Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T06:03:57.709Z Has data issue: false hasContentIssue false
  • English
  • Français

Age at onset of non-affective psychosis in relation to cannabis use, other drug use and gender

Published online by Cambridge University Press:  27 March 2012

N. Dekker ,
J. Meijer ,
M. Koeter ,
W. van den Brink ,
N. van Beveren ,
R. S. Kahn ,
D. H. Linszen ,
J. van Os ,
D. Wiersma  and
R. Bruggeman
...Show all authors
N. Dekker
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
J. Meijer
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
M. Koeter
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
W. van den Brink
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
N. van Beveren
Affiliation:
Department of Psychiatry, Erasmus University Medical Centre Rotterdam, The Netherlands
R. S. Kahn
Affiliation:
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, The Netherlands
D. H. Linszen
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
J. van Os
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
D. Wiersma
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands
R. Bruggeman
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands
W. Cahn
Affiliation:
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, The Netherlands
L. de Haan*
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
L. Krabbendam
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
I. Myin-Germeys
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
*
*Address for correspondence: Dr L. de Haan, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cannabis use is associated with an earlier age at onset of psychotic illness. The aim of the present study was to examine whether this association is confounded by gender or other substance use in a large cohort of patients with a non-affective psychotic disorder.

Method

In 785 patients with a non-affective psychotic disorder, regression analysis was used to investigate the independent effects of gender, cannabis use and other drug use on age at onset of first psychosis.

Results

Age at onset was 1.8 years earlier in cannabis users compared to non-users, controlling for gender and other possible confounders. Use of other drugs did not have an additional effect on age at onset when cannabis use was taken into account. In 63.5% of cannabis-using patients, age at most intense cannabis use preceded the age at onset of first psychosis. In males, the mean age at onset was 1.3 years lower than in females, controlling for cannabis use and other confounders.

Conclusions

Cannabis use and gender are independently associated with an earlier onset of psychotic illness. Our findings also suggest that cannabis use may precipitate psychosis. More research is needed to clarify the neurobiological factors that make people vulnerable to this precipitating effect of cannabis.

Keywords

Cannabisgenderillness-onsetpsychosisschizophreniasubstance use
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 9 , September 2012 , pp. 1903 - 1911
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, J, Addington, D (2007). Patterns, predictors and impact of substance use in early psychosis: a longitudinal study. Acta Psychiatrica Scandinavica 115, 304–309.CrossRefGoogle ScholarPubMed
Aleman, A, Kahn, RS, Selten, JP (2003). Sex differences in the risk of schizophrenia: evidence from meta-analysis. Archives of General Psychiatry 60, 565–571.CrossRefGoogle ScholarPubMed
Andreasen, NC, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615–623.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Barnes, TR, Mutsatsa, SH, Hutton, SB, Watt, HC, Joyce, EM (2006). Comorbid substance use and age at onset of schizophrenia. British Journal of Psychiatry 188, 237–242.CrossRefGoogle ScholarPubMed
Barnett, JH, Werners, U, Secher, SM, Hill, KE, Brazil, R, Masson, K, Pernet, DE, Kirkbride, JB, Murray, GK, Bullmore, ET, Jones, PB (2007). Substance use in a population-based clinic sample of people with first-episode psychosis. British Journal of Psychiatry 190, 515–520.CrossRefGoogle Scholar
Barrigon, ML, Gurpegui, M, Ruiz-Veguilla, M, Diaz, FJ, Anguita, M, Sarramea, F, Cervilla, J (2010). Temporal relationship of first-episode non-affective psychosis with cannabis use: a clinical verification of an epidemiological hypothesis. Journal of Psychiatric Research 44, 413–420.CrossRefGoogle ScholarPubMed
Bersani, G, Orlandi, V, Kotzalidis, GD, Pancheri, P (2002). Cannabis and schizophrenia: impact on onset, course, psychopathology and outcomes. European Archives of Psychiatry and Clinical Neuroscience 252, 86–92.CrossRefGoogle ScholarPubMed
Brady, KT, Lydiard, RB, Malcolm, R, Ballenger, JC (1991). Cocaine-induced psychosis. Journal of Clinical Psychiatry 52, 509–512.Google ScholarPubMed
Buhler, B, Hambrecht, M, Loffler, W, an der Heiden, W, Hafner, H (2002). Precipitation and determination of the onset and course of schizophrenia by substance abuse – a retrospective and prospective study of 232 population-based first illness episodes. Schizophrenia Research 54, 243–251.CrossRefGoogle ScholarPubMed
Castle, D, Sham, P, Murray, R (1998). Differences in distribution of ages of onset in males and females with schizophrenia. Schizophrenia Research 33, 179–183.CrossRefGoogle ScholarPubMed
De Hert, M, Wampers, M, Jendricko, T, Franic, T, Vidovic, D, De Vriendt, N, Sweers, K, Peuskens, J, van Winkel, R (2011). Effects of cannabis use on age at onset in schizophrenia and bipolar disorder. Schizophrenia Research 126, 270–276.CrossRefGoogle ScholarPubMed
Dekker, N, de Haan, L, Berg, S, Gier, M, Becker, H, Linzen, DH (2008). Cessation of cannabis use by patients with recent-onset schizophrenia and related disorders. Psychopharmacology Bulletin 41, 142–153.Google ScholarPubMed
Dekker, N, Smeerdijk, AM, Wiers, RW, Duits, JH, van Gelder, G, Houben, K, Schippers, G, Linszen, DH, de Haan, L (2010). Implicit and explicit affective associations towards cannabis use in patients with recent-onset schizophrenia and healthy controls. Psychological Medicine 40, 1325–1336.CrossRefGoogle ScholarPubMed
DeRosse, P, Kaplan, A, Burdick, KE, Lencz, T, Malhotra, AK (2010). Cannabis use disorders in schizophrenia: effects on cognition and symptoms. Schizophrenia Research 120, 95–100.CrossRefGoogle ScholarPubMed
Divisie Psychiatrie Academisch Ziekenhuis Utrecht (2003). Dutch Version of the Comprehensive Assessment of Symptoms and History (CASH). Divisie Psychiatrie Academisch Ziekenhuis Utrecht: Utrecht.Google Scholar
Dragt, S, Nieman, DH, Becker, HE, van de Fliert, R, Dingemans, PM, de Haan, L, van Amelsvoort, TA, Linszen, DH (2010). Age of onset of cannabis use is associated with age of onset of high-risk symptoms for psychosis. Canadian Journal of Psychiatry 55, 165–171.CrossRefGoogle ScholarPubMed
Estrada, G, Fatjó-Vilas, M, Muñoz, MJ, Pulido, G, Miñano, MJ, Toledo, E, Illa, JM, Martín, M, Miralles, ML, Miret, S, Campanera, S, Bernabeu, C, Navarro, ME, Fañanás, L (2011). Cannabis use and age at onset of psychosis: further evidence of interaction with COMT Val158Met polymorphism. Acta Psychiatrica Scandinavica 123, 485–492.CrossRefGoogle ScholarPubMed
Foti, DJ, Kotov, R, Guey, LT, Bromet, EJ (2010). Cannabis use and the course of schizophrenia: 10-year follow-up after first hospitalization. American Journal of Psychiatry 167, 987–993.CrossRefGoogle ScholarPubMed
Giel, R, Nienhuis, FJ (2001). SCAN 2.1: Dutch Version of the Schedules for Clinical Assessment in Neuropsychiatry. Harcourt Test Publishers: Amsterdam.Google Scholar
Goldberger, C, Dervaux, A, Gourion, D, Bourdel, MC, Lôo, H, Laqueille, X, Krebs, MO (2010). Variable individual sensitivity to cannabis in patients with schizophrenia. International Journal of Neuropsychopharmacology 13, 1145–1154.CrossRefGoogle ScholarPubMed
González-Pinto, A, Vega, P, Ibáñez, B, Mosquera, F, Barbeito, S, Gutiérrez, M, Ruiz de Azúa, S, Ruiz, I, Vieta, E (2008). Impact of cannabis and other drugs on age at onset of psychosis. Journal of Clinical Psychiatry 69, 1210–1216.CrossRefGoogle ScholarPubMed
Hafner, H (2003). Gender differences in schizophrenia. Psychoneuroendocrinology 28 (Suppl. 2), 17–54.CrossRefGoogle ScholarPubMed
Hambrecht, M, Häfner, H (1996). Substance abuse and the onset of schizophrenia. Biological Psychiatry 40, 1155–1163.CrossRefGoogle ScholarPubMed
Hambrecht, M, Maurer, K, Häfner, H, Sartorius, N (1992). Translational stability of gender differences in schizophrenia? An analysis based on the WHO study on determinants of outcome of severe mental disorders. European Archives of Psychiatry and Clinical Neuroscience 242, 6–12.CrossRefGoogle Scholar
Korver, N, Quee, PJ, Boos, H, Simons, CJP, Genetic Risk and Outcome of Psychosis (GROUP) Investigators (in press). Genetic Risk and Outcome of Psychosis (GROUP), a multi site longitudinal cohort study focused on gene-environment interaction: objectives, sample characteristics, recruitment and assessment methods. International Journal of Methods in Psychiatric Research.Google Scholar
Landabaso, MA, Iraurgi, I, Jimenez-Lerma, JM, Calle, R, Sanz, J, Gutierrez-Fraile, M (2002). Ecstasy-induced psychotic disorder: six-month follow-up study. European Addiction Research 8, 133–140.CrossRefGoogle ScholarPubMed
Large, M, Sharma, S, Compton, MT, Slade, T, Nielssen, O (2011). Cannabis use and earlier onset of psychosis: a systematic meta-analysis. Archives of General Psychiatry 68, 555–561.CrossRefGoogle ScholarPubMed
Lauronen, E, Miettunen, J, Veijola, J, Karhu, M, Jones, PB, Isohanni, M (2007). Outcome and its predictors in schizophrenia within the Northern Finland 1966 Birth Cohort. European Psychiatry 22, 129–136.CrossRefGoogle ScholarPubMed
Leung, A, Chue, P (2000). Sex differences in schizophrenia, a review of the literature. Acta Psychiatrica Scandinavica. Supplementum 401, 3–38.Google Scholar
Linszen, DH, Dingemans, PM, Lenior, ME (1994). Cannabis abuse and the course of recent-onset schizophrenic disorders. Archives of General Psychiatry 51, 273–279.CrossRefGoogle ScholarPubMed
Mauri, MC, Volonteri, LS, De Gaspri, I, Colasanti, A, Brambilla, MA, Cerruti, L (2006). Substance abuse in first-episode schizophrenic patients: a retrospective study. Clinical Practice and Epidemiology in Mental Health 2, 4.CrossRefGoogle ScholarPubMed
McKetin, R, McLaren, J, Lubman, DI, Hides, L (2006). The prevalence of psychotic symptoms among methamphetamine users. Addiction 101, 1473–1478.CrossRefGoogle ScholarPubMed
Ongur, D, Lin, L, Cohen, BM (2009). Clinical characteristics influencing age at onset in psychotic disorders. Comprehensive Psychiatry 50, 13–19.CrossRefGoogle ScholarPubMed
Pelayo-Terán, JM, Pérez-Iglesias, R, Mata, I, Carrasco-Marin, E, Vazquez-Barquero, JL, Crespo-Facorro, B (2010). Catechol-O-Methyltransferase (COMT) Val158Met variations and cannabis use in first-episode non-affective psychosis: clinical-onset implications. Psychiatry Research 179, 291–296.CrossRefGoogle ScholarPubMed
Rabinowitz, J, Levine, SZ, Hafner, H (2006). A population based elaboration of the role of age of onset on the course of schizophrenia. Schizophrenia Research 88, 96–101.CrossRefGoogle ScholarPubMed
Satel, SL, Southwick, SM, Gawin, FH (1990). Clinical features of cocaine induced paranoia. National Institute on Drug Abuse Research Monograph 105, 371.Google ScholarPubMed
Sevy, S, Robinson, DG, Napolitano, B, Patel, RC, Gunduz-Bruce, H, Miller, R, McCormack, J, Lorell, BS, Kane, J (2010). Are cannabis use disorders associated with an earlier age at onset of psychosis? A study in first episode schizophrenia. Schizophrenia Research 120, 101–107.CrossRefGoogle ScholarPubMed
Sugranyes, G, Flamarique, I, Parellada, E, Baeza, I, Goti, J, Fernandez-Egea, E, Bernardo, M (2009). Cannabis use and age of diagnosis of schizophrenia. European Psychiatry 24, 282–286.CrossRefGoogle ScholarPubMed
Szymanski, S, Lieberman, JA, Alvir, JM, Mayerhoff, D, Loebel, A, Geisler, S, Chakos, M, Koreen, A, Jody, D, Kane, J (1995). Gender differences in onset of illness, treatment response, course, and biologic indexes in first-episode schizophrenic patients. American Journal of Psychiatry 152, 698–703.Google ScholarPubMed
Vardy, MM, Kay, SR (1983). LSD psychosis or LSD-induced schizophrenia? A multimethod inquiry. Archives of General Psychiatry 40, 877–883.CrossRefGoogle ScholarPubMed
Veen, ND, Selten, JP, van der Tweel, I, Feller, WG, Hoek, HW, Kahn, RS (2004). Cannabis use and age at onset of schizophrenia. American Journal of Psychiatry 161, 501–506.CrossRefGoogle ScholarPubMed
WHO (1994). Composite International Diagnostic Interview: Researchers' Manual. World Health Organization: Geneva.Google Scholar
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D, Sartorius, N (1990). SCAN. Schedules for Clinical Assessment in Neuropsychiatry. American Journal of Psychiatry 47, 589–593.Google ScholarPubMed