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Cannabis abuse is associated with decision-making impairment among first-episode patients with schizophrenia-spectrum psychosis

Published online by Cambridge University Press:  16 November 2007

I. Mata ,
J. M. Rodríguez-Sánchez ,
J. M. Pelayo-Terán ,
R. Pérez-Iglesias ,
C. González-Blanch ,
M. Ramírez-Bonilla ,
O. Martínez-García ,
J. L. Vázquez-Barquero  and
B. Crespo-Facorro
I. Mata
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
J. M. Rodríguez-Sánchez
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
J. M. Pelayo-Terán
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
R. Pérez-Iglesias
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
C. González-Blanch
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
M. Ramírez-Bonilla
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
O. Martínez-García
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
J. L. Vázquez-Barquero
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
B. Crespo-Facorro*
Affiliation:
University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
*
*Address for correspondence: Professor B. Crespo-Facorro, Hospital Universitario Marques de Valdecilla, Department of Psychiatry, Planta 2, edificio 2 de Noviembre, Avda Valdecilla s/n, 39008, Santander, Spain. (Email: [email protected])
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Abstract

Background

Cannabis use appears to be a risk factor for schizophrenia. Moreover, cannabis abusers show impaired decision-making capacities, linked to the orbitofrontal cortex (OFC). Although there is substantial evidence that first-episode schizophrenia patients show impairments in cognitive tasks associated with the dorsolateral prefrontal cortex (DLPFC), it is not clear whether decision making is impaired at schizophrenia onset. In this study, we examined the association between antecedents of cannabis abuse and cognitive impairment in cognitive tasks associated with the DLPFC and the OFC in a sample of first-episode patients with schizophrenia-spectrum disorders.

Method

One hundred and thirty-two patients experiencing their first episode of a schizophrenia-spectrum psychosis were assessed with a cognitive battery including DLPFC-related tasks [backward digits, verbal fluency (FAS) and the Trail Making Test (TMT)] and an OFC-related task [the Iowa Gambling Task (GT)]. Performance on these tasks was compared between patients who had and had not abused cannabis before their psychosis onset.

Results

No differences were observed between the two groups on the performance of any of the DLPFC-related tasks. However, patients who had abused cannabis before their psychosis onset showed a poorer total performance on the gambling task and a lower improvement on the performance of the task compared to no-abusers.

Conclusions

Pre-psychotic cannabis abuse is associated with decision-making impairment, but not working memory and executive function impairment, among first-episode patients with a schizophrenia-spectrum psychosis. Further studies are needed to examine the direction of causality of this impairment; that is, does the impairment make the patients abuse cannabis, or does cannabis abuse cause the impairment?

Keywords

Cannabisdecision-makingIowa Gambling Taskprefrontal cortexschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 9 , September 2008 , pp. 1257 - 1266
Copyright
Copyright © 2007 Cambridge University Press

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