Cannabis potency, defined as the concentration of Δ⁹-tetrahydrocannabinol (THC), has increased internationally, which could increase the risk of adverse health outcomes for cannabis users. We present, to our knowledge, the first systematic review of the association of cannabis potency with mental health and addiction (PROSPERO, CRD42021226447). We searched Embase, PsycINFO, and MEDLINE (from database inception to Jan 14, 2021). Included studies were observational studies of human participants comparing the association of high-potency cannabis (products with a higher concentration of THC) and low-potency cannabis (products with a lower concentration of THC), as defined by the studies included, with depression, anxiety, psychosis, or cannabis use disorder (CUD). Of 4171 articles screened, 20 met the eligibility criteria: eight studies focused on psychosis, eight on anxiety, seven on depression, and six on CUD. Overall, use of higher potency cannabis, relative to lower potency cannabis, was associated with an increased risk of psychosis and CUD. Evidence varied for depression and anxiety. The association of cannabis potency with CUD and psychosis highlights its relevance in health-care settings, and for public health guidelines and policies on cannabis sales. Standardisation of exposure measures and longitudinal designs are needed to strengthen the evidence of this association.

大麻效力，定义为 Δ ^9的浓度-四氢大麻酚 (THC) 在国际上有所增加，这可能会增加大麻使用者出现不良健康后果的风险。据我们所知，我们首次对大麻效力与心理健康和成瘾的关联进行了系统评价 (PROSPERO, CRD42021226447)。我们搜索了 Embase、PsycINFO 和 MEDLINE（从数据库创建到 2021 年 1 月 14 日）。纳入的研究是对人类参与者的观察性研究，比较了包括研究所定义的高效大麻（THC 浓度较高的产品）和低效大麻（THC 浓度较低的产品）与抑郁症的关系，焦虑、精神病或大麻使用障碍 (CUD)。在筛选的 4171 篇文章中，有 20 篇符合资格标准：8 篇研究关注精神病，8 篇关于焦虑，7 篇关于抑郁，六个在 CUD 上。总体而言，相对于较低效力的大麻，使用较高效力的大麻与精神病和 CUD 的风险增加有关。抑郁和焦虑的证据各不相同。大麻效力与 CUD 和精神病的关联突出了它在医疗保健环境中的相关性，以及大麻销售的公共卫生指南和政策。需要暴露措施和纵向设计的标准化来加强这种关联的证据。