease.
