Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-19T09:48:20.276Z Has data issue: false hasContentIssue false
  • English
  • Français

Cannabis, schizophrenia and other non-affective psychoses: 35 years of follow-up of a population-based cohort

Published online by Cambridge University Press:  17 October 2011

E. Manrique-Garcia ,
S. Zammit ,
C. Dalman ,
T. Hemmingsson ,
S. Andreasson  and
P. Allebeck
E. Manrique-Garcia*
Affiliation:
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden
S. Zammit
Affiliation:
Department of Psychological Medicine and Neurology, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
C. Dalman
Affiliation:
Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sweden
T. Hemmingsson
Affiliation:
Department of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
S. Andreasson
Affiliation:
Swedish National Institute of Public Health, Sweden
P. Allebeck
Affiliation:
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden
*
*Address for correspondence: E. Manrique-Garcia, M.D., Karolinska Hospital, Department of Public Health, Norrbacka floor 6, S-17176 Stockholm, Sweden. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

There is now strong evidence that cannabis use increases the risk of psychoses including schizophrenia, but the relationship between cannabis and different psychotic disorders, as well as the mechanisms, are poorly known. We aimed to assess types of psychotic outcomes after use of cannabis in adolescence and variation in risk over time.

Method

A cohort of 50 087 military conscripts with data on cannabis use in late adolescence was followed up during 35 years with regard to in-patient care for psychotic diagnoses.

Results

Odds ratios for psychotic outcomes among frequent cannabis users compared with non-users were 3.7 [95% confidence interval (CI) 2.3–5.8] for schizophrenia, 2.2 (95% CI 1.0–4.7) for brief psychosis and 2.0 (95% CI 0.8–4.7) for other non-affective psychoses. Risk of schizophrenia declined over the decades in moderate users but much less so in frequent users. The presence of a brief psychosis did not increase risk of later schizophrenia more in cannabis users compared with non-users.

Conclusions

Our results confirm an increased risk of schizophrenia in a long-term perspective, although the risk declined over time in moderate users.

Keywords

Cannabispsychosisschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 6 , June 2012 , pp. 1321 - 1328
Copyright
Copyright © Cambridge University Press 2011

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

Andréasson, S, Allebeck, P, Engström, A, Rydberg, U (1987). Cannabis and schizophrenia. A longitudinal study of Swedish conscripts. Lancet ii, 1483–1486.CrossRefGoogle Scholar
Arendt, M, Rosenberg, R, Foldager, L, Perto, G, Munk-Jorgensen, P (2005). Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases. British Journal of Psychiatry 187, 510–515.CrossRefGoogle ScholarPubMed
Arseneault, L, Cannon, M, Poulton, R, Murray, R, Caspi, A, Moffitt, TE (2002). Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ 325, 1212–1213.CrossRefGoogle ScholarPubMed
Castagnini, A, Berrios, GE (2009). Acute and transient psychotic disorders (ICD-10 F23): a review from a European perspective. European Archives of Psychiatry and Clinical Neuroscience 259, 433–443.CrossRefGoogle ScholarPubMed
Chen, K, Kandel, DB (1995). The natural history of drug use from adolescence to the mid-thirties in a general population sample. American Journal of Public Health 85, 41–47.CrossRefGoogle Scholar
David, AS, Malmberg, A, Brandt, L, Allebeck, P, Lewis, G (1997). IQ and risk for schizophrenia: a population-based cohort study. Psychological Medicine 27, 1311–1323.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
Hall, W, Degenhardt, L (2004). Is there a specific ‘cannabis psychosis’? In Marihuana and Madness (ed. Castle, D. and Murray, R.), pp. 89–100. Cambridge University Press: Cambridge.CrossRefGoogle Scholar
Hall, W, Degenhardt, L (2009). Adverse health effects of non-medical cannabis use. Lancet 374, 1383–1391.CrossRefGoogle ScholarPubMed
Henquet, C, Di Forti, M, Morrison, P, Kuepper, R, Murray, RM (2008). Gene–environment interplay between cannabis and psychosis. Schizophrenia Bulletin 34, 1111–1121.CrossRefGoogle ScholarPubMed
Hickman, M, Vickerman, P, Macleod, J, Kirkbride, J, Jones, PB (2007). Cannabis and schizophrenia: model projections of the impact of the rise in cannabis use on historical and future trends in schizophrenia in England and Wales. Addiction 102, 597–606.CrossRefGoogle ScholarPubMed
Johns, A (2001). Psychiatric effects of cannabis. British Journal of Psychiatry 178, 116–122.CrossRefGoogle ScholarPubMed
Konings, M, Henquet, C, Maharajh, HD, Hutchinson, G, Van Os, J (2008). Early exposure to cannabis and risk for psychosis in young adolescents in Trinidad. Acta Psychiatrica Scandinavica 118, 209–213.CrossRefGoogle ScholarPubMed
Kuepper, R, van Os, J, Lieb, R, Wittchen, HU, Hofler, M, Henquet, C (2011). Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study. British Medical Journal 342, d738.CrossRefGoogle ScholarPubMed
MacCoun, R, Reuter, P (1997). Interpreting Dutch cannabis policy: reasoning by analogy in the legalization debate. Science 278, 47–52.CrossRefGoogle ScholarPubMed
Malmberg, A, Lewis, G, David, A, Allebeck, P (1998). Premorbid adjustment and personality in people with schizophrenia. British Journal of Psychiatry 172, 308–315.CrossRefGoogle ScholarPubMed
McGrath, J, Welham, J, Scott, J, Varghese, D, Degenhardt, L, Hayatbakhsh, MR, Alati, R, Williams, GM, Bor, W, Najman, JM (2010). Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults. Archives of General Psychiatry 67, 440–447.CrossRefGoogle Scholar
Moore, TH, Zammit, S, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370, 319–328.CrossRefGoogle ScholarPubMed
Murray, RM, Morrison, PD, Henquet, C, Di Forti, M (2007). Cannabis, the mind and society: the hash realities. Nature Reviews Neuroscience 8, 885–895.CrossRefGoogle Scholar
Nahas, GG, Latour, C (1993). Epidemiology. In Cannabis: Physiopathology, Epidemiology, Detection (ed. Nahas, G. G. and Latour, C.), pp. 193–273. CRC Press: Boca Raton, FL.Google Scholar
Smit, F, Bolier, L, Cuijpers, P (2004). Cannabis use and the risk of later schizophrenia: a review. Addiction 99, 425–430.CrossRefGoogle ScholarPubMed
Solowij, N, Grenyer, BF (2002). Are the adverse consequences of cannabis use age-dependent? Addiction 97, 1083–1086.CrossRefGoogle ScholarPubMed
Thornicroft, G (1990). Cannabis and psychosis. Is there epidemiological evidence for an association? British Journal of Psychiatry 157, 25–33.CrossRefGoogle ScholarPubMed
van Os, J, Bak, M, Hanssen, M, Bijl, RV, de Graaf, R, Verdoux, H (2002). Cannabis use and psychosis: a longitudinal population-based study. American Journal of Epidemiology 156, 319–327.CrossRefGoogle ScholarPubMed
Winstock, AR, Ford, C, Witton, J (2010). Assessment and management of cannabis use disorders in primary care. BMJ 340, c1571.CrossRefGoogle ScholarPubMed
Zammit, S, Allebeck, P, Andreasson, S, Lundberg, I, Lewis, G (2002). Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. British Medical Journal 325, 1199.CrossRefGoogle ScholarPubMed
Zammit, S, Moore, TH, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G (2008). Effects of cannabis use on outcomes of psychotic disorders: systematic review. British Journal of Psychiatry 193, 357–363.CrossRefGoogle ScholarPubMed