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Rachid H, Saif Z, Raoui S, Serhier Z, Agoub M. Does cannabis affect cognitive functioning in patients with schizophrenia? Schizophr Res Cogn 2024; 36:100299. [PMID: 38196922 PMCID: PMC10772380 DOI: 10.1016/j.scog.2023.100299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/27/2023] [Accepted: 12/09/2023] [Indexed: 01/11/2024]
Abstract
Introduction Cannabis use impairs cognitive performance in healthy subjects; several studies have shown improved cognitive outcomes in schizophrenic patients using cannabis. The aim of this study was to evaluate the effects of cannabis use on cognitive function in Moroccan patients with schizophrenia who were cannabis users. Method Two groups were recruited in a Moroccan University Psychiatric Centre. Fifty patients diagnosed with schizophrenia according to the DSM-V who were cannabis users (SZ CANN +) and forty-nine patients diagnosed with schizophrenia according to DSM-V who do not use cannabis (SZ CANN-). Cognitive functioning was assessed using the CogState neuropsychological battery. Results The results of the study suggest that SZ CANN- patients performed better in the test of psychomotor function, attention and verbal memory. While SZ CANN+ patients performed better in the test of working memory, visual memory and emotional recognition. We found no relationship between SZ CANN+ patients and SZ CANN- patients concerning executive function. Conclusions Our results suggest that cannabis use may have different effects on neurocognitive functioning. It is associated with disorders of psychomotor function, attention and verbal memory. So, it is associated with an improvement in working memory, visual memory and emotion recognition.
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Affiliation(s)
- Hajar Rachid
- Laboratory of Clinical Neuroscience and Mental Health, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- University Psychiatric Center, Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Zineb Saif
- Legal medicine service University Hospital Center, Ibn Rochd, Casablanca, Morocco
| | - Salma Raoui
- University Psychiatric Center, Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Zineb Serhier
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Medical Informatics Laboratory-Faculty of Medicine and Pharmacy, University Hassan II, Casablanca, Morocco
| | - Mohamed Agoub
- Laboratory of Clinical Neuroscience and Mental Health, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- University Psychiatric Center, Ibn Rochd, Casablanca, Morocco
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
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2
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Argote M, Sescousse G, Brunelin J, Baudin G, Schaub MP, Rabin R, Schnell T, Ringen PA, Andreassen OA, Addington JM, Brambilla P, Delvecchio G, Bechdolf A, Wobrock T, Schneider-Axmann T, Herzig D, Mohr C, Vila-Badia R, Rodie JU, Mallet J, Ricci V, Martinotti G, Knížková K, Rodriguez M, Cookey J, Tibbo P, Scheffler F, Asmal L, Garcia-Rizo C, Amoretti S, Huber C, Thibeau H, Kline E, Fakra E, Jardri R, Nourredine M, Rolland B. Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals. EClinicalMedicine 2023; 64:102199. [PMID: 37731936 PMCID: PMC10507201 DOI: 10.1016/j.eclinm.2023.102199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
Background The association between cannabis use and positive symptoms in schizophrenia spectrum disorders is well documented, especially via meta-analyses. Yet, findings are inconsistent regarding negative symptoms, while other dimensions such as disorganization, depression, and excitement, have not been investigated. In addition, meta-analyses use aggregated data discarding important confounding variables which is a source of bias. Methods PubMed, ScienceDirect and PsycINFO were used to search for publications from inception to September 27, 2022. We contacted the authors of relevant studies to extract raw datasets and perform an Individual Participant Data meta-analysis (IPDMA). Inclusion criteria were: psychopathology of individuals with schizophrenia spectrum disorders assessed by the Positive and Negative Syndrome Scale (PANSS); cannabis-users had to either have a diagnosis of cannabis use disorder or use cannabis at least twice a week. The main outcomes were the PANSS subscores extracted via the 3-factor (positive, negative and general) and 5-factor (positive, negative, disorganization, depression, excitement) structures. Preregistration is accessible via Prospero: ID CRD42022329172. Findings Among the 1149 identified studies, 65 were eligible and 21 datasets were shared, totaling 3677 IPD and 3053 complete cases. The adjusted multivariate analysis revealed that relative to non-use, cannabis use was associated with higher severity of positive dimension (3-factor: Adjusted Mean Difference, aMD = 0.34, 95% Confidence Interval, CI = [0.03; 0.66]; 5-factor: aMD = 0.38, 95% CI = [0.08; 0.63]), lower severity of negative dimension (3-factor: aMD = -0.49, 95% CI [-0.90; -0.09]; 5-factor: aMD = -0.50, 95% CI = [-0.91; -0.08]), higher severity of excitement dimension (aMD = 0.16, 95% CI = [0.03; 0.28]). No association was found between cannabis use and disorganization (aMD = -0.13, 95% CI = [-0.42; 0.17]) or depression (aMD = -0.14, 95% CI = [-0.34; 0.06]). Interpretation No causal relationship can be inferred from the current results. The findings could be in favor of both a detrimental and beneficial effect of cannabis on positive and negative symptoms, respectively. Longitudinal designs are needed to understand the role of cannabis is this association. The reported effect sizes are small and CIs are wide, the interpretation of findings should be taken with caution. Funding This research did not receive any specific grant or funding. Primary financial support for authors was provided by Le Vinatier Psychiatric Hospital.
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Affiliation(s)
- Mathilde Argote
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Guillaume Sescousse
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Jérôme Brunelin
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Grégoire Baudin
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100, France
| | - Michael Patrick Schaub
- Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Zurich, Switzerland
| | - Rachel Rabin
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Thomas Schnell
- Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Petter Andreas Ringen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ole Andreas Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy und Psychosomatic, Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, CCM, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Wobrock
- Centre for Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
- Department of Psychiatry and Psychotherapy, Georg-August University Göttingen, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, Ludwig Maximillian University Munich, Munich, Germany
| | - Daniela Herzig
- Clienia Littenheid AG, Psychiatrische Tagesklinik Frauenfeld, 8500, Frauenfeld, Switzerland
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
| | - Christine Mohr
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
| | - Regina Vila-Badia
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Judith Usall Rodie
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Jasmina Mallet
- Université Paris Cité, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris France, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
| | - Valerio Ricci
- Department of Neuroscience, San Luigi Gonzaga University Hospital, 10043, Orbassano, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University of Chieti-Pescara, Italy
| | - Karolína Knížková
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
- General University Hospital in Prague, Czech Republic
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic
| | - Jacob Cookey
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Philip Tibbo
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Freda Scheffler
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Psychiatric Genetics Unit, Vall d’Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Christian Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Wilhelm Klein-Str. 27, 4002 Basel, Switzerland
| | - Heather Thibeau
- Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
| | - Emily Kline
- Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
- Department of Psychiatry, Boston University School of Medicine, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
| | - Eric Fakra
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Pôle Universitaire de Psychiatrie, CHU Saint-Etienne, Saint-Etienne, France
| | - Renaud Jardri
- Lille University, Inserm U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France
- CHU Lille, Fontan Hospital, Child & Adolescent Psychiatry Department & CURE Research Platform, Lille, France
| | - Mikail Nourredine
- Université Claude Bernard Lyon 1, Lyon, France
- Service de biostatistique, Hospices Civils de Lyon, Lyon, France
- Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
- Service Universitaire d’Addictologie de Lyon (SUAL), HCL, CH Le Vinatier, Lyon, France
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Marquez-Arrico JE, Gonzalez-Sanchez A, Navarro JF, Penadés R, Adan A. Patients with Schizophrenia Showed Worse Cognitive Performance than Bipolar and Major Depressive Disorder in a Sample with Comorbid Substance Use Disorders. J Clin Med 2022; 11:jcm11226648. [PMID: 36431125 PMCID: PMC9698443 DOI: 10.3390/jcm11226648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Comorbidity of substance use disorders (SUD) and severe mental illness (SMI) is highly frequent in patients, the most common diagnoses being schizophrenia (SZ), bipolar disorder (BD) and major depressive disorder (MDD). Since comorbidity has its own clinical features, and neurocognitive functioning is not always similar to psychiatric symptoms the present study explores the cognitive performance of patients with dual disorders. A neuropsychological battery of tests was used to assess 120 under treatment male patients, 40 for each group considered (SZ + SUD, BD + SUD and MDD + SUD) who were mainly polyconsumers. Significant differences (with premorbid IQ as a covariate) were found among the groups, with SZ + SUD having a worse performance in attention, verbal learning, short term memory and recognition. The consideration of a global Z score for performance evidenced an impaired neurocognitive pattern for SZ + SUD compared with BD + SUD and MDD + SUD. According to norms, all patients showed difficulties in verbal learning, short-term memory and recognition. Our research indicated that the neurocognitive functioning of dual disorder patients was influenced by the comorbid SMI, with SZ + SUD presenting major difficulties. Future studies should thoroughly explore the role of such difficulties as indicators or endophenotypes for dual schizophrenia disorders, and their usefulness for prevention and treatment.
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Affiliation(s)
- Julia E. Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
| | - Alvaro Gonzalez-Sanchez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
| | - José Francisco Navarro
- Department of Psychobiology, School of Psychology, University of Málaga, Campus de Teatinos s/n, 29071 Málaga, Spain
| | - Rafael Penadés
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain
- Barcelona Clínic Schizophrenia Unit (BCSU), Hospital Clínic Barcelona, 08036 Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
- Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Passeig de la Vall d’Hebrón 171, 08035 Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, 08035 Barcelona, Spain
- Correspondence:
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4
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Dellazizzo L, Potvin S, Giguère S, Dumais A. The Potential Paradoxical Neurocognitive Effects of Cannabis Use in Patients with Psychotic Disorders: A Critical Meta-Review of Meta-Analytical Evidence. Cannabis Cannabinoid Res 2022. [PMID: 35666226 DOI: 10.1089/can.2021.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The association between cannabis and cognitive functions has been thoroughly studied in psychotic disorders, but conflictual/paradoxical results have emerged. This critical meta-review examined the magnitude of effects of cannabis on neurocognitive functions in patients with psychotic disorders provided by meta-analyses and evaluated the quality of evidence. Methods: A systematic search of meta-analyses was performed in PubMed, PsycINFO, Web of Science, and Google Scholar. Results: The search retrieved six meta-analyses. Quality of evidence varied from very low to moderate quality. No neurocognitive difference was observed between cannabis users and nonusers in first episode of psychosis samples. Limited evidence showed no significant difference in language, psychomotor functioning, and verbal/visual learning/memory, apart from improvements in verbal and visual memory (recognition). Findings showed better neurocognitive performances in cannabis-using patients for planning/reasoning and working memory. There were tendencies toward significance for processing speed and attention. Most effect sizes showed small to moderate degrees of outperformances in cannabis users. Individuals with lifetime use appeared to show better neurocognitive functions. Conclusion: Evidence indicated nonuniform effects of cannabis use across cognitive domains, with some areas suggesting better cognitive performances in cannabis users, entitled the paradoxical effect of the dually diagnosed. Clinical significance of these findings should be interpreted cautiously.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Sabrina Giguère
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, Canada
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5
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Longitudinal effects of cannabis use on attentional processes in patients with first episode of psychosis. Schizophr Res 2022; 244:71-80. [PMID: 35640355 DOI: 10.1016/j.schres.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/31/2022] [Accepted: 05/15/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Attention deficits have been considered to be a central characteristic of schizophrenia-spectrum disorders. However, the specific interactions with, and longitudinal effects of, cannabis use at the different stages of the disorder remain unknown. Due to the high percentage of patients who are cannabis users at the onset of the disease, our objective was to explore this relationship and how it evolves in the first three years of the disease. METHOD A total of 461 patients with a first episode of psychosis (FEP) and 187 healthy controls were studied. The differences between cannabis users and non-users at baseline were explored based on both sociodemographic variables and performance in neuropsychological tests of attention. The interaction between cannabis, attentional, and clinical variables was followed up at 3 years. RESULTS Of the 648 participants included in this study, 229 (35.34%) were cannabis users. Of them, 187 (40.6%) were patients and 42 (22.5%) were healthy controls. At baseline, control groups [cannabis users (N = 42); non-users (N = 145)] outperformed the patient groups [cannabis users (N = 187); non-users (N = 274)] in all attention tasks. Longitudinal analyses showed significant improvements in the attentional domains at 3-year follow-up, mainly in the group of patients who had never used cannabis (N = 238), followed by ex-users (N = 105), and persistent users (N = 43). At 3-year follow-up, the group of ex-users was the one that achieved scores closer to those of healthy controls. CONCLUSION FEP patients, both cannabis users and non-users, showed attention deficits. However, the patients who had never used cannabis fared better than cannabis users.
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6
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Amoretti S, Verdolini N, Varo C, Mezquida G, Sánchez-Torres AM, Vieta E, Garcia-Rizo C, Lobo A, González-Pinto A, Abregú-Crespo R, Corripio I, Serra M, de la Serna E, Mané A, Ramos-Quiroga JA, Ribases M, Cuesta MJ, Bernardo M. Is the effect of cognitive reserve in longitudinal outcomes in first-episode psychoses dependent on the use of cannabis? J Affect Disord 2022; 302:83-93. [PMID: 35066012 DOI: 10.1016/j.jad.2022.01.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Cognitive reserve (CR) is a protective factor against cognitive and functional impairment in first-episode psychosis (FEP). The aim of this study was to evaluate the differences in clinical presentation according to the use of cannabis (cannabis users vs non-users) among patients presenting a FEP (non-affective vs affective psychosis), to investigate the impact of CR and cannabis use on several outcomes and to explore the potentially mediatory role played by CR in the relationship between cognitive domains or clinical status and functionality, depending on the use of cannabis. METHODS Linear regression analysis models were carried out to assess the predictive value of CR on clinical, functional and cognitive variables at baseline and at two-year follow-up. The mediation analyzes were performed according to the principles of Baron and Kenny. RESULTS CR was associated with better cognitive performance, regardless of cannabis consumption or diagnosis. In both diagnoses, CR was associated with better clinical and functional outcomes in those patients who did not use cannabis. In terms of mediation procedure, CR mediates the relationship between some cognitive domains and functioning at follow-up only in patients without cannabis use. LIMITATIONS The small sample size of the affective group. CONCLUSIONS CR plays a differential role in the outcome of psychoses according to whether patients are cannabis users or not. Both in affective and non-affective groups CR exerted a greater effect in patients without cannabis use. Our results suggest that the deleterious effect of cannabis use on functioning in FEP surpasses the protective effect of CR.
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Affiliation(s)
- Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain
| | - Norma Verdolini
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Cristina Varo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Ana M Sánchez-Torres
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Eduard Vieta
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain.
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain.
| | - Antonio Lobo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Medicine and Psychiatry, Zaragoza University. Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Araba University Hospital, Bioaraba Research Institute, Spain; University of the Basque Country (UPV-EHU), Spain
| | - Renzo Abregú-Crespo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Serra
- Department of Psychiatry and Psychology, Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Villarroel, 170, Catalonia, Barcelona 08036, Spain
| | - Elena de la Serna
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, SGR2017881, Institut Clinic de Neurociències, Hospital Clínic Universitari, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Anna Mané
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Hospital del Mar Medical research Institute (IMIM), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J Antoni Ramos-Quiroga
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Catalonia, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Catalonia, Barcelona, Spain
| | - Marta Ribases
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Catalonia, Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, SGR2017881, Institut Clinic de Neurociències, Hospital Clínic Universitari, CIBERSAM, IDIBAPS, Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
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Glick L, Kertzman S, Wolf A, Kupchik M, Kuperberg M, Dannon P. The Influence of Substance Abuse on Inhibition Capacities and Risky Decision in a Group of Outpatient Schizophrenia Patients. J Dual Diagn 2021; 17:143-150. [PMID: 33784943 DOI: 10.1080/15504263.2021.1904164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Substance abuse is common among patients with schizophrenia, is related to worse course and outcome of illness. Unfortunately, little is known about how substance abuse affects the cognitive function of schizophrenia patients, whose cognitive function is often already comprised. Neurocognitive functioning includes inhibition control and decision-making, and both schizophrenia and substance use disorder are related to impairments of inhibition control. However, the influence of substance abuse on inhibition capacities among schizophrenia patients is unclear. Methods: This study measured the influence of substance use disorder on inhibition capacities and risky decision-making in a group of 39 schizophrenia patients that were evaluated using a socio-demographic questionnaire and clinical assessment using the Positive and Negative Syndromes Scale for Schizophrenia. To assess inhibition control we utilized the Matching Familiar Figure Test (MFFT) and the Stroop task, and to evaluate decision-making we used the Iowa Gambling Task (IGT) and self-report questionnaire, the Barratt Impulsiveness Scale. Results: Univariate analysis found significant differences between the groups with regard to criminal history (χ2 = 5.97, p=.015), smoking status (χ2 = 12.30, p<.001), and total BIS score (t= -2.69, df = 37, p=.01). Our model did not find a significant effect of substance abuse on the first response time and number of errors on the MFFT or in the total interference index of Stroop performance and net score on risky decision-making in the IGT. The two groups did not differ significantly either in first response time or in number of errors on the MFFT (F = 0.54, p=.47, d = 0.24, 95% CI [-0.4, 0.88]; F = 0.28, p=.60, d = 0.61, 95% CI [0, 1.26], respectively), nor did they differ in the total interference index of the Stroop task (F(1)=0.49, p=.49, d = 0.25, 95% CI [-0.38, 0.88]). Conclusion: The analyses did not detect any statistically significant effect of substance abuse on inhibition control or risky decision-making processes in outpatients diagnosed with schizophrenia, despite increased impulsivity, criminal history and smoking status. These results neither support nor disprove previous findings.
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Affiliation(s)
- Lior Glick
- Co-occurring Disorders Treatment Ward Ness Ziona-Beer Yaakov Mental Health Centers, & The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Semion Kertzman
- Co-occurring Disorders Treatment Ward Ness Ziona-Beer Yaakov Mental Health Centers, & The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviva Wolf
- Co-occurring Disorders Treatment Ward Ness Ziona-Beer Yaakov Mental Health Centers, & The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Marina Kupchik
- Co-occurring Disorders Treatment Ward Ness Ziona-Beer Yaakov Mental Health Centers, & The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Kuperberg
- Co-occurring Disorders Treatment Ward Ness Ziona-Beer Yaakov Mental Health Centers, & The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Pinhas Dannon
- Co-occurring Disorders Treatment Ward Ness Ziona-Beer Yaakov Mental Health Centers, & The Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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8
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de Vos C, Leopold K, Blanke ES, Siebert S, Baumgardt J, Burkhardt E, Bechdolf A. The relationship between cannabis use and cognition in people diagnosed with first-episode psychosis. Psychiatry Res 2020; 293:113424. [PMID: 32862065 DOI: 10.1016/j.psychres.2020.113424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 01/18/2023]
Abstract
Cannabis use is highly prevalent among young people diagnosed with first-episode psychosis (FEP), however, its impact on cognition is still unclear. The aim of the present study was to examine the association of cannabis use with cognition in people diagnosed with FEP. We extended previous research findings by operationalising the comorbid cannabis use, considering recency of cannabis use and use of other illicit substances and including people with a broad spectrum of psychotic diagnoses. A total of 89 people diagnosed with FEP were interviewed about their history of substance use and completed a cognitive test battery assessing verbal memory, verbal fluency and attention. Sixty-one participants were lifetime cannabis users (CU; ≥three times per week for ≥four weeks; 68.5%) and 28 were cannabis non-users (CNU; 31.5%). CU were significantly more likely to be male and exhibited significantly more positive symptoms than CNU. In contrast, CNU displayed significantly more negative symptoms than CU. There were no differences between CU and CNU on neurocognitive tasks of verbal memory, verbal fluency and attention. In conclusion, there was no indication that cannabis use was associated with cognitive impairments in people diagnosed with FEP.
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Affiliation(s)
- Chloé de Vos
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Department of Psychiatry and Psychotherapy, University Hospital Cologne, Germany.
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany
| | - Elisabeth S Blanke
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Institute of Psychology, Humboldt-University Berlin, Germany
| | - Stefan Siebert
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany
| | - Johanna Baumgardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Germany
| | - Eva Burkhardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Orygen, Parkville, Victoria, Australia
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Department of Psychiatry and Psychotherapy, University Hospital Cologne, Germany; Orygen, Parkville, Victoria, Australia
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9
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Cannabis, nicotine and the negative symptoms of schizophrenia: Systematic review and meta-analysis of observational studies. Neurosci Biobehav Rev 2020; 116:415-425. [DOI: 10.1016/j.neubiorev.2020.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022]
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10
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Ferraro L, La Cascia C, Quattrone D, Sideli L, Matranga D, Capuccio V, Tripoli G, Gayer-Anderson C, Morgan C, Sami MB, Sham P, de Haan L, Velthorst E, Jongsma HE, Kirkbride JB, Rutten BPF, Richards AL, Roldan L, Arango C, Bernardo M, Bobes J, Sanjuan J, Santos JL, Arrojo M, Tarricone I, Tortelli A, Szöke A, Del-Ben CM, Selten JP, Lynskey M, Jones PB, Van Os J, La Barbera D, Murray RM, Di Forti M. Premorbid Adjustment and IQ in Patients With First-Episode Psychosis: A Multisite Case-Control Study of Their Relationship With Cannabis Use. Schizophr Bull 2020; 46:517-529. [PMID: 31361020 PMCID: PMC7147569 DOI: 10.1093/schbul/sbz077] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = -0.3, 95% CI = [-0.5; -0.2]) and never-users (Mdiff = -0.4, 95% CI = [-0.6; -0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders.
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Affiliation(s)
- Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,To whom correspondence should be addressed; Via Gaetano La Loggia, 1, 90129 Palermo, Italy; tel: 091-6555175, fax: 091-6555164, e-mail:
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Lucia Sideli
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Domenica Matranga
- Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Veronica Capuccio
- Department of Economic, Management and Statistical Sciences (DSEAS) University of Palermo, Palermo, Italy
| | - Giada Tripoli
- 2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Musa B Sami
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Pak Sham
- Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands,Departments of Psychiatry and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Hannah E Jongsma
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Cambridge, UK,Psylife Group, Division of Psychiatry, University College London, London, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Alexander L Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Laura Roldan
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuan
- Department of Psychiatry, School of Medicine, Universidad de Valencia, CIBERSAM, Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz,” Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, Paris, France,INSERM, Créteil, France
| | | | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Jean-Paul Selten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands,Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
| | - Michael Lynskey
- Department of Addiction, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jim Van Os
- 2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | | | - Robin M Murray
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,2Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Marta Di Forti
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy,Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK,South London and Maudsley NHS Mental Health Foundation Trust, London, UK
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11
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Bosia M, Buonocore M, Bechi M, Stere LM, Silvestri MP, Inguscio E, Spangaro M, Cocchi F, Bianchi L, Guglielmino C, Cavallaro R. Schizophrenia, cannabis use and Catechol-O-Methyltransferase (COMT): Modeling the interplay on cognition. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:363-368. [PMID: 30790675 DOI: 10.1016/j.pnpbp.2019.02.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 02/11/2019] [Accepted: 02/14/2019] [Indexed: 11/17/2022]
Abstract
Cognitive impairments are considered core features of schizophrenia and are recognized as the most important predictors of functional outcome and quality of life. A better study of the mechanisms underlying the cognition is of extreme relevance. Literature has shown that several genetic and environmental factors affect cognitive performance. In particular, the interaction between Catechol-O-Methyltransferase (COMT) gene and cannabis use has gained increasing attention in the past years. Based on these premises, the present study, aimed to analyze the interplay between cannabis use and COMT polymorphism on cognitive performance in a sample of 135 patients with chronic schizophrenia. Patients were assessed for neurocognitive measures with a broad battery, genotyped for COMT Val158Met polymorphism from peripheral blood sample, and evaluated with a semi-structured interview in order to establish the history of cannabis abuse. Results showed a significant interaction effect between COMT polymorphism and cannabis use on verbal fluency and speed of processing. The analysis revealed significant differences between subjects COMT Val/Val homozygous and Met carriers with history of cannabis use, with a better performance on both tasks among the Met carriers group. These data are in line with literature on healthy subjects that suggests a more detrimental effect of cannabis among subjects with Val/Val genotype. In conclusions, results highlight the need to better disentangle the biological pathways in which cannabis use and COMT are converging, as possible treatment targets, as well as the importance to assess these factors in clinical to optimize individualized interventions.
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Affiliation(s)
- Marta Bosia
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita -Salute San Raffaele University, Milan, Italy
| | - Mariachiara Buonocore
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Emanuela Inguscio
- School of Psychology, Vita -Salute San Raffaele University, Milan, Italy
| | - Marco Spangaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Cocchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Bianchi
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carmelo Guglielmino
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Cavallaro
- Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita -Salute San Raffaele University, Milan, Italy
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12
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Bogaty SER, Crouse JJ, Hickie IB, Hermens DF. The neuropsychological profiles of young psychosis patients with and without current cannabis use. Cogn Neuropsychiatry 2019; 24:40-53. [PMID: 30621505 DOI: 10.1080/13546805.2018.1562887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Evidence suggests that patients with psychosis who have a history of cannabis use, but currently abstain, demonstrate superior cognitive performance than patients who have never used cannabis. The present study aimed to determine the neurocognitive profiles of patients who are in adolescence or early adulthood, when both illness- and drug-onset typically occur. METHODS Subjects were 24 cannabis-using and 79 cannabis-naïve psychosis patients between 16 and 25 years of age. Patients and controls were administered a neurocognitive battery, indexing estimated pre-morbid intelligence, psychomotor speed, mental flexibility, verbal learning and memory, verbal fluency, sustained attention, motor and mental response, and visuospatial learning and memory. RESULTS While healthy controls outperformed both patient groups across most cognitive measures, no significant differences between cannabis-using and cannabis-abstinent patients were evident. CONCLUSION Evidently although there may be a group of patients who are diagnosed with a non-affective psychosis disorder regardless of external factors (i.e. cannabis use), some may instead have their illness precipitated through cannabis use at a young age, presenting with unique cognitive and symptomatic repercussions later in life. These results demonstrate no cognitive differences between cannabis-using patients and abstinent patients at the time of illness-onset, providing partial support for an alternative pathway to schizophrenia through early cannabis use.
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Affiliation(s)
- Sophia E R Bogaty
- a Youth Mental Health Team, Brain and Mind Centre , University of Sydney , Sydney , Australia
| | - Jacob J Crouse
- a Youth Mental Health Team, Brain and Mind Centre , University of Sydney , Sydney , Australia
| | - Ian B Hickie
- a Youth Mental Health Team, Brain and Mind Centre , University of Sydney , Sydney , Australia
| | - Daniel F Hermens
- a Youth Mental Health Team, Brain and Mind Centre , University of Sydney , Sydney , Australia.,b Sunshine Coast Mind and Neuroscience Thompson Institute , University of the Sunshine Coast , Birtinya , Australia
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13
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Abush H, Ghose S, Van Enkevort EA, Clementz BA, Pearlson GD, Sweeney JA, Keshavan MS, Tamminga CA, Ivleva EI. Associations between adolescent cannabis use and brain structure in psychosis. Psychiatry Res Neuroimaging 2018; 276:53-64. [PMID: 29628270 PMCID: PMC5959798 DOI: 10.1016/j.pscychresns.2018.03.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 01/28/2023]
Abstract
Associations between cannabis use and psychotic disorders suggest that cannabis may be a contributory risk factor in the neurobiology of psychosis. In this study, we examined brain structure characteristics, total and regional gray matter density (GMD), using Voxel Based Morphometry, in psychotic individuals, stratified by history of cannabis use (total n = 109). We also contrasted GMD estimates in individual diagnostic groups (schizophrenia/bipolar I disorder) with and without history of adolescent cannabis use (ACU). Individuals with psychosis as a whole, both with and without history of ACU, had lower total and regional GMD, compared to healthy controls. ACU was associated with attenuated GMD reductions, compared to non-users, especially in the schizophrenia cases, who showed robust GMD reductions in fronto-temporal and parietal cortex, as well as subcortical regions. Notably, total and regional GMD estimates in individuals with psychosis and ACU were not different from controls with no ACU. These data indicate that the history of ACU in psychotic individuals is associated with attenuated GMD abnormalities. Future investigations targeting potential unique etiological and risk factors associated with psychosis in individuals with ACU may help in understanding of the neurobiology of psychotic disorders and novel treatment options for these individuals.
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Affiliation(s)
- Hila Abush
- Department of Psychiatry, UT Southwestern Medical Center, Dallas TX, USA
| | - Subroto Ghose
- Department of Psychiatry, UT Southwestern Medical Center, Dallas TX, USA
| | | | - Brett A Clementz
- Departments of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens GA, USA
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven CT, USA; Institute of Living, Hartford Hospital, Hartford CT, USA
| | - John A Sweeney
- Department of Psychiatry, UT Southwestern Medical Center, Dallas TX, USA
| | | | - Carol A Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas TX, USA
| | - Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas TX, USA.
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14
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Whitfield-Gabrieli S, Fischer AS, Henricks AM, Khokhar JY, Roth RM, Brunette MF, Green AI. Understanding marijuana's effects on functional connectivity of the default mode network in patients with schizophrenia and co-occurring cannabis use disorder: A pilot investigation. Schizophr Res 2018; 194:70-77. [PMID: 28823723 PMCID: PMC6886576 DOI: 10.1016/j.schres.2017.07.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 07/06/2017] [Accepted: 07/09/2017] [Indexed: 10/19/2022]
Abstract
Nearly half of patients with schizophrenia (SCZ) have co-occurring cannabis use disorder (CUD), which has been associated with decreased treatment efficacy, increased risk of psychotic relapse, and poor global functioning. While reports on the effects of cannabis on cognitive performance in patients with SCZ have been mixed, study of brain networks related to executive function may clarify the relationship between cannabis use and cognition in these dual-diagnosis patients. In the present pilot study, patients with SCZ and CUD (n=12) and healthy controls (n=12) completed two functional magnetic resonance imaging (fMRI) resting scans. Prior to the second scan, patients smoked a 3.6% tetrahydrocannabinol (THC) cannabis cigarette or ingested a 15mg delta-9-tetrahydrocannabinol (THC) pill. We used resting-state functional connectivity to examine the default mode network (DMN) during both scans, as connectivity/activity within this network is negatively correlated with connectivity of the network involved in executive control and shows reduced activity during task performance in normal individuals. At baseline, relative to controls, patients exhibited DMN hyperconnectivity that correlated with positive symptom severity, and reduced anticorrelation between the DMN and the executive control network (ECN). Cannabinoid administration reduced DMN hyperconnectivity and increased DMN-ECN anticorrelation. Moreover, the magnitude of anticorrelation in the controls, and in the patients after cannabinoid administration, positively correlated with WM performance. The finding that DMN brain connectivity is plastic may have implications for future pharmacotherapeutic development, as treatment efficacy could be assessed through the ability of therapies to normalize underlying circuit-level dysfunction.
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Affiliation(s)
- Susan Whitfield-Gabrieli
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Adina S. Fischer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Angela M. Henricks
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Jibran Y. Khokhar
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Robert M. Roth
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Mary F. Brunette
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Alan I. Green
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.,Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.,Dartmouth Clinical and Translational Science Institute, Dartmouth College, Hanover, NH, USA.,Corresponding Author: Department of Psychiatry, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH 03756, USA.
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15
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Khokhar JY, Todd TP. Behavioral predictors of alcohol drinking in a neurodevelopmental rat model of schizophrenia and co-occurring alcohol use disorder. Schizophr Res 2018; 194:91-97. [PMID: 28285734 PMCID: PMC5591749 DOI: 10.1016/j.schres.2017.02.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 12/31/2022]
Abstract
Alcohol use disorder commonly occurs in patients with schizophrenia and contributes greatly to its morbidity. Unfortunately, the neural and behavioral underpinnings of alcohol drinking in these patients are not well understood. In order to begin to understand the cognitive and reward-related changes that may contribute to alcohol drinking, this study was designed to address: 1) latent inhibition; 2) conditioning; and 3) extinction of autoshaping in a neurodevelopmental rat model with relevance to co-occurring schizophrenia and alcohol use disorders, the neonatal ventral hippocampal lesioned (NVHL) rat. NVHL lesions (or sham surgeries) were performed on post-natal day 7 (PND7) and animals were given brief exposure to alcohol during adolescent (PND 28-42). Latent inhibition of autoshaping, conditioning and extinction were assessed between PND 72-90. On PND90 animals were given alcohol again and allowed to establish stable drinking. Latent inhibition of autoshaping was found to be prolonged in the NVHL rats; the NVHL rats pre-exposed to the lever stimulus were slower to acquire autoshaping than sham pre-exposed rats. NVHL rats that were not pre-exposed to the lever stimulus did not differ during conditioning, but were slower to extinguish conditioned responding compared to sham controls. Finally, the NVHL rats from both groups drank significantly more alcohol than sham rats, and the extent of latent inhibition predicted future alcohol intake in the pre-exposed animals. These findings suggest that the latent inhibition of autoshaping procedure can be used to model cognitive- and reward-related dysfunctions in schizophrenia, and these dysfunctions may contribute to the development of co-occurring alcohol use.
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Affiliation(s)
- Jibran Y Khokhar
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, United States.
| | - Travis P Todd
- Department of Psychological and Brain Sciences, Dartmouth College, United States
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Bogaty SER, Lee RSC, Hickie IB, Hermens DF. Meta-analysis of neurocognition in young psychosis patients with current cannabis use. J Psychiatr Res 2018; 99:22-32. [PMID: 29407284 DOI: 10.1016/j.jpsychires.2018.01.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/12/2018] [Accepted: 01/12/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Adult psychosis patients (i.e. over the age of 25 years) who are also lifetime cannabis users (CANN±) appear to exhibit superior cognition compared to never-using patients (CANN-). The objective of this meta-analysis was to evaluate the cognitive differences between CANN- and patients who currently use cannabis (CANN+) (i.e. during the CANN± patients' cannabis-using stage). Specifically, focusing on young patients under the age of 25 years, the typical stage of both psychosis- and cannabis-onset. METHOD Of the 308 studies identified through database searches and secondary referencing, 14 compared neurocognition of CANN+ and CANN- in young people with psychotic disorders (mean age between 15 and 45 years). Effect sizes were extracted using neurocognitive test performance between CANN+ and CANN- and random effects modelling was conducted on pooled ES and moderator analyses. RESULTS CANN+ performed worse on several cognitive domains (i.e. premorbid IQ, current IQ, verbal learning, verbal working memory, motor inhibition) compared to CANN-. The association between age and performance in CANN+ cognition was varied, with older age predictive of worse performance in processing speed, sustained attention, verbal memory, and better performance in verbal learning and very fluency. Of note, CANN+ outperformed CANN- in tests of conceptual set-shifting. CONCLUSION These results are consistent with previous findings indicating that CANN+ demonstrate poorer neurocognition than CANN-; and that this is exacerbated with increasing age. Our findings demonstrate significant cognitive differences between patients with CANN+ versus CANN- even at early-onset psychosis, which could suggest a different underlying mechanism towards psychosis for cannabis users.
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Affiliation(s)
| | - Rico S C Lee
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia; Brain and Mental Health Laboratory, Monash University, Melbourne, VIC, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - Daniel F Hermens
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia; Sunshine Coast Mind and Neuroscience Thompson Institute, University of the Sunshine Coast, Birtinya, QLD, Australia.
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Moustafa AA, Salama M, Peak R, Tindle R, Salem A, Keri S, Misiak B, Frydecka D, Mohamed W. Interactions between cannabis and schizophrenia in humans and rodents. Rev Neurosci 2018; 28:811-823. [PMID: 28498796 DOI: 10.1515/revneuro-2016-0083] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/18/2017] [Indexed: 12/12/2022]
Abstract
In this review, we provide an overview of the relationship between cannabis use and the development of schizophrenia, using both animal and human studies. We further discuss the potential neural mechanism that may mediate the relationship between cannabis use and schizophrenia symptoms. We finally provide clinical implications and future studies that can further elucidate the relationship between cannabis and schizophrenia.
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18
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Colizzi M, Bhattacharyya S. Neurocognitive effects of cannabis: Lessons learned from human experimental studies. PROGRESS IN BRAIN RESEARCH 2018; 242:179-216. [DOI: 10.1016/bs.pbr.2018.08.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Waterreus A, Badcock JC, Di Prinzio P, Martin-Iverson M, Morgan VA. The impact of current cannabis use on general cognitive function in people with psychotic illness. Schizophr Res 2017; 190:164-171. [PMID: 28381332 DOI: 10.1016/j.schres.2017.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Despite growing research, it remains unclear if cannabis use is associated with additive cognitive impairment in people with psychotic illness and whether exposure in early adolescence is associated with poorer cognitive performance in adulthood. METHODS This cross-sectional study of a nationally representative sample of 1199 adults with psychotic illness compared current cognition (digit symbol coding) of 297 current users of cannabis (used in the past year), 460 past users (used previously but not in the past year) and 442 non-users (never used). Multiple logistic regression was used to examine whether cognitive performance of cannabis-user groups varied by exposure age and diagnosis (non-affective/affective psychoses). RESULTS Unadjusted analysis showed current cannabis users had significantly higher odds of impaired cognitive function compared to non-users (odds ratio=1.52, 95%CI=1.04-2.22). After adjusting for potential confounders, differences between the three groups were not significant. Exposure age was not significant in adjusted analysis. In participants with nonaffective psychoses, cognitive ability of current cannabis users did not differ from non-users. However, in participants with affective psychoses, using cannabis in the last year was a significant predictor of impaired cognitive function (odds ratio=2.25, 95%CI=1.05-4.84). CONCLUSION Among people with psychotic illness, there was no significant difference in cognitive function between current, past and non-users of cannabis. However, when we compared cognitive performance of the three cannabis groups by diagnostic grouping, current cannabis use had a significant negative relationship with cognitive function in people with affective psychoses, but not in those with non-affective psychoses. This finding requires replication and further investigation.
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Affiliation(s)
- Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia.
| | - Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| | - Mathew Martin-Iverson
- Pharmacology, M510, School of Biomedical Sciences, University of Western Australia, Stirling Highway, Crawley, 6009, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia; Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
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20
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Effects of Extended Cannabis Abstinence on Cognitive Outcomes in Cannabis Dependent Patients with Schizophrenia vs Non-Psychiatric Controls. Neuropsychopharmacology 2017; 42:2259-2271. [PMID: 28443616 PMCID: PMC5603819 DOI: 10.1038/npp.2017.85] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 04/10/2017] [Accepted: 04/21/2017] [Indexed: 01/12/2023]
Abstract
Cross-sectional studies of the effects of cannabis on cognition in schizophrenia have produced mixed results. Heavy and persistent cannabis use in schizophrenia is a common clinical problem, and effects of controlled abstinence from cannabis in these patients have not been carefully evaluated. The present study sought to determine the effects of cannabis abstinence on cognition in patients with schizophrenia and co-occurring cannabis dependence. We utilized a 28-day cannabis abstinence paradigm to investigate the state-dependent effects of cannabis on select cognitive outcomes in cannabis-dependent patients with schizophrenia and non-psychiatric controls. Nineteen patients and 20 non-psychiatric male cannabis-dependent participants underwent 28 days of cannabis abstinence. Cognition was assessed on day 0, 14, and 28 using a comprehensive neuropsychological battery. Clinical symptoms were assessed weekly. Abstinence was facilitated by contingency reinforcement confirmed by twice weekly urinalysis. Forty-two percent of patients and 55% of controls achieved end-point abstinence (p=0.53), which was biochemically-verified (day 28 urinary THC-COOH <20 ng/ml). In this preliminary study, schizophrenia-abstainers demonstrated improvements in Hopkins Verbal Learning Test-Revised (HVLT-R) performance over time [F(2,14)=4.73, p<0.03] (d=1.07). Lesser improvements on HVLT-R were observed in non-psychiatric control abstainers (d=0.66), and with abstinence on other cognitive test measures, in both patients and controls. Verbal memory and learning may improve in schizophrenia and control subjects with cannabis abstinence, but larger more definitive studies are needed. Our findings underscore the importance of developing effective interventions for cannabis use disorders in schizophrenia.
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Does Cannabis Composition Matter? Differential Effects of Delta-9-tetrahydrocannabinol and Cannabidiol on Human Cognition. CURRENT ADDICTION REPORTS 2017; 4:62-74. [PMID: 28580227 PMCID: PMC5435777 DOI: 10.1007/s40429-017-0142-2] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose of Review The lack of clarity about the effect of cannabis use on cognition may be attributable to the considerable heterogeneity among studies in terms of cannabis composition. This article selectively reviews studies examining the distinctive effects of cannabinoids on human cognition, particularly those of delta-9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD). Recent Findings Research indicates that ∆9-THC administration acutely impairs cognition, particularly memory and emotional processing. Limited evidence suggests that CBD administration might improve cognition in cannabis users but not in individuals with neuropsychiatric disorders. Moreover, studies indicate that some acute Δ9-THC-induced cognitive impairments may be prevented if Δ9-THC is administered in combination or following CBD treatment. Δ9-THC and CBD have also shown opposite effects on cognition-related brain activation, possibly reflecting their antagonistic behavioral effects. Summary Research suggests greater cognitive impairments in individuals when exposed to high ∆9-THC or low CBD cannabis. It is unclear whether at specific concentrations CBD might outweigh any harmful effects of Δ9-THC on cognition.
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Rentzsch J, Kronenberg G, Stadtmann A, Neuhaus A, Montag C, Hellweg R, Jockers-Scherübl MC. Opposing Effects of Cannabis Use on Late Auditory Repetition Suppression in Schizophrenia Patients and Healthy Control Subjects. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017. [DOI: 10.1016/j.bpsc.2016.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Helle S, Løberg EM, Gjestad R, Schnakenberg Martin AM, Lysaker PH. The positive link between executive function and lifetime cannabis use in schizophrenia is not explained by current levels of superior social cognition. Psychiatry Res 2017; 250:92-98. [PMID: 28152399 DOI: 10.1016/j.psychres.2017.01.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 11/26/2022]
Abstract
There has been a growing link between a history of cannabis use and neurocognitive performance in patients with schizophrenia. Fewer neurocognitive deficits may be a marker of the superior social cognition needed to obtain illicit substances, or cannabis use may indicate a distinct path to schizophrenia with less neurocognitive vulnerability. This study sought to determine whether the relationship of cannabis use and executive function exists independently of social cognition. Eighty-seven patients with schizophrenia were administered measures of social cognition and executive function. Social cognition was assessed using the Bell-Lysaker Emotion Recognition Test to measure affect recognition, and the Eyes and Hinting Tests to measure theory of mind. Executive function was assessed by the Mental Flexibility component of the Delis-Kaplan Executive Functioning Scale. The relations between the variables were examined with structural equation modeling. Cannabis use positively related to executive function, negatively related to affect recognition, and had no relationship with theory of mind. There were no indirect effects of other illicit substances on amount of regular cannabis use. Alcohol use was related to worse affect recognition. The relationship between cannabis use and better executive function was supported and was not explained by superior social cognition.
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Affiliation(s)
- Siri Helle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Norway
| | - Rolf Gjestad
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ashley M Schnakenberg Martin
- Roudebush Veteran Affairs Medical Center, Indianapolis, IN, USA; Indiana University - Bloomington, Bloomington, IN, USA
| | - Paul H Lysaker
- Roudebush Veteran Affairs Medical Center, Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA.
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24
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Schnakenberg Martin AM, Bonfils KA, Davis BJ, Smith EA, Schuder K, Lysaker PH. Compared to high and low cannabis use, moderate use is associated with fewer cognitive deficits in psychosis. SCHIZOPHRENIA RESEARCH-COGNITION 2016; 6:15-21. [PMID: 28740820 DOI: 10.1016/j.scog.2016.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/07/2016] [Accepted: 09/08/2016] [Indexed: 10/20/2022]
Abstract
Literature on the relationship of cannabis use and cognition in schizophrenia provides the paradoxical view that cannabis use is sometimes linked with less severe impairment in neurocognition. This paper explored the possibility that this is a reflection of a dose related response between lifetime cannabis use and two forms of cognition, neurocognition and metacognition, in schizophrenia. It was hypothesized that three groups of patients could be differentiated, those with (1) little to no cannabis use with poor levels of cognition, (2) moderate cannabis use and relatively better levels of cognition and (3) high cannabis use with relatively poorer levels of cognition. Sixty-six adults with schizophrenia completed assessments of neurocognition, metacognition and months of lifetime cannabis use. A k-means cluster analysis yielded three distinct groups based on these assessments. The clusters included: (1) low cannabis/poor cognition (n = 34); (2) heavy cannabis/moderately impaired cognition (n = 10); and (3) moderate cannabis/higher cognition (n = 22). Consistent with our hypothesis, participants with high and moderate lifetime cannabis use had lesser impairment of neurocognition and metacognition compared to low lifetime cannabis use. Participants with moderate lifetime cannabis use also had lesser impairment of metacognition compared to low and heavy use. These findings suggest that a dose related relationship exists between cannabis use and cognition. Results could be due to an influence of pre-existing cognitive level on likelihood of lifetime cannabis use, or to an interaction between use and cognitive function.
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Affiliation(s)
- Ashley M Schnakenberg Martin
- Department of Psychological and Brain Sciences, Indiana University-Bloomington, 1101 E 10th Street, Bloomington, IN 47405, USA.,Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Street, Indianapolis, IN 46202, USA
| | - Kelsey A Bonfils
- Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Street, Indianapolis, IN 46202, USA.,Department of Psychology, Indiana University-Purdue University, 402 N. Blackford Street, Indianapolis, IN 46202, USA
| | - Beshaun J Davis
- Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Street, Indianapolis, IN 46202, USA.,Department of Psychology, Indiana University-Purdue University, 402 N. Blackford Street, Indianapolis, IN 46202, USA
| | - Elizabeth A Smith
- Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Street, Indianapolis, IN 46202, USA.,Department of Psychology, Indiana State University, B-207 Root Hall, 200 North Seventh Street, Terre Haute, IN 47809, USA
| | - Kelly Schuder
- Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Street, Indianapolis, IN 46202, USA.,Department of Psychology, Indiana State University, B-207 Root Hall, 200 North Seventh Street, Terre Haute, IN 47809, USA
| | - Paul H Lysaker
- Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Street, Indianapolis, IN 46202, USA.,Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th St., Suite 4800, Indianapolis, IN 46202, USA
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Hanna RC, Perez JM, Ghose S. Cannabis and development of dual diagnoses: A literature review. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 43:442-455. [PMID: 27612527 DOI: 10.1080/00952990.2016.1213273] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND The use of cannabis has garnered more attention recently with ongoing efforts at marijuana legalization. The consequences of cannabis use are not clearly understood and remain a concern. OBJECTIVES To review the acute and persistent effects of cannabis use and associations with psychiatric disorders. METHODS Using Pubmed and PsychInfo, we conducted a narrative review of the literature on cannabis and psychiatric comorbidity using the keywords cannab*, marijuana, schizo*, psychosis, mood, depression, mania, bipolar, and anxiety. RESULTS There is substantial evidence of cannabis use leading to other illicit drug use and of an association between cannabis use and psychosis. A few reports suggest an association with bipolar disorder while the association with depression and anxiety disorders is mixed. CONCLUSIONS Whenever an association is observed between cannabis use and psychiatric disorders, the relationship is generally an adverse one. Age at the time of cannabis use appears to be an important factor with stronger associations observed between adolescent onset cannabis use and later onset of psychiatric disorders. Additional studies taking into account potential confounds (such as withdrawal symptoms, periods of abstinence, and other substance use) and moderators (such as age of initiation of cannabis use, the amount and frequency of drug use, prior history of childhood maltreatment, and gender) are needed to better understand the psychiatric consequences of cannabis use.
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Affiliation(s)
- Rebecca C Hanna
- a Department of Psychiatry , UT Southwestern , Dallas , TX , USA
| | - Jessica M Perez
- a Department of Psychiatry , UT Southwestern , Dallas , TX , USA
| | - Subroto Ghose
- a Department of Psychiatry , UT Southwestern , Dallas , TX , USA
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Duijkers JCLM, Vissers CTWM, Egger JIM. Unraveling Executive Functioning in Dual Diagnosis. Front Psychol 2016; 7:979. [PMID: 27445939 PMCID: PMC4923259 DOI: 10.3389/fpsyg.2016.00979] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 06/13/2016] [Indexed: 01/01/2023] Open
Abstract
In mental health, the term dual-diagnosis is used for the co-occurrence of Substance Use Disorder (SUD) with another mental disorder. These co-occurring disorders can have a shared cause, and can cause/intensify each other’s expression. Forming a threat to health and society, dual-diagnosis is associated with relapses in addiction-related behavior and a destructive lifestyle. This is due to a persistent failure to control impulses and the maintaining of inadequate self-regulatory behavior in daily life. Thus, several aspects of executive functioning like inhibitory, shifting and updating processes seem impaired in dual-diagnosis. Executive (dys-)function is currently even seen as a shared underlying key component of most mental disorders. However, the number of studies on diverse aspects of executive functioning in dual-diagnosis is limited. In the present review, a systematic overview of various aspects of executive functioning in dual-diagnosis is presented, striving for a prototypical profile of patients with dual-diagnosis. Looking at empirical results, inhibitory and shifting processes appear to be impaired for SUD combined with schizophrenia, bipolar disorder or cluster B personality disorders. Studies involving updating process tasks for dual-diagnosis were limited. More research that zooms in to the full diversity of these executive functions is needed in order to strengthen these findings. Detailed insight in the profile of strengths and weaknesses that underlies one’s behavior and is related to diagnostic classifications, can lead to tailor-made assessment and indications for treatment, pointing out which aspects need attention and/or training in one’s self-regulative abilities.
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Affiliation(s)
- Judith C L M Duijkers
- Centre of Excellence for Korsakoff and Alcohol Related Cognitive Dysfunctions/Addiction Care, Vincent van Gogh Institute for PsychiatryVenray, Netherlands; Behavioural Science Institute, Radboud University NijmegenNijmegen, Netherlands
| | - Constance Th W M Vissers
- Behavioural Science Institute, Radboud University NijmegenNijmegen, Netherlands; Kentalis Academy, Royal Dutch KentalisSint-Michielsgestel, Netherlands
| | - Jos I M Egger
- Behavioural Science Institute, Radboud University NijmegenNijmegen, Netherlands; Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for PsychiatryVenray, Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University NijmegenNijmegen, Netherlands; Pompe Institute for Forensic Psychiatry, Pro PersonaNijmegen, Netherlands
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Núñez C, Ochoa S, Huerta-Ramos E, Baños I, Barajas A, Dolz M, Sánchez B, Del Cacho N, Usall J. Cannabis use and cognitive function in first episode psychosis: differential effect of heavy use. Psychopharmacology (Berl) 2016; 233:809-21. [PMID: 26621349 DOI: 10.1007/s00213-015-4160-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 11/15/2015] [Indexed: 11/26/2022]
Abstract
RATIONALE First episode patients and patients with schizophrenia exhibit increased rates of cannabis use compared to the general population. Contrary to what has been reported in studies with healthy people, most of the published studies so far have reported no impairments or even beneficial effects on neurocognition associated with cannabis consumption in psychotic patients. However, these studies did not address the effects of very high cannabis consumption. OBJECTIVES Our aim in this study was to assess the effects on neurocognition of medium and heavy cannabis consumption in first psychotic episode patients. METHODS A total of 74 patients were included in the study and assigned to three different groups according to their mean cannabis consumption during the last year (non-users, medium users, and heavy users). Participants were administered verbal memory and other neurocognitive tasks. RESULTS Heavy cannabis users were significantly impaired in all the verbal memory measures with respect to non-users, including immediate (p = .026), short-term (p = .005), and long-term (p = .002) memory. There were no significant differences between medium and non-users. Moreover, non-users performed better than all cannabis users in the arithmetic task (p = .020). Heavy cannabis consumption was associated with more commission errors in the continuous performance task (CPT) (p = .008) and more time to complete trail making test A (TMT-A) (p = .008), compared to the group of medium users. CONCLUSIONS Heavy cannabis consumption seems to impair verbal memory in first psychotic episode patients. Heavy users also perform worse than medium users in other neurocognitive tasks. Based on the results and the available evidence, a dose-related effect of cannabis consumption is suggested.
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Affiliation(s)
- Christian Núñez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.
- Universitat de Barcelona, Barcelona, Spain.
| | - Susana Ochoa
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Elena Huerta-Ramos
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Iris Baños
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Ana Barajas
- Research Unit, Centre d'Higiene Mental Les Corts, Barcelona, Spain
| | - Montserrat Dolz
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Psychiatry Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Bernardo Sánchez
- Psychiatry Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Núria Del Cacho
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Schoeler T, Kambeitz J, Behlke I, Murray R, Bhattacharyya S. The effects of cannabis on memory function in users with and without a psychotic disorder: findings from a combined meta-analysis. Psychol Med 2016; 46:177-188. [PMID: 26353818 DOI: 10.1017/s0033291715001646] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Effect of cannabis use on memory function is a contentious issue, with effects being different in healthy individuals and patients with psychosis. METHOD Employing a meta-analytic approach we investigated the effects of cannabis use on memory function in patients with psychosis and healthy individuals, and the effect of diagnosis, memory dimension and moderating factors. A total of 88 studies were identified through a systematic literature search, investigating healthy (n = 7697) and psychotic (n = 3261) individuals. Standardized mean differences between the cannabis user and non-user groups on memory tasks were estimated using random-effects models and the effect-size statistic Cohen's d. Effects of potential moderating factors were tested using mixed-effects models and subgroup analyses. RESULTS We found that cannabis use was associated with significantly (p ⩽ 0.05) impaired global (d = 0.27) and prospective memory (d = 0.61), verbal immediate (d = 0.40) and delayed (d = 0.36) recall as well as visual recognition (d = 0.41) in healthy individuals, but a better global memory (d = -0.11), visual immediate recall (d = -0.73) and recognition (d = -0.42) in patients. Lower depression scores and younger age appeared to attenuate the effects of cannabis on memory. Cannabis-using patients had lower levels of depression and were younger compared with non-using patients, whilst healthy cannabis-users had higher depression scores than age-matched non-users. Longer duration of abstinence from cannabis reduced the effects on memory in healthy and patient users. CONCLUSIONS These results suggest that cannabis use is associated with a significant domain-specific impairment in memory in healthy individuals but not in cannabis-using patients, suggesting that they may represent a less developmentally impaired subgroup of psychotic patients.
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Affiliation(s)
- T Schoeler
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
| | - J Kambeitz
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
| | - I Behlke
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
| | - R Murray
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
| | - S Bhattacharyya
- Department of Psychosis Studies,Institute of Psychiatry, Psychology & Neuroscience,King's College London,De Crespigny Park,London SE5 8AF,UK
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Buchy L, Seidman LJ, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Stone W, Tsuang MT, Walker EF, Woods SW, Bearden CE, Mathalon DH, Addington J. Evaluating the relationship between cannabis use and IQ in youth and young adults at clinical high risk of psychosis. Psychiatry Res 2015; 230:878-84. [PMID: 26626949 PMCID: PMC5037441 DOI: 10.1016/j.psychres.2015.11.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 11/12/2015] [Accepted: 11/13/2015] [Indexed: 11/28/2022]
Abstract
Among people with psychosis, those with a history of cannabis use show better cognitive performance than those who are cannabis naïve. It is unknown whether this pattern is present in youth at clinical high risk (CHR) of psychosis. We evaluated relationships between IQ and cannabis use while controlling for use of other substances known to impact cognition in 678 CHR and 263 healthy control (HC) participants. IQ was estimated using the Vocabulary and Block Design subtests of the Wechsler Abbreviated Scale of Intelligence. Drug and alcohol use severity and frequency were assessed with the Alcohol and Drug Use Scale, and we inquired participants' age at first use. CHR were further separated into early and late age at onset of cannabis use sub-groups, and low-, moderate- and high-frequency sub-groups. No significant differences in IQ emerged between CHR or HC cannabis users vs. non-users, or between use frequency groups. CHR late-onset users showed significantly higher IQ than CHR early-onset users. Age at onset of cannabis use was significantly and positively correlated with IQ in CHR only. Results suggest that age at onset of cannabis may be a more important factor for IQ than use current use or use frequency in CHR.
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Affiliation(s)
- Lisa Buchy
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, United States
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, United States
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States; Massachusetts General Hospital, Boston, MA, United States
| | - William Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, La Jolla, CA, United States
| | - Elaine F Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, United States
| | - Scott W Woods
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, United States
| | | | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
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Arnold C, Allott K, Farhall J, Killackey E, Cotton S. Neurocognitive and social cognitive predictors of cannabis use in first-episode psychosis. Schizophr Res 2015; 168:231-7. [PMID: 26260081 DOI: 10.1016/j.schres.2015.07.051] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Revised: 07/28/2015] [Accepted: 07/29/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Findings are unclear as to whether cannabis use is associated with better cognitive functioning in individuals with psychosis. OBJECTIVES To elucidate the association between cannabis use, neurocognition and social cognition in first-episode psychosis (FEP). METHODS Secondary data analysis was conducted on data from 133 FEP participants who had enrolled in a randomized controlled trial of a vocational intervention. Participants completed a neurocognitive and social cognitive battery and characteristics of cannabis use were documented (disorder, recency, frequency and dose). Principal axis factor analysis was used to determine the underlying structure of the cognitive batteries. Regression techniques were used to examine cognitive predictors of current cannabis use disorder (CUD), and recency and frequency of cannabis use. Bivariate correlations were used to examine associations between cognition and dose of cannabis consumption. RESULTS Male gender (p=.037) was the only significant predictor of having a current CUD. Better processing speed (p=.022) and social cognition (p=.039), male gender (p<.001), and fewer negative symptoms (p=.036) predicted recency of cannabis use. Faster processing speed (p=.007) and male gender (p=.006) also predicted frequency of cannabis use. No variables were significantly associated with dose of cannabis consumption. CONCLUSIONS Better social cognition and processing speed abilities predicting recency and frequency of cannabis use are consistent with cannabis users having higher cognitive abilities. A positive relationship between cannabis use and cognition may be the result of more drug taking opportunities in less cognitively impaired individuals with psychosis.
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Affiliation(s)
- Chelsea Arnold
- Department of Psychology & Counselling, La Trobe University, Bundoora, VIC 3086, Australia
| | - Kelly Allott
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - John Farhall
- Department of Psychology & Counselling, La Trobe University, Bundoora, VIC 3086, Australia
| | - Eoin Killackey
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Rd, Parkville, VIC 3052, Australia
| | - Sue Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, Parkville, VIC 3052, Australia; Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Rd, Parkville, VIC 3052, Australia.
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Power BD, Dragovic M, Badcock JC, Morgan VA, Castle D, Jablensky A, Stefanis NC. No additive effect of cannabis on cognition in schizophrenia. Schizophr Res 2015; 168:245-51. [PMID: 26235754 DOI: 10.1016/j.schres.2015.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 06/18/2015] [Accepted: 06/28/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND We aimed to examine the association between lifetime cannabis use and estimates of both premorbid and current cognitive function in psychotic disorders in an Australian cohort. METHODS In an Australian multicenter cohort, 1237 participants with an established ICD-10 diagnosis of psychotic disorder were categorised according to history of lifetime cannabis use (non-users, n=354; cannabis users, n=221; cannabis dependency, n=662). Groups were analyzed according to available indices of cognitive ability: the National Adult Reading Test - Revised (NART-R) for ability prior to illness onset; and the Digit Symbol Coding Test (DSCT) for current ability. Two-way analysis of variance was conducted without any covariate, followed by a two-way analysis of covariance (using age, age at onset of psychiatric illness, premorbid IQ and the Socio-Economic Index for Areas (SEIFA) rankings). RESULTS Whilst there appeared to be a significant association between cannabis use and mean DSCT (higher DSCT scores in cannabis using groups) F(2,1080)=9.478, p<0.001, η2=0.017), once covariates were used in the analysis there were no significant differences between groups in mean DSCT scores (F(2,1011)=0.929, p=0.395, η2=0.002). Similarly there were no differences between groups in mean NART scores once, age, age at illness onset and SEIFA rankings were used as covariates (F(2,1032)=1.617, p=0.199, η2=0.003). CONCLUSIONS Confounding variables underpin the association between cannabis use and cognitive function in psychotic disorders. Taken together, it would appear that cannabis use or dependence has no additive effect on cognitive dysfunction in these disorders.
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Affiliation(s)
- Brian D Power
- School of Medicine Fremantle, The University of Notre Dame Australia, Fremantle, Australia; South Metropolitan Area Health Service, Perth, Australia; Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia.
| | - Milan Dragovic
- Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Johanna C Badcock
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Vera A Morgan
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - David Castle
- St. Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Assen Jablensky
- School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
| | - Nikos C Stefanis
- Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia; School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Australia
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32
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Colizzi M, Iyegbe C, Powell J, Ursini G, Porcelli A, Bonvino A, Taurisano P, Romano R, Masellis R, Blasi G, Morgan C, Aitchison K, Mondelli V, Luzi S, Kolliakou A, David A, Murray RM, Bertolino A, Forti MD. Interaction Between Functional Genetic Variation of DRD2 and Cannabis Use on Risk of Psychosis. Schizophr Bull 2015; 41:1171-82. [PMID: 25829376 PMCID: PMC4535639 DOI: 10.1093/schbul/sbv032] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Both cannabis use and the dopamine receptor (DRD2) gene have been associated with schizophrenia, psychosis-like experiences, and cognition. However, there are no published data investigating whether genetically determined variation in DRD2 dopaminergic signaling might play a role in individual susceptibility to cannabis-associated psychosis. We genotyped (1) a case-control study of 272 patients with their first episode of psychosis and 234 controls, and also from (2) a sample of 252 healthy subjects, for functional variation in DRD2, rs1076560. Data on history of cannabis use were collected on all the studied subjects by administering the Cannabis Experience Questionnaire. In the healthy subjects' sample, we also collected data on schizotypy and cognitive performance using the Schizotypal Personality Questionnaire and the N-back working memory task. In the case-control study, we found a significant interaction between the rs1076560 DRD2 genotype and cannabis use in influencing the likelihood of a psychotic disorder. Among cannabis users, carriers of the DRD2, rs1076560, T allele showed a 3-fold increased probability to suffer a psychotic disorder compared with GG carriers (OR = 3.07; 95% confidence interval [CI]: 1.22-7.63). Among daily users, T carrying subjects showed a 5-fold increase in the odds of psychosis compared to GG carriers (OR = 4.82; 95% CI: 1.39-16.71). Among the healthy subjects, T carrying cannabis users had increased schizotypy compared with T carrying cannabis-naïve subjects, GG cannabis users, and GG cannabis-naïve subjects (all P ≤ .025). T carrying cannabis users had reduced working memory accuracy compared with the other groups (all P ≤ .008). Thus, variation of the DRD2, rs1076560, genotype may modulate the psychosis-inducing effect of cannabis use.
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Affiliation(s)
- Marco Colizzi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy;,Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - John Powell
- Department of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gianluca Ursini
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy;,Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, MA
| | - Annamaria Porcelli
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy
| | - Aurora Bonvino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy
| | - Paolo Taurisano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy
| | - Raffaella Romano
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy
| | - Rita Masellis
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy
| | - Giuseppe Blasi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy
| | - Craig Morgan
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Katherine Aitchison
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Sonija Luzi
- Department of Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Anna Kolliakou
- National Institute for Health Research Maudsley Biomedical Research Centre and Dementia Unit, London, UK
| | - Anthony David
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Alessandro Bertolino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro,” Bari, Italy;,pRED, NORD DTA, F. Hoffman-La Roche Ltd., Basel, Switzerland
| | - Marta Di Forti
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK;,To whom correspondence should be addressed; Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London SE5 8AF, UK; tel: 44-(0)20-7848-0100, fax: 44-(0)20-7848-0287, e-mail:
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Lee J, Green MF, Calkins ME, Greenwood TA, Gur RE, Gur RC, Lazzeroni LC, Light GA, Nuechterlein KH, Radant AD, Seidman LJ, Siever LJ, Silverman JM, Sprock J, Stone WS, Sugar CA, Swerdlow NR, Tsuang DW, Tsuang MT, Turetsky BI, Braff DL. Verbal working memory in schizophrenia from the Consortium on the Genetics of Schizophrenia (COGS) study: the moderating role of smoking status and antipsychotic medications. Schizophr Res 2015; 163:24-31. [PMID: 25248939 PMCID: PMC4368500 DOI: 10.1016/j.schres.2014.08.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/03/2014] [Accepted: 08/06/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Working memory impairment has been extensively studied in schizophrenia, but less is known about moderators of the impairment. Using the Consortium on the Genetics of Schizophrenia case-control study (COGS-2), we examined smoking status, types of antipsychotic medication, and history of substance as moderators for working memory impairment in schizophrenia. METHODS From 5 sites, 1377 patients with schizophrenia or schizoaffective, depressed type and 1037 healthy controls completed the letter-number span (LNS) task. The LNS uses intermixed letter and digit stimuli that increase from 2 up to 8 stimuli. In the forward condition, participants repeated the letters and numbers in the order they were presented. In the reorder condition, participants repeated the digits in ascending order followed by letters in alphabetical order. RESULTS Schizophrenia patients performed more poorly than controls, with a larger difference on reorder than forward conditions. Deficits were associated with symptoms, functional capacity, and functional outcome. Patients who smoked showed larger impairment than nonsmoking patients, primarily due to deficits on the reorder condition. The impairing association of smoking was more pronounced among patients taking first-generation than those taking second-generation antipsychotic medications. Correlations between working memory and community functioning were stronger for nonsmokers. History of substance use did not moderate working memory impairment. CONCLUSIONS Results confirm the working memory impairment in schizophrenia, and indicate smoking status as an important moderator for these deficits. The greater impairment in smokers may reflect added burden of smoking on general health or that patients with greater deficits are more likely to smoke.
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Affiliation(s)
- Junghee Lee
- Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California Los Angeles, CA, United States; VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.
| | - Michael F. Green
- Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California Los Angeles, CA, United States
,VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Monica E. Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - Tiffany A. Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - Laura C. Lazzeroni
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, CA United States
,Department of Pediatrics, Stanford University, Stanford, CA, United States
| | - Gregory A. Light
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
,VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - Keith H. Nuechterlein
- Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California Los Angeles, CA, United States
| | - Allen D. Radant
- Department of Psychiatry and Behavioral Science, University of Washington, Seattle, WA, United States
,VA Puget Sound Healthcare System, Seattle, WA, United States
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
,Massachusetts Mental Health Center Public Psychiatry Devision of the Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Larry J. Siever
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY, United States
,James J. Peters VA Medical Center, New York, NY, United States
| | - Jeremy M. Silverman
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, NY, United States
,James J. Peters VA Medical Center, New York, NY, United States
| | - Joyce Sprock
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
,VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
| | - William S. Stone
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
,Massachusetts Mental Health Center Public Psychiatry Devision of the Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Catherine A. Sugar
- Department of Psychiatry and Biobehavioral Science, Geffen School of Medicine, University of California Los Angeles, CA, United States
,VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
,Department of Biostatistics, University of California Los Angeles, CA, United States
| | - Neal R. Swerdlow
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Debby W. Tsuang
- Department of Psychiatry and Behavioral Science, University of Washington, Seattle, WA, United States
,VA Puget Sound Healthcare System, Seattle, WA, United States
| | - Ming T. Tsuang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
,Institute for Genomic Medicine, University of California, San Diego, CA, United States
,Harvard Institute of Psychiatry Epidemiology and Genetics, Boston, MA, United States
| | - Bruce I. Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia, United States
| | - David L. Braff
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
,VISN22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, United States
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Functional genetic variation of the cannabinoid receptor 1 and cannabis use interact on prefrontal connectivity and related working memory behavior. Neuropsychopharmacology 2015; 40:640-9. [PMID: 25139064 PMCID: PMC4289952 DOI: 10.1038/npp.2014.213] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 06/29/2014] [Accepted: 07/14/2014] [Indexed: 02/06/2023]
Abstract
Cannabinoid signaling is involved in different brain functions and it is mediated by the cannabinoid receptor 1 (CNR1), which is encoded by the CNR1 gene. Previous evidence suggests an association between cognition and cannabis use. The logical interaction between genetically determined cannabinoid signaling and cannabis use has not been determined. Therefore, we investigated whether CNR1 variation predicts CNR1 prefrontal mRNA expression in postmortem prefrontal human tissue. Then, we studied whether functional variation in CNR1 and cannabis exposure interact in modulating prefrontal function and related behavior during working memory processing. Thus, 208 healthy subjects (113 males) were genotyped for the relevant functional SNP and were evaluated for cannabis use by the Cannabis Experience Questionnaire. All individuals performed the 2-back working memory task during functional magnetic resonance imaging. CNR1 rs1406977 was associated with prefrontal mRNA and individuals carrying a G allele had reduced CNR1 prefrontal mRNA levels compared with AA subjects. Moreover, functional connectivity MRI demonstrated that G carriers who were also cannabis users had greater functional connectivity in the left ventrolateral prefrontal cortex and reduced working memory behavioral accuracy during the 2-back task compared with the other groups. Overall, our results indicate that the deleterious effects of cannabis use are more evident on a specific genetic background related to its receptor expression.
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Wojtalik JA, Hogarty SS, Cornelius JR, Phillips ML, Keshavan MS, Newhill CE, Eack SM. Cognitive Enhancement Therapy Improves Frontolimbic Regulation of Emotion in Alcohol and/or Cannabis Misusing Schizophrenia: A Preliminary Study. Front Psychiatry 2015; 6:186. [PMID: 26793128 PMCID: PMC4709416 DOI: 10.3389/fpsyt.2015.00186] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 12/21/2015] [Indexed: 12/17/2022] Open
Abstract
Individuals with schizophrenia who misuse substances are burdened with impairments in emotion regulation. Cognitive enhancement therapy (CET) may address these problems by enhancing prefrontal brain function. A small sample of outpatients with schizophrenia and alcohol and/or cannabis substance use problems participating in an 18-month randomized trial of CET (n = 10) or usual care (n = 4) completed posttreatment functional neuroimaging using an emotion regulation task. General linear models explored CET effects on brain activity in emotional neurocircuitry. Individuals treated with CET had significantly greater activation in broad regions of the prefrontal cortex, limbic, and striatal systems implicated in emotion regulation compared to usual care. Differential activation favoring CET in prefrontal regions and the insula mediated behavioral improvements in emotional processing. Our data lend preliminary support of CET effects on neuroplasticity in frontolimbic and striatal circuitries, which mediate emotion regulation in people with schizophrenia and comorbid substance misuse problems.
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Affiliation(s)
| | - Susan S Hogarty
- Department of Psychiatry, School of Medicine, University of Pittsburgh , Pittsburgh, PA , USA
| | - Jack R Cornelius
- Department of Psychiatry, School of Medicine, University of Pittsburgh , Pittsburgh, PA , USA
| | - Mary L Phillips
- Department of Psychiatry, School of Medicine, University of Pittsburgh , Pittsburgh, PA , USA
| | | | | | - Shaun M Eack
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
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Hazan L, Gaisler-Salomon I. Glutaminase1 heterozygous mice show enhanced trace fear conditioning and Arc/Arg3.1 expression in hippocampus and cingulate cortex. Eur Neuropsychopharmacol 2014; 24:1916-24. [PMID: 25453483 DOI: 10.1016/j.euroneuro.2014.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 07/22/2014] [Accepted: 10/11/2014] [Indexed: 01/27/2023]
Abstract
Mice heterozygous for a mutation in the glutaminase (GLS1) gene (GLS1 HZ mice), with reduced glutamate recycling and release, display reduced hippocampal function as well as memory of contextual cues in a delay fear conditioning (FC) paradigm. Here, we asked whether this deficit reflects an inability to process contextual information or a selective alteration in salience attribution. In addition, we asked whether baseline and activity-induced hippocampal activity were diminished in GLS1 HZ mice. For this purpose, we manipulated the relative salience of the conditioned stimulus (CS) and contextual cues in FC tasks, and examined gene expression of the immediate early gene Arc (Arc/Arg3.1) in hippocampus and anterior cingulate cortex (ACC) following trace FC (tFC). The results indicate that GLS1 HZ mice succeed in processing contextual information when the salient CS is absent or less predictive. In addition, in the hippocampus-dependent tFC paradigm GLS1 HZ mice display enhanced CS learning. Furthermore, while baseline arc activation was reduced in GLS1 HZ mice in the hippocampus, in line with previous fMRI findings, it was enhanced in the hippocampus and anterior cingulate cortex following tFC. These findings suggest that GLS1 HZ mice have a pro-cognitive profile in the tFC paradigm, and this phenotype involves activation of both hippocampus and ACC. Taken together with previous work on the GLS1 HZ mouse, this study sheds light on the importance of glutamate transmission to memory processes that require the allocation of attentional resources, and extends our understanding of the underpinnings of attention deficits in SZ.
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Affiliation(s)
- Liran Hazan
- Department of Psychology, University of Haifa, Haifa 3498838, Israel
| | - Inna Gaisler-Salomon
- Department of Psychology, University of Haifa, Haifa 3498838, Israel; Department of Psychiatry, Columbia University, New York, NY 10032, USA.
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37
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Løberg EM, Helle S, Nygård M, Berle JØ, Kroken RA, Johnsen E. The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability. Front Psychiatry 2014; 5:159. [PMID: 25477825 PMCID: PMC4235385 DOI: 10.3389/fpsyt.2014.00159] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 10/24/2014] [Indexed: 12/19/2022] Open
Abstract
There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings.
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Affiliation(s)
- Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Siri Helle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Merethe Nygård
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Jan Øystein Berle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Rune A. Kroken
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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O'Tuathaigh CMP, Gantois I, Waddington JL. Genetic dissection of the psychotomimetic effects of cannabinoid exposure. Prog Neuropsychopharmacol Biol Psychiatry 2014; 52:33-40. [PMID: 24239593 DOI: 10.1016/j.pnpbp.2013.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Revised: 10/31/2013] [Accepted: 11/04/2013] [Indexed: 12/31/2022]
Abstract
Cannabis use is an established risk factor for the development of schizophrenia and related psychotic disorders. Factors that may mediate susceptibility to the psychosis-inducing effects of cannabis include the age at onset of first cannabis use, genetic predisposition, as well as interaction with other environmental risk variables. Clinical and preclinical genetic studies provide increasing evidence that, in particular, genes encoding proteins implicated in dopamine signalling are implicated in the cannabis-psychosis association. In the present review, we focus on both human and animal studies which have focused on identifying the neuronal basis of these interactions. We conclude that further studies are required to provide greater mechanistic insight into the long-term and neurodevelopmental effects of cannabis use, with implications for improved understanding of the cannabis-psychosis relationship.
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Affiliation(s)
- Colm M P O'Tuathaigh
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2, Ireland; School of Medicine, University College Cork, Cork, Ireland.
| | - Ilse Gantois
- Laboratory of Biological Psychology, KU Leuven, 3000 Leuven, Belgium
| | - John L Waddington
- Molecular & Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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Bahorik AL, Newhill CE, Eack SM. Neurocognitive functioning of individuals with schizophrenia: using and not using drugs. Schizophr Bull 2014; 40:856-67. [PMID: 23884348 PMCID: PMC4059433 DOI: 10.1093/schbul/sbt099] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Research on neurocognition in schizophrenia, using modest samples and self-rated assessments, reports drug use contributes to improved rather than impaired cognitive function. We have sought to replicate these findings in a large sample of patients that had their drug-use status confirmed by laboratory assays and evaluated the potential differences in cognitive function between patients with positive and negative results. METHODS Nine hundred and seventy four schizophrenia patients completed neuropsychological and laboratory tests at screening/baseline of the Clinical Antipsychotic Trials of Intervention Effectiveness study. Radioimmunoassay (RIA) of hair tested for cannabis, cocaine and methamphetamine. RESULTS Many patients screened positive for drug use (n = 262; 27%), and there were no differences between patients with positive and negative results in terms of cognitive function after adjusting for multiple inference testing, except patients with positive RIA for methamphetamine demonstrated increased processing speed (corrected, P = .024). Moderator models were employed to explore potential subgroup differences in this pattern of results. At low medication dosages, patients with positive RIA for cocaine demonstrated decreased processing speed compared with patients with negative RIA for cocaine (uncorrected, P = .008). And for any other drugs with low psychopathology, patients with positive RIA demonstrated decreased working memory compared with patients with negative RIA (uncorrected, P = .006). CONCLUSIONS No positive effects of cannabis on cognitive function were observed, and drug use was not associated with improved neurocognition across most of the subgroup characteristics explored in this sample of schizophrenia patients.
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Affiliation(s)
- Amber L. Bahorik
- School of Social Work, University of Pittsburgh, Pittsburgh, PA;,Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA,*To whom correspondence should be addressed; School of Social Work, University of Pittsburgh, 2117 Cathedral of Learning, 4200 Fifth Avenue, Pittsburgh, PA 15260, US; tel: 814-659-5713; e-mail:
| | | | - Shaun M. Eack
- School of Social Work, University of Pittsburgh, Pittsburgh, PA;,Western Psychiatric Institute and Clinic, University of Pittsburgh, Pittsburgh, PA
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Sara GE, Burgess PM, Malhi GS, Whiteford HA, Hall WC. Cannabis and stimulant disorders and readmission 2 years after first-episode psychosis. Br J Psychiatry 2014; 204:448-53. [PMID: 24578446 DOI: 10.1192/bjp.bp.113.135145] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Few studies have examined the impact of stimulant use on outcome in early psychosis. Ceasing substance use may lead to positive outcomes in psychosis. AIMS To examine whether baseline cannabis or stimulant disorders and ongoing drug use predict readmission within 2 years of a first psychosis admission. METHOD Predictors of readmission were examined with Cox regression in 7269 people aged 15-29 years with a first psychosis admission. RESULTS Baseline cannabis and stimulant disorders did not predict readmission. A stimulant disorder diagnosis prior to index psychosis admission predicted readmission, but a prior cannabis disorder diagnosis did not. Ongoing problem drug use predicted readmission. The lowest rate of readmission occurred in people whose baseline drug problems were discontinued. CONCLUSIONS Prior admissions with stimulant disorder may be a negative prognostic sign in first-episode psychosis. Drug use diagnoses at baseline may be a good prognostic sign if they are identified and controlled.
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Affiliation(s)
- Grant E Sara
- Grant E. Sara, MB BS, MM, MM (Psychotherapy), FRANZCP, InforMH, Mental Health and Drug and Alcohol Office, NSW Health, Discipline of Psychiatry, Sydney Medical School, University of Sydney, and School of Population Health, University of Queensland, Brisbane, Queensland; Philip M. Burgess, MA, PhD, School of Population Health, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Gin S. Malhi, MBChB, BSc, MD, FRCPsych, FRANZCP, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, and CADE Clinic, Department of Academic Psychiatry, Royal North Shore Hospital, Sydney, New South Wales; Harvey A. Whiteford, MB BS, MPH, MD, FRANZCP, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Wayne C. Hall, MSc, PhD, Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Philip M Burgess
- Grant E. Sara, MB BS, MM, MM (Psychotherapy), FRANZCP, InforMH, Mental Health and Drug and Alcohol Office, NSW Health, Discipline of Psychiatry, Sydney Medical School, University of Sydney, and School of Population Health, University of Queensland, Brisbane, Queensland; Philip M. Burgess, MA, PhD, School of Population Health, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Gin S. Malhi, MBChB, BSc, MD, FRCPsych, FRANZCP, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, and CADE Clinic, Department of Academic Psychiatry, Royal North Shore Hospital, Sydney, New South Wales; Harvey A. Whiteford, MB BS, MPH, MD, FRANZCP, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Wayne C. Hall, MSc, PhD, Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Gin S Malhi
- Grant E. Sara, MB BS, MM, MM (Psychotherapy), FRANZCP, InforMH, Mental Health and Drug and Alcohol Office, NSW Health, Discipline of Psychiatry, Sydney Medical School, University of Sydney, and School of Population Health, University of Queensland, Brisbane, Queensland; Philip M. Burgess, MA, PhD, School of Population Health, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Gin S. Malhi, MBChB, BSc, MD, FRCPsych, FRANZCP, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, and CADE Clinic, Department of Academic Psychiatry, Royal North Shore Hospital, Sydney, New South Wales; Harvey A. Whiteford, MB BS, MPH, MD, FRANZCP, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Wayne C. Hall, MSc, PhD, Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Harvey A Whiteford
- Grant E. Sara, MB BS, MM, MM (Psychotherapy), FRANZCP, InforMH, Mental Health and Drug and Alcohol Office, NSW Health, Discipline of Psychiatry, Sydney Medical School, University of Sydney, and School of Population Health, University of Queensland, Brisbane, Queensland; Philip M. Burgess, MA, PhD, School of Population Health, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Gin S. Malhi, MBChB, BSc, MD, FRCPsych, FRANZCP, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, and CADE Clinic, Department of Academic Psychiatry, Royal North Shore Hospital, Sydney, New South Wales; Harvey A. Whiteford, MB BS, MPH, MD, FRANZCP, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Wayne C. Hall, MSc, PhD, Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Wayne C Hall
- Grant E. Sara, MB BS, MM, MM (Psychotherapy), FRANZCP, InforMH, Mental Health and Drug and Alcohol Office, NSW Health, Discipline of Psychiatry, Sydney Medical School, University of Sydney, and School of Population Health, University of Queensland, Brisbane, Queensland; Philip M. Burgess, MA, PhD, School of Population Health, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Gin S. Malhi, MBChB, BSc, MD, FRCPsych, FRANZCP, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, and CADE Clinic, Department of Academic Psychiatry, Royal North Shore Hospital, Sydney, New South Wales; Harvey A. Whiteford, MB BS, MPH, MD, FRANZCP, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Wayne C. Hall, MSc, PhD, Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
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Wojtalik JA, Barch DM. An FMRI study of the influence of a history of substance abuse on working memory-related brain activation in schizophrenia. Front Psychiatry 2014; 5:1. [PMID: 24478729 PMCID: PMC3896871 DOI: 10.3389/fpsyt.2014.00001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/03/2014] [Indexed: 11/18/2022] Open
Abstract
There has been little investigation of the effects of past substance abuse (SA) on working memory (WM) impairments in schizophrenia. This study examined the behavioral and neurobiological impact of past SA (6 months or longer abstinence period) on WM in schizophrenia. Thirty-seven schizophrenia patients (17 with past SA and 20 without) and 32 controls (12 with past SA and 20 without) completed two versions of a two-back WM task during fMRI scanning on separate days. Analyses focused on regions whose patterns of activation replicated across both n-back tasks. Schizophrenia patients were significantly less accurate than controls on both n-back tasks. No main effects or interactions with past SA on WM performance were observed. However, several fronto-parietal-thalamic regions showed an interaction between diagnostic group and past SA. These regions were significantly more active in controls with past SA compared to controls without past SA. Schizophrenia patients with or without past SA either showed no significant differences, or patients with past SA showed somewhat less activation compared to patients without past SA during WM. These results suggest robust effects of past SA on WM brain functioning in controls, but less impact of past SA in schizophrenia. This is consistent with previous literature indicating less impaired neurocognition in schizophrenia with SA.
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Affiliation(s)
- Jessica A Wojtalik
- Department of Psychiatry, Washington University School of Medicine , St. Louis, MO , USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine , St. Louis, MO , USA ; Department of Psychology, Washington University in St. Louis , St. Louis, MO , USA ; Edward Mallinckrodt Institute of Radiology, Washington University School of Medicine , St. Louis, MO , USA
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[Clinical prognosis of schizophrenic patients with cannabis addiction. Between nihilism and hope]. DER NERVENARZT 2013; 85:1084-92. [PMID: 24343109 DOI: 10.1007/s00115-013-3926-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Comorbid substance use disorders in schizophrenia are mostly associated with an unfavorable course of the disease and with difficulties in clinical management. Therefore, some therapists tend to react to these patients in a resigned manner. However, there is growing evidence for higher cognitive functioning and less severe deficits in brain morphology of these patients compared to patients without cannabis use. A common interpretation refers to relatively low vulnerability for psychosis in some of these patients, who mainly became schizophrenic because of the pro-psychotic properties of cannabis. Low vulnerability is reflected by a higher cognitive functioning; therefore, the pessimistic view of therapists seems unjustified for at least a subgroup of young patients. Provided that patients are treated in adequate therapeutic settings and that they stop using cannabis, a lower vulnerability may be associated with overall better socio-rehabilitative outcome parameters.
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Lifetime cannabis use and cognition in patients with schizophrenia spectrum disorders and their unaffected siblings. Eur Arch Psychiatry Clin Neurosci 2013; 263:643-53. [PMID: 23580110 DOI: 10.1007/s00406-013-0404-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 04/01/2013] [Indexed: 10/27/2022]
Abstract
The relationship between cannabis and cognitive performance is controversial. While both acute administration and long-term cannabis use impair cognitive performance in healthy subjects, several studies have shown improved cognitive outcomes in patients with schizophrenia spectrum disorders who use cannabis. The aim of this study was to determine the relationship between lifetime cannabis use, as assessed longitudinally over 10 years of follow-up in a sample of 42 patients and 35 of their unaffected siblings, and current cognitive performance. Forty-two healthy control subjects were assessed at follow-up with the same instruments. Stepwise linear regression revealed a negative effect of longitudinal cannabis use on performance in a social cognition task in the patient group. In the sibling group, lifetime cannabis use had a negative effect on processing speed and declarative memory performance. In the control group, cannabis use per se did not predict cognitive performance; however, when adding lifetime tobacco use to the model, we found a negative association between lifetime cannabis and tobacco use and processing speed and social cognition performance. Moreover, a lower IQ associated with current cannabis use predicted worse attentional performance in the control group. The differential pattern of associations between cannabis use and cognitive performance in patients compared with siblings and controls can be explained by the negative impact of illness on cognition.
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Bugra H, Studerus E, Rapp C, Tamagni C, Aston J, Borgwardt S, Riecher-Rössler A. Cannabis use and cognitive functions in at-risk mental state and first episode psychosis. Psychopharmacology (Berl) 2013; 230:299-308. [PMID: 23756588 DOI: 10.1007/s00213-013-3157-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 05/18/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Meta-analyses suggest that schizophrenia patients with a history of cannabis use have less impaired cognitive functioning compared to patients without cannabis use. AIMS The objective of this study was to assess the association between recency and frequency of cannabis use and cognitive functioning in at-risk mental state for psychosis (ARMS) and first episode psychosis (FEP) individuals. METHODS One hundred thirty-six participants completed a cognitive test battery and were assessed for current and past cannabis use. Analyses of covariance models were applied to evaluate the main effects of cannabis use and patient group (ARMS vs. FEP) as well as their interactions on cognitive functioning. RESULTS No differences were observed in cognitive performance between current, former, and never users, and there were no significant interactions between cannabis use and patient group. Furthermore, within the group of current cannabis users, the frequency of cannabis use was not significantly associated with cognitive functioning. CONCLUSION The results of the present study do not support the notion that FEP patients and ARMS individuals with a history of cannabis use have less impaired cognitive functioning compared to those without cannabis use.
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Affiliation(s)
- H Bugra
- Center for Gender Research and Early Detection, University of Basel Psychiatric Clinics, c/o University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
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Bourque J, Mendrek A, Durand M, Lakis N, Lipp O, Stip E, Lalonde P, Grignon S, Potvin S. Cannabis abuse is associated with better emotional memory in schizophrenia: a functional magnetic resonance imaging study. Psychiatry Res 2013; 214:24-32. [PMID: 23906663 DOI: 10.1016/j.pscychresns.2013.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 05/16/2013] [Accepted: 05/17/2013] [Indexed: 11/18/2022]
Abstract
In schizophrenia cannabis abuse/dependence is associated with poor compliance and psychotic relapse. Despite this, the reasons for cannabis abuse remain elusive, but emotions may play a critical role in this comorbidity. Accordingly, we performed a functional magnetic resonance imaging study of emotional memory in schizophrenia patients with cannabis abuse (dual-diagnosis, DD). Participants comprised 14 DD patients, 14 non-abusing schizophrenia patients (SCZ), and 21 healthy controls (HC) who had to recognize positive and negative pictures while being scanned. Recognition of positive and negative emotions was prominently impaired in SCZ patients, relative to HC, while differences between DD and HC were smaller. For positive and negative stimuli, we observed significant activations in frontal, limbic, temporal and occipital regions in HC; in frontal, limbic and temporal regions in DD; and in temporal, parietal, limbic and occipital regions in the SCZ group. Our results suggest that emotional memory and prefrontal lobe functioning are preserved in DD relative to SCZ patients. These results are consistent with previous findings showing that cannabis abuse is associated with fewer negative symptoms and better cognitive functioning in schizophrenia. Longitudinal studies will need to determine whether the relative preservation of emotional memory is primary or secondary to cannabis abuse in schizophrenia.
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Abstract
The nature of the relationship between cannabis use (CU) and psychosis is complex and remains unclear. Researchers and clinicians remain divided regarding key issues such as whether or not cannabis is an independent cause of psychosis and schizophrenia. This paper reviews the field in detail, examining questions of causality, the neurobiological basis for such causality and for differential inter-individual risk, the clinical and cognitive features of psychosis in cannabis users, and patterns of course and outcome of psychosis in the context of CU. The author proposes two major pathways from cannabis to psychosis based on a differentiation between early-initiated lifelong CU and a scenario where vulnerable individuals without a lifelong pattern of use consume cannabis over a relatively brief period of time just prior to psychosis onset. Additional key factors determining the clinical and neurobiological manifestation of psychosis as well as course and outcome in cannabis users include: underlying genetic and developmental vulnerability to schizophrenia-spectrum disorders; and whether or not CU ceases or continues after the onset of psychosis. Finally, methodological guidelines are presented for future research aimed at both elucidating the pathways that lead from cannabis to psychosis and clarifying the long-term outcome of the disorder in those who have a history of using cannabis.
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Affiliation(s)
- Jonathan K Burns
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban , South Africa
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Ferraro L, Russo M, O'Connor J, Wiffen BDR, Falcone MA, Sideli L, Gardner-Sood P, Stilo S, Trotta A, Dazzan P, Mondelli V, Taylor H, Friedman B, Sallis H, La Cascia C, La Barbera D, David AS, Reichenberg A, Murray RM, Di Forti M. Cannabis users have higher premorbid IQ than other patients with first onset psychosis. Schizophr Res 2013; 150:129-35. [PMID: 23958486 DOI: 10.1016/j.schres.2013.07.046] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 07/09/2013] [Accepted: 07/25/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND A number of studies have reported that patients with psychosis who use cannabis have better cognitive performance than those who do not. This is surprising as cannabis can impair cognition in healthy subjects. An obvious question is whether the better current performance of psychotic patients who have used cannabis is a reflection of their having a higher premorbid IQ than those psychotic patients who haven't used cannabis. AIM In a sample of patients at their first episode of psychosis, we tested the hypothesis that patients who smoked cannabis would have a higher premorbid IQ than patients who did not. METHODOLOGY 279 participants (119 patients and 160 healthy controls) were assessed in order to obtain current and premorbid IQ measures and detailed information on cannabis use. We examined the association between cannabis use and both premorbid and current IQ in patients and controls. RESULTS Patients who had ever smoked cannabis had significantly higher current (p<.001) and premorbid IQ (p=.004) compared to patients who had never used cannabis. This difference was not found among controls. CONCLUSIONS These findings suggest that the better cognitive performance of patients with their first episode of psychosis who have used cannabis compared with those who haven't is due to the better premorbid IQ of the former.
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Affiliation(s)
- Laura Ferraro
- Institute of Psychiatry, Department of Psychosis Studies and Biomedical Research Centre, King's College, de Crespigny Park, Denmark Hill, London SE5 8AF, United Kingdom; Sezione di Psichiatria del Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche (BioNeC), Università di Palermo, Via "Gaetano La Loggia" 1, 90100 Palermo, Italy.
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Thoma P, Daum I. Comorbid substance use disorder in schizophrenia: a selective overview of neurobiological and cognitive underpinnings. Psychiatry Clin Neurosci 2013; 67:367-83. [PMID: 23890122 DOI: 10.1111/pcn.12072] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2011] [Revised: 01/21/2013] [Accepted: 05/29/2013] [Indexed: 01/06/2023]
Abstract
Although individuals with schizophrenia show a lifetime prevalence of 50% for suffering from a comorbid substance use disorder, substance abuse usually represents an exclusion criterion for studies on schizophrenia. This implies that surprisingly little is known about a large group of patients who are particularly difficult to treat. The aim of the present work is to provide a brief and non-exhaustive overview of the current knowledgebase about neurobiological and cognitive underpinnings for dual diagnosis schizophrenia patients. Studies published within the last 20 years were considered using computerized search engines. The focus was on nicotine, caffeine, alcohol, cannabis and cocaine being among the most common substances of abuse. All drugs of abuse target dopaminergic, glutamatergic and GABAergic transmission which are also involved in the pathophysiology of schizophrenia. Current literature suggests that neurocognitive function might beless disrupted in substance-abusing compared to non-abusing schizophrenia patients, but in particular the neuroimaging database on this topic is sparse. Detrimental effects on brain structure and function were shown for patients for whom alcohol is the main substance of abuse. It is as yet unclear whether this finding might be an artifact of age differences of patient subgroups with different substance abuse patterns. More research is warranted on the specific neurocognitive underpinnings of schizophrenia patients abusing distinct psychoactive substances. Treatment programs might either benefit from preserved cognitive function as a resource or specifically target cognitive impairment in different subgroups of addicted schizophrenia patients.
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Affiliation(s)
- Patrizia Thoma
- Department of Neuropsychology, Institute of Cognitive Neuroscience, Ruhr-University Bochum, Bochum, Germany.
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Rabin RA, Giddens JL, George TP. Relationship between tobacco and cannabis use status in outpatients with schizophrenia. Am J Addict 2013; 23:170-5. [PMID: 25187052 DOI: 10.1111/j.1521-0391.2013.12084.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 03/26/2013] [Accepted: 04/28/2013] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVE While high prevalence of tobacco and cannabis use are well established in schizophrenia, reports on their co-morbid use is limited. We explored the links between tobacco and cannabis use in an outpatient population meeting DSM-IV criteria for schizophrenia. METHODS Cigarette smoking behaviors were assessed in an outpaitent population with schizophrenia (N=54) with current (n=18), former (n=24), and no lifetime cannabis dependence (n=12). RESULTS We found significant differences in cigarettes per day (CPD) across groups: current dependent patients smoked less CPD than patients with former dependence and those with no history of dependence; former dependent patients smoked significantly less than patients with no history of cannabis dependence. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Preliminary results support an effect of cannabis use status on tobacco consumption. In the absence of cannabis, patients may increase cigarette smoking, suggesting state-dependent effects of cannabis on tobacco. Prospective designs should further examine this relationship between cannabis and tobacco in schizophrenia versus non-psychiatric controls.
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Affiliation(s)
- Rachel A Rabin
- The Institute of Medical Sciences (IMS), University of Toronto, Toronto, Ontario, Canada; Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
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Effects of cannabis use status on cognitive function, in males with schizophrenia. Psychiatry Res 2013; 206:158-65. [PMID: 23246245 DOI: 10.1016/j.psychres.2012.11.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 11/07/2012] [Accepted: 11/11/2012] [Indexed: 01/13/2023]
Abstract
Cognitive impairment and cannabis use are common among patients with schizophrenia. However, the moderating role of cannabis on cognition remains unclear. We sought to examine cognitive performance as a function of cannabis use patterns in schizophrenia. A secondary aim was to determine the effects of cumulative cannabis exposure on cognition. Cognition was assessed in male outpatients with current cannabis dependence (n=18) and no current cannabis use disorders (n=29). We then parsed non-current users into patients with lifetime cannabis dependence (n=21) and no lifetime cannabis dependence (n=8). Finally, as an exploratory analysis, we examined relationships between cumulative cannabis exposure and cognition in lifetime dependent patients. Cross-sectional comparisons suggest that lifetime cannabis users demonstrate better processing speed than patients with no lifetime dependence. Exploratory analyses indicated that patients with current dependence exhibited robust negative relationships between cumulative cannabis exposure and cognition; these associations were absent in former users. Cannabis status has minimal effects on cognition in males with schizophrenia. However, cumulative cannabis exposure significantly impairs cognition in current, but not former users, suggesting that the state dependent negative effects of cannabis may be reversed with sustained abstinence. Prospective studies are needed to confirm these findings.
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