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Cannabis use and childhood trauma interact additively to increase the risk of psychotic symptoms in adolescence

Published online by Cambridge University Press:  09 December 2009

M. Harley ,
I. Kelleher ,
M. Clarke ,
F. Lynch ,
L. Arseneault ,
D. Connor ,
C. Fitzpatrick  and
M. Cannon
M. Harley
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland Department of Child and Adolescent Mental Health, Mater Misericordiae University Hospital, The Children's University Hospital Temple Street, and University College Dublin, Dublin, Ireland
I. Kelleher
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland
M. Clarke
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland
F. Lynch
Affiliation:
Department of Child and Adolescent Mental Health, Mater Misericordiae University Hospital, The Children's University Hospital Temple Street, and University College Dublin, Dublin, Ireland
L. Arseneault
Affiliation:
Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK
D. Connor
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland
C. Fitzpatrick
Affiliation:
Department of Child and Adolescent Mental Health, Mater Misericordiae University Hospital, The Children's University Hospital Temple Street, and University College Dublin, Dublin, Ireland
M. Cannon*
Affiliation:
Department of Psychiatry, Royal College of Surgeons in Ireland and Beaumont Hospital, Dublin, Ireland
*
*Address for correspondence: Professor M. Cannon, Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland. (Email: [email protected])
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Abstract

Background

Adolescent cannabis use has been shown in many studies to increase the risk of later psychosis. Childhood trauma is associated with both substance misuse and risk for psychosis. In this study our aim was to investigate whether there is a significant interaction between cannabis use and childhood trauma in increasing the risk for experiencing psychotic symptoms during adolescence.

Method

Psychiatric interviews using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) semi-structured instrument were carried out with 211 adolescents aged between 12 and 15 years and their parents as part of a population-based study. The interview enquired about early traumatic events, cannabis use and psychiatric symptoms in adolescence.

Results

In separate analyses both cannabis use and childhood trauma were significantly associated with risk of experiencing psychotic symptoms. However, the presence of both childhood trauma and early cannabis use significantly increased the risk for psychotic symptoms beyond the risk posed by either risk factor alone, indicating that there was a greater than additive interaction between childhood trauma and cannabis use.

Conclusion

Our finding of a greater than additive interaction between childhood trauma and cannabis use may have implications for the identification of individuals at high risk of experiencing psychotic symptoms. For example, measures to actively discourage or intensively treat cannabis use in children and adolescents who have experienced abuse may help to prevent the development of psychosis in this vulnerable group. Our findings require replication in larger samples to confirm this interaction effect.

Keywords

Additive interactionadolescencecannabischildhood traumapsychotic symptoms
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 10 , October 2010 , pp. 1627 - 1634
Copyright
Copyright © Cambridge University Press 2009

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References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Arseneault, L, Cannon, M, Poulton, R, Murray, R, Caspi, A, Moffitt, TE (2002). Cannabis use in adolescence and risk for adult psychosis. British Medical Journal 325, 1212–1213.CrossRefGoogle ScholarPubMed
Arseneault, L, Cannon, M, Witton, J, Murray, RM (2004). Causal association between cannabis and psychosis: examination of the evidence. British Journal of Psychiatry 184, 110–117.CrossRefGoogle ScholarPubMed
Bak, M, Krabbendam, L, Janssen, I, de Graaf, R, Vollebergh, W, van Os, J (2005). Early trauma may increase the risk for psychotic experiences by impacting on emotional response and perception of control. Acta Psychiatrica Scandinavica 112, 360–366.CrossRefGoogle ScholarPubMed
Bendall, S, Jackson, HJ, Hulbert, CA, McGorry, PD (2008). Childhood trauma and psychotic disorders: a systematic, critical review of the evidence. Schizophrenia Bulletin 34, 568–579.CrossRefGoogle ScholarPubMed
Bossong, MG, van Berckel, BN, Boelhaard, R, Zuurman, L, Schuit, RC, Windhorst, AD, van Gerves, JM, Ramsey, NF, Lammerstsma, AA, Kahn, RS (2009). Delta-9-tetrahydrocannabinol induces dopamine release in the human striatum. Neuropsychopharmacology 34, 759–766.CrossRefGoogle ScholarPubMed
Cannon, M, Harley, M, Clarke, MC, Arseneault, L (2006). Genes, cannabis and psychosis. In Beyond Nature and Nurture in Psychiatry: Genes, Environment and their Interplay (ed. MacCabe, J., O'Daly, O., Murray, R. M., McGuffin, P. and Wright, P.), ch. 16, pp. 141–155. Informa UK Ltd: Abingdon, Oxon.CrossRefGoogle Scholar
Carpenter, LL, Carvalho, JP, Tyrka, AR, Wier, LM, Mello, MF, Anderson, GM, Wilkinson, CW, Price, LH (2007). Decreased adrenocorticotropic hormone and cortisol responses to stress in healthy adults reporting significant childhood maltreatment. Biological Psychiatry 62, 1080–1087.CrossRefGoogle ScholarPubMed
Caspi, A, Moffitt, TE (2006). Gene–environment interactions in psychiatry: joining forces with neuroscience. Nature Reviews Neuroscience 7, 583–590.CrossRefGoogle ScholarPubMed
Central Statistics Office (1996). Census of Population in Ireland. Central Statistics Office: Dublin, Ireland.Google Scholar
Clarke, MC, Tanskanen, A, Huttunen, M, Whittaker, J, Cannon, M (2009). Evidence for an interaction between familial liability and prenatal exposure to infection in the causation of schizophrenia. American Journal of Psychiatry 166, 1025–1030.CrossRefGoogle ScholarPubMed
Cougnard, A, Marcelis, M, Myin-Germeys, I, De Graaf, R, Volleburgh, W, Krabbendam, L, Leb, R, Wittchen, HU, Henquiet, C, Spauwen, J, van Os, J (2007). Does normal developmental expression of psychosis combine with environmental risk to cause persistence of psychosis? A psychosis proneness-persistence model. Psychological Medicine 37, 513–527.CrossRefGoogle ScholarPubMed
Darroch, J (1997). Biologic synergism and parallelism. American Journal of Epidemiology 145, 661–668.CrossRefGoogle ScholarPubMed
De Bellis, MD (2002). Developmental traumatology: a contributory mechanism for alcohol and substances use disorders. Psychoneuroendocrinology 27, 155–170.CrossRefGoogle Scholar
Degenhardt, L, Lynskey, M, Hall, W (2000). Cohort trends in the age of initiation of drug use in Australia. Australian and New Zealand Journal of Public Health 24, 421–426.CrossRefGoogle ScholarPubMed
Fergusson, DM, Horwood, LJ, Ridder, EM (2005). Tests of causal linkages between cannabis use and psychotic symptoms. Addiction 100, 354–366.CrossRefGoogle ScholarPubMed
Giedd, JN, Blumenthal, J, Jeffries, NO, Castellanos, FX, Liu, H, Zijdenbos, A, Pano, J, Evans, AC, Rapoport, JL (1999). Brain development during childhood and adolescence: a longitudinal MRI study. Nature Neuroscience 2, 861–863.CrossRefGoogle ScholarPubMed
Gledhill-Hoyt, J, Lee, H, Strote, J, Wechsler, H (2000). Increased use of marijuana and other illicit drugs at US colleges in the 1990s: results of three national surveys. Addiction 95, 1655–1667.CrossRefGoogle ScholarPubMed
Goodman, R (1997). The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry 38, 581–586.CrossRefGoogle ScholarPubMed
Goodman, R, Ford, T, Simmons, H, Gatward, R, Meitzer, H (2000). Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. British Journal of Psychiatry 177, 534–539.CrossRefGoogle Scholar
Gordon, HW (2002). Early environmental stress and biological vulnerability to drug abuse. Psychoneuroendocrinology 27, 115–126.CrossRefGoogle ScholarPubMed
Heim, C, Newport, DJ, Heit, S, Graham, YP, Wilcox, M, Bonsall, R, Miller, AH, Nemeroff, CB (2000). Pituitary-adrenal and autonomic responses to stress in women after sexual and physical abuse in childhood. Journal of the American Medical Association 284, 592–597.CrossRefGoogle ScholarPubMed
Henquet, C, Krabbendam, L, Spauwen, J, Kaplan, C, Lieb, R, Wittchen, HU, van Os, J (2005). Prospective cohort study of cannabis use, predisposition for psychosis and psychotic symptoms in young people. British Medical Journal 330, 11.CrossRefGoogle ScholarPubMed
Houston, JE, Murphy, J, Adamson, G, Stringer, M, Shevlin, M (2008). Childhood sexual abuse, early cannabis use, and psychosis: testing an interaction model based on the National Comorbidity Survey. Schizophrenia Bulletin 34, 580–585.CrossRefGoogle ScholarPubMed
Kalinichev, M, Easterling, KW, Plotsky, PM, Holtzman, SG (2002). Long-lasting changes in stress-induced corticosterone response and anxiety-like behaviours as a consequence of neonatal maternal separation in Long-Evans rats. Pharmacology, Biochemistry and Behaviour 73, 131–140.CrossRefGoogle ScholarPubMed
Kapur, S, Mizrahi, R, Li, M (2005). From dopamine to salience to psychosis: linking biology, pharmacology and phenomenology of psychosis. Schizophrenia Research 79, 59–68.CrossRefGoogle ScholarPubMed
Kaufman, JBB, Brent, D, Rao, U, Ryan, N (1996). The Schedule for Affective Disorders and Schizophrenia for School-Age Children: Present and Lifetime Version. University of Pittsburgh, Western Psychiatric Institute and Clinic: Pittsburgh.Google Scholar
Kelleher, I, Harley, M, Lynch, F, Arseneault, L, Fitzpatrick, C, Cannon, M (2008). Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample. British Journal of Psychiatry 193, 378–382.CrossRefGoogle ScholarPubMed
Kovacs, M (1985). The Children's Depression Inventory (CDI). Psychopharmacology Bulletin 21, 995–998.Google ScholarPubMed
Ladd, CO, Owens, MJ, Nemeroff, CB (1996). Persistent changes in corticotropin-releasing factor neuronal symptoms induced by maternal deprivation. Endocrinology 137, 1212–1218.CrossRefGoogle ScholarPubMed
Laruelle, M (2000). The role of endogenous sensitization in the pathophysiology of schizophrenia: implications from recent brain imaging studies. Brain Research Reviews 31, 371–384.CrossRefGoogle ScholarPubMed
Liu, D, Caldji, C, Sharma, S, Plotzky, PM, Meaney, MJ (2000). Influence of neonatal rearing conditions on stress-induced adrenocorticotropin responses and norepinepherine release in the hypothalamic paraventricular nucleus. Journal of Neuroendocrinology 12, 5–12.CrossRefGoogle ScholarPubMed
Luzi, S, Morrison, PD, Powell, J, di Forti, M, Murray, RM (2008). What is the mechanism whereby cannabis use increases risk of psychosis? Neurotoxicity Research 14, 105–112.CrossRefGoogle ScholarPubMed
Lynch, F, Mills, C, Daly, I, Fitzpatrick, C (2004). Challenging times: a study to detect Irish adolescents at risk of psychiatric disorders and suicidal ideation. Journal of Adolescence 27, 441–451.CrossRefGoogle ScholarPubMed
Lynch, F, Mills, C, Daly, I, Fitzpatrick, C (2006). Challenging times: prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents. Journal of Adolescence 29, 555–573.CrossRefGoogle ScholarPubMed
Macleod, J, Davey Smith, G, Hickman, M (2006). Does cannabis use cause schizophrenia? Lancet 367, 1055.CrossRefGoogle ScholarPubMed
Macleod, J, Oakes, R, Copello, A, Crome, I, Egger, M, Hickman, M, Oppenkovski, T, Stokes-Lampard, H, Davey Smith, G (2004). Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies. Lancet 363, 1579–1588.CrossRefGoogle ScholarPubMed
Mills, CGS, Lynch, F, Daly, I, Fitzpatrick, C (2004). The relationship between bullying, depression and suicidal thoughts/behaviour in Irish adolescents. Irish Journal of Psychological Medicine 21, 112–116.CrossRefGoogle ScholarPubMed
Moffitt, TE, Caspi, A, Rutter, M (2005). Strategy for investigating interactions between measured genes and measured environments. Archives of General Psychiatry 62, 473–481.CrossRefGoogle ScholarPubMed
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
Morgan, C, Fisher, H (2007). Environmental factors in schizophrenia: childhood trauma – a critical review. Schizophrenia Bulletin 33, 3–10.CrossRefGoogle ScholarPubMed
Plotsky, PM, Meaney, MJ (1993). Early, postnatal experience alters hypothalamic corticotropin-releasing factor (CRF) mRNA, median eminence CRF content and stress-induced release in adult rats. Brain Research. Molecular Brain Research 18, 195–200.CrossRefGoogle Scholar
Poulton, R, Caspi, A, Moffitt, TE, Cannon, M, Murray, R, Harrington, H (2000). Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Archives of General Psychiatry 57, 1053–1058.CrossRefGoogle ScholarPubMed
Read, J, Perry, BD, Moskowitz, A, Connolly, J (2001). The contribution of early traumatic events to schizophrenia in some patients: a traumagenic neurodevelopmental model. Psychiatry 64, 319–345.CrossRefGoogle ScholarPubMed
Read, J, van Os, J, Morrison, AP, Ross, CA (2005). Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica 112, 330–350.CrossRefGoogle ScholarPubMed
Risch, N, Herrell, R, Lehner, T, Liang, KY, Eaves, L, Hoh, J, Griem, A, Kovacs, M, Ott, J, Merikangas, KR (2009). Interaction between the serotonin transporter gene (5-HTTLPR), stressful life events and risk of depression: a meta-analysis. Journal of the American Medical Association 310, 2462–2471.CrossRefGoogle Scholar
Rothman, K, Greenland, S (1998). Modern Epidemiology, 2nd edn. Lippincott-Raven: Philadelphia.Google Scholar
Schwartz, S, Susser, E (2006). Causal explanation with a risk factor framework. In Psychiatric Epidemiology: Searching for the Causes of Mental Disorders (ed. Susser, E., Schwartz, S., Morabia, A. and Bromet, E. J.), pp. 422–440. Oxford University Press: New York.Google Scholar
Scott, J, Martin, G, Welham, J, Bor, W, Najman, J, O'Callaghan, M, Williams, G, Aird, R, McGrath, J (2009). Psychopathology during childhood and adolescence predicts delusional-like experiences in adults: a 21-year birth cohort study. American Journal of Psychiatry 166, 567–574.CrossRefGoogle ScholarPubMed
Shevlin, M, Murphy, J, Houston, JE, Adamson, G (2009). Childhood sexual abuse, early cannabis use, and psychosis: testing the effects of different temporal orderings based on the National Comorbidity Survey. Psychosis: Psychological, Social and Integrative Approaches 1, 19–28.CrossRefGoogle Scholar
van Os, J, Rutten, BP, Poulton, R (2008). Gene–environment interactions in schizophrenia: review of epidemiological findings and future directions. Schizophrenia Bulletin 34, 66–82.CrossRefGoogle ScholarPubMed
van Os, J, Sham, P (2003). Gene–environment correlation and interaction in schizophrenia. In The Epidemiology of Schizophrenia (ed. Murray, R. M., Jones, P. B., Susser, E., van Os, J. and Cannon, M.), pp. 235–253. Cambridge University Press: Cambridge, UK.Google Scholar
Verrico, CD, Jentsch, JD, Roth, RH (2003). Persistent and anatomically selective reduction in prefrontal cortical dopamine metabolism after repeated intermittent cannabinoid administration in rats. Synapse 49, 61–66.CrossRefGoogle Scholar
Zammit, S, Wiles, N, Lewis, G (2009). The study of gene–environment interactions in psychiatry: limited gains at a substantial cost? Psychological Medicine. Published online: 24 September 2009. doi:10.1017/S0033291709991280.CrossRefGoogle Scholar