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Cannabis use and age of diagnosis of schizophrenia

Published online by Cambridge University Press:  16 April 2020

Gisela Sugranyes ,
Itziar Flamarique ,
Eduard Parellada ,
Immaculada Baeza ,
Javier Goti ,
Emilio Fernandez-Egea  and
Miquel Bernardo
Gisela Sugranyes*
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain
Itziar Flamarique*
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain
Eduard Parellada
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain Centro de Investigación Biomédica en Red de Salud mental (CIBER-SAM), Spain
Immaculada Baeza
Affiliation:
Centro de Investigación Biomédica en Red de Salud mental (CIBER-SAM), Spain Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic i Universitari, Barcelona, Spain
Javier Goti
Affiliation:
Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic i Universitari, Barcelona, Spain
Emilio Fernandez-Egea*
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, United Kingdom
Miquel Bernardo
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain Centro de Investigación Biomédica en Red de Salud mental (CIBER-SAM), Spain Institut d'Investigacions Biomèdiques Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain
*
*Correspondence to: Emilio Fernandez-Egea, Programa Esquizofrenia Clinic, Sala d'Hospitalitzacio (G096), Servei de Psiquiatria, Institut de Neurociencies, Hospital Clínic, 08036 Barcelona, Spain. Tel.: +34 932275477; fax: +34 932275548. E-mail address: [email protected] (E. Fernandez-Egea).
*Correspondence to: Emilio Fernandez-Egea, Programa Esquizofrenia Clinic, Sala d'Hospitalitzacio (G096), Servei de Psiquiatria, Institut de Neurociencies, Hospital Clínic, 08036 Barcelona, Spain. Tel.: +34 932275477; fax: +34 932275548. E-mail address: [email protected] (E. Fernandez-Egea).
*Correspondence to: Emilio Fernandez-Egea, Programa Esquizofrenia Clinic, Sala d'Hospitalitzacio (G096), Servei de Psiquiatria, Institut de Neurociencies, Hospital Clínic, 08036 Barcelona, Spain. Tel.: +34 932275477; fax: +34 932275548. E-mail address: [email protected] (E. Fernandez-Egea).
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Abstract

Background and objectives

Observational studies have reported earlier onset of psychosis in schizophrenic patients with a history of cannabis use. Earlier age of onset of schizophrenia has been associated with a poorer outcome. We aimed to examine whether cannabis use determined an earlier onset of schizophrenia in a sample of first episode patients, in an area with one of Europe's highest rates of cannabis use.

Methods

116 subjects with first episode psychosis and subsequent diagnosis of schizophrenia (after a 12-month follow-up) were included Age at first antipsychotic treatment (A1T) was used as proxy for age of psychosis onset, and acted as dependent variable for the statistical analysis. Cannabis use was evaluated retrospectively, and divided into three groups according to peak frequency (never, sporadic/frequent, daily).

Results

46 (39.7%) subjects had never used cannabis, 23 (19.9%) had done so sporadically/frequently, and 47 (40.5%) daily. A1T differed between the three groups (mean, in years and [SD]: 27.0 [4.94]; 25.7 [4.44] and 24.5 [4.36]; p = 0.033) and diminished as cannabis use increased (linear tendency; p = 0.009). Post-hoc analysis showed that cannabis use (irrespective of frequency) was significantly associated with decrease in A1T (p = 0.033), as shown by the first contrast [1 −1/2 −1/2]. Post-hoc contrast showed that cannabis users had a significantly lower age of onset of psychosis (mean decrease, in years: 1.93; CI (confidence interval) 95%: 0.17–3.70; p = 0.033).

Conclusions

Cannabis use was significantly associated with a decrease in age of onset of schizophrenia. Age of onset of the disease correlated with frequency of cannabis use.

Keywords

EpidemiologyPsychosisSubstance abuseFirst episodeSchizophrenia
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 5 , June 2009 , pp. 282 - 286
Copyright
Copyright © Elsevier Masson SAS 2009

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References

Andreasson, S., Allebeck, P., Engstrom, A., Rydberg, U. Cannabis and schizophrenia: a longitudinal study of Swedish conscripts. Lancet 1987; 1483–1486.CrossRefGoogle Scholar
Archie, S., Rush, B.R., Akhtar-Danesh, N., Norman, R., Malla, A., Roy, P.et al.Substance use and abuse in first-episode psychosis: prevalence before and after early intervention. Schizophrenia Bulletin 2008;33:1354–1363.CrossRefGoogle Scholar
Arendt, M., Rosenberg, R., Foldager, L., Perto, G., Munk-Jorgensen, P.Cannabis induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases. The British Journal of Psychiatry 2005;187:510–515.CrossRefGoogle ScholarPubMed
Arseneault, L., Cannon, M., Poulton, R., Murray, R., Caspi, A., Moffitt, T.E.Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ 2002;325:1212–1213.CrossRefGoogle ScholarPubMed
Barnett, J.H., Werners, U., SEcher, S.M., Hill, K.E., Brazil, R., Masson, K.et al.Substance use in a population-based clinic sample of people with first-episode psychosis. British Journal of Psychiatry 2007;190:515–520.CrossRefGoogle Scholar
Cantor-Graae, E., Nordström, L.G., McNeil, T.F.Substance abuse in schizophrenia: a review of the literature and study of correlates in Sweden. Schizophrenia Research 2001;48:69–82.CrossRefGoogle ScholarPubMed
Caton, C.L., Hasin, D.S., Shrout, P.E., Drake, R.E., Dominguez, B., Samet, S.et al.Predictors of psychosis remission in psychotic disorders that co-occur with substance use. Schizophrenia Bulletin 2006;32:618–625.CrossRefGoogle ScholarPubMed
D'Souza, D.C.Cannabinoids and psychosis. International Review Neurobiology 2007;78:289–326.CrossRefGoogle ScholarPubMed
Degenhardt, L., Hall, W., Lynskey, M.Testing hypothesis about the relationship between cannabis use and psychosis. Drug and Alcohol Dependence 2003;71:37–48.CrossRefGoogle Scholar
European Observatory on Drugs Informe anual 2007: El problema de la drogodependencia en Europa 2007. Lisbon.Google Scholar
Fergusson, D.M., Horwood, L.J., Ridder, E.M.Test of causal linkages between cannabis use and psychotic symptoms. Addiction 2005;100:354–366.CrossRefGoogle ScholarPubMed
Grech, A., Van Os, J., Jones, P.B., Lewis, S.M., Murray, R.Cannabis use and outcome of recent onset psychosis. European Psychiatry 2005;20:349–353.Google ScholarPubMed
Green, A.I., Tohen, M.F., Hamer, R.M., Strakowski, S.M., Lieberman, J.A., Click, I.et al.First-episode schizophrenia-related psychosis and substance use disorders: acute response to olanzapine and haloperidol. HGDH Research Group. Schizophrenia Research 2004;66:125–135.CrossRefGoogle Scholar
Hambrecht, M., Häfner, H.Substance abuse and the onset of schizophrenia. Biological Psychiatry 1996;40:1155–1163.CrossRefGoogle ScholarPubMed
Hambrecht, M., Häfner, H.Cannabis, vulnerability and the onset of schizophrenia: an epidemiological perspective. Australian and New Zealand Journal of Psychiatry 2000;34:468–475.Google Scholar
Henquet, C., Di Forti, M., Morrison, P., Kuepper, R., Murray, R.M.Gene–environment interplay between cannabis and psychosis. Schizophrenia Bulletin 2008;34(6):1111–1121.CrossRefGoogle ScholarPubMed
Henquet, C., Murray, R., Linszen, D., Van Os, J.. The environment and schizophrenia: the role of cannabis use. Schizophrenia Bulletin 2005;31(3):608–612.CrossRefGoogle ScholarPubMed
Hides, L., Dawe, S., Kavanagh, D.J., Young, R.M.Psychotic symptom and cannabis relapse in recent-onset psychosis. Prospective study. British Journal of Psychiatry 2006;189:137–143.CrossRefGoogle ScholarPubMed
Johns, A.Psychiatric effects of cannabis. Br J Psychiatry 2001;178:116–122.CrossRefGoogle ScholarPubMed
Konings, M., Henquet, C., Maharajh, H.D., Hutchinson, G., Van Os, J.Early exposure to cannabis and risk for psychosis in young adolescents in Trinidad. Acta Psychiatrica Scandinavica 2008;118:209–213.CrossRefGoogle ScholarPubMed
Kovasznay, B., Leischer, J., Tanenberg-Karant, M., Jandorf, L., Illar, A.D., Bromet, E.Substance use disorder and the early course of illness in schizophrenia and affective psychosis. Schizophrenia Bulletin 1997;23:195–201.CrossRefGoogle ScholarPubMed
Lauronen, E., Miettunen, J., Veijola, J., Karhu, M., Jones, P.B., Isohanni, M. Outcome and its predictors in schizophrenia within the Northern Finland 1966 Birth Cohort. European Psychiatry 2007; 129–136.Google Scholar
Macleod, J., Oakes, R., Copello, A., Crome, I., Egger, M., Hickman, M.et al.Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies. Lancet 2004;363:1579–1588.CrossRefGoogle ScholarPubMed
Malla, A., Payne, J.First-episode psychosis: psychopathology, quality of life, and functional outcome. Schizophrenia Bulletin 2005;31:650–671.CrossRefGoogle ScholarPubMed
Monshouwer, K., Smit, F., De Graaf, R., Van Os, J., Vollebergh, W.First cannabis use: does onset shift to younger ages? Findings from 1988 to 2003 from the Dutch National School Survey on Substance Use. Addiction 2005;100:963–970.CrossRefGoogle ScholarPubMed
Moore, T.H., Zammit, S., Lingford-Hughes, A., Barnes, T.R., Jones, P.B., Burke, M.et al.Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 2007;370:319–328.CrossRefGoogle ScholarPubMed
Morgan, C., Fisher, H.Environment and schizophrenia: environmental factors in schizophrenia: childhood trauma–a critical review. Schizophrenia Bulletin 2007;33:3–10.CrossRefGoogle ScholarPubMed
Norman, R.M.G., Lewis, S.W., Marshall, M.Duration of untreated psychosis and its relation to clinical outcome. The British Journal of Psychiatry. Supplement 2005;48:s19–s23.CrossRefGoogle Scholar
Perkins, D.O., Gu, H., Boteva, K., Lieberman, J.A.Relationship between duration of untreated psychosis and outcome in first-episode schizophrenia: a critical review and meta-analysis. American Journal Psychiatry 2005;162:1785–1804.CrossRefGoogle ScholarPubMed
Rabinowitz, J., Levine, S.Z., Häfner, H.A population based elaboration of the role of age of onset on the course of schizophrenia. Schizophrenia Research 2006;88:96–101.CrossRefGoogle ScholarPubMed
Read, J., Van Os, J., Morrison, A.P., Ross, C.A.Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 2006;113:238Google Scholar
Semple, D.M., McIntosh, A.M., Lawrie, S.M.Cannabis as a risk factor for psychosis: systematic review. Journal of Psychopharmacology 2005;19:187–194.CrossRefGoogle ScholarPubMed
Smit, F., Bolier, F., Cuijpers, P.Cannabis and risk of later schizophrenia: a review. Addiction 2004;99:425–430.CrossRefGoogle ScholarPubMed
Spanish Observatory on Drugs Encuesta estatal sobre uso de drogas en estudiantes de enseñanzas secundarias 2006–2007 2007. Madrid.Google Scholar
Spanish Observatory on Drugs Delegación del gobierno, Ministerio de sanidad y consumo. Informe 2004: Situación y tendencias de los problemas de drogas en España 2005. Madrid.Google Scholar
Stefanis, N.C., Delespaul, P., Henquet, C., Bakoula, C., Stefanis, C.N., Van Os, J.Early adolescent cannabis exposure and positive and negative dimensions of psychosis. Addiction 2004;99:1333–1341.CrossRefGoogle Scholar
Van Os, J., Bak, M., Bijl, R.V., De Graaf, R., Verdoux, H.Cannabis use and psychosis: a longitudinal population-based study. American Journal of Epidemiology 2002;156:319–327.CrossRefGoogle ScholarPubMed
Veen, N.D., Selten, J.P., Van Dit, I., Feller, W.G., Hoek, H.W., Kahn, R.S.Cannabis use and age at onset of schizophrenia. American Journal Psychiatry 2004;161:501–506.CrossRefGoogle ScholarPubMed
Verdoux, H., Gindre, C., Sorbara, F., Tournier, M., Swendsen, J.D.Effects of cannabis and psychosis vulnerability in daily life: an experience sampling test study. Psychological Medicine 2003;33:23–32.CrossRefGoogle ScholarPubMed
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