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Sheridan Rains L, Middleton-Curran L, Mason O, Morant N, Johnson S. The Whys and Wherefores of Reducing Cannabis Use in Early Psychosis: A Qualitative Study of Service Users ' Experiences of Quitting and the Support. J Dual Diagn 2024:1-13. [PMID: 39180491 DOI: 10.1080/15504263.2024.2369517] [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] [Indexed: 08/26/2024]
Abstract
Objectives: Cannabis is the most widely used substance among people with recent onset psychosis, but it can have significant negative consequences for long term wellbeing in this cohort. We explored the perspectives of people with recent onset psychosis who used cannabis on their motivations for quitting, their experiences of trying to do so, and their views of the support they had received and the strategies that they had tried. Methods: Twenty one-to-one qualitative interviews were conducted with Early Intervention in Psychosis service users in England who had participated in the CIRCLE trial. Purposive sampling was used to recruit a mix of demographic, cannabis use status, and other characteristics. Results: Quitting cannabis is often very challenging for people and can require making substantial changes in their lives, including to their social relationships, living arrangements, or pathways through work or education. Participants reported wanting help, but often experienced support from mental health services as insubstantial and poorly tailored. Support from peers with relevant lived-experience, where available, was highly valued. Common reasons for quitting included its impact on key life goals or engaging with hobbies, finances, mental health, incompatibility with self-image, and negative use expectancies of intoxication. Concerns regarding mental health were primarily related to psychotic illness, including fear of exacerbating symptoms or experiencing future hospital admissions. Discussion: It is currently unclear how best to support people in this cohort. Interventions that provide support from people with relevant lived experience may be more valued and more clinically effective than current offerings.
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Affiliation(s)
| | | | - Oliver Mason
- School of Psychology, University of Surrey, Surrey, UK
| | - Nicola Morant
- Division of Psychiatry, University College London, London, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
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Myers NL, Wilkey J, Chacon M, Hutnyan M, Janssen C, Tarvin H, Cohen D, Holmes I, Klodnick VV, Mihiret MA, Reznik SJ, Shimizu TK, Stein E, Lopez MA. Perspectives of young adults diagnosed with early psychosis using coordinated specialty care in Texas on substance use and substance use interventions. Early Interv Psychiatry 2024; 18:502-512. [PMID: 38030586 PMCID: PMC11133765 DOI: 10.1111/eip.13488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/29/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
AIM Despite known prevalence of substance use (SU) among young people experiencing early psychosis and increasing evidence for the relationship between certain substances (e.g., cannabis) and psychosis, there are no specialized interventions developed for effectively addressing substance use among young people participating in coordinated early psychosis services. This study elicited the perspectives of young people with early psychosis participating in Coordinated Specialty Care (CSC) programs about their substance use, including their motivations and concerns around their use, and their ideas on how to best support young people who are interested in reducing or quitting substance use. METHODS We recruited young adults (ages 18 to 30) from CSC programs across Texas through flyers sent to program staff inviting young persons willing to talk about substance use to engage in a 60-90 min person-centered, semi-structured, audio-recorded Zoom interview. RESULTS A total of 22 young adults were recruited and 18 completed an interview. Participants described mixed positive and negative responses to substance use, and while many understood the importance of discontinuing substance use, many expressed ambivalence related to social, contextual, mental and physical factors that motivated them to keep using. Participants desired practical substance use information, opportunities to explore their substance use ambivalence in supportive relationships, positive peer communities to support healthy choices, help engage, with work, school, and hobbies, and strategies for addressing psychological and physical pain that did not include substance use. CONCLUSION Study findings illuminate what motivates young people with early psychosis to initiate, continue, or cut back on substance use, and ideas for CSC practices for exploring substances and helping young people to reduce substance use.
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Affiliation(s)
- Neely Laurenzo Myers
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Justin Wilkey
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Marne Chacon
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Matthew Hutnyan
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Claire Janssen
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Halle Tarvin
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Deborah Cohen
- The University of Texas at Austin, Steve Hicks School of Social Work, Texas Institute for Excellence in Mental Health, Austin, Texas, USA
| | - Imani Holmes
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Vanessa Vorhies Klodnick
- The University of Texas at Austin, Steve Hicks School of Social Work, Texas Institute for Excellence in Mental Health, Austin, Texas, USA
| | - Mesganaw A Mihiret
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Samantha J Reznik
- The University of Texas at Austin, Steve Hicks School of Social Work, Texas Institute for Excellence in Mental Health, Austin, Texas, USA
| | | | - Emily Stein
- Department of Anthropology, Southern Methodist University, Dallas, Texas, USA
| | - Molly A Lopez
- The University of Texas at Austin, Steve Hicks School of Social Work, Texas Institute for Excellence in Mental Health, Austin, Texas, USA
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Ghelani A. Perspectives toward cannabidiol (CBD) among youth in Early Psychosis Intervention programs: A qualitative study. Early Interv Psychiatry 2024; 18:10-17. [PMID: 37038248 DOI: 10.1111/eip.13428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/30/2022] [Accepted: 03/28/2023] [Indexed: 04/12/2023]
Abstract
AIM Cannabis is used by one third of youth in Early Psychosis Intervention (EPI) programs and high dose consumption of the primary constituent Δ-9 tetrahydrocannabinol (THC) is associated with higher risk for relapse in this group. Cannabidiol (CBD) is a secondary cannabis constituent that may have antipsychotic properties, though its health risks are only beginning to be understood. Little is known about the views of youth in EPI programs toward CBD, including their reasons for use and perceptions of risk. METHODS This qualitative study used Interpretive Phenomenological Analysis to investigate the perspectives of a sample (n = 15) of cannabis-consuming youth in EPI programs toward CBD. RESULTS Those who used CBD (n = 13) did so for pain relief, THC substitution, relaxation, social reasons, and sleep enhancement. CBD was perceived to be beneficial for health and wellness, though many consumers were disappointed with its effects. Most believed there were no risks associated with its use or were unaware of any risks, and all believed CBD could be used safely. CONCLUSION Clinicians should assess THC and CBD consumption patterns, motives for use, and perceptions of risk separately to tailor interventions accordingly. Youth in EPI programs would benefit from education related to the known health risks and benefits associated with this drug. Clinicians in regions where cannabis is regulated should be open to discussing CBD as a safer substitute for THC. The potential for CBD to serve as viable treatment for psychosis requires further study.
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Affiliation(s)
- Amar Ghelani
- Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada
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4
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Spinazzola E, Quattrone D, Rodriguez V, Trotta G, Alameda L, Tripoli G, Gayer-Anderson C, Freeman TP, Johnson EC, Jongsma HE, Stilo S, La Cascia C, Ferraro L, La Barbera D, Lasalvia A, Tosato S, Tarricone I, D'Andrea G, Galatolo M, Tortelli A, Tagliabue I, Turco M, Pompili M, Selten JP, de Haan L, Rossi Menezes P, Del Ben CM, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, O'Donovan M, Rutten BP, Van Os J, Morgan C, Sham PC, Austin-Zimmerman I, Li Z, Vassos E, Murray RM, Di Forti M. The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study. Psychol Med 2023; 53:7418-7427. [PMID: 37129249 PMCID: PMC10719678 DOI: 10.1017/s0033291723001071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 01/23/2023] [Accepted: 04/03/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis. METHODS We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status. RESULTS Controls (86.1%) and FEPp (75.63%) were most likely to report 'because of friends' as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: 'to feel better' as their RFUC (χ2 = 50.97; p < 0.001). RFUC 'to feel better' was associated with being a FEPp (OR 1.74; 95% CI 1.03-2.95) while RFUC 'with friends' was associated with being a control (OR 0.56; 95% CI 0.37-0.83). The path model indicated an association between RFUC 'to feel better' with heavy cannabis use and with FEPp-control status. CONCLUSIONS Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use 'to feel better'. People who reported their reason for first using cannabis to 'feel better' were more likely to progress to heavy use and develop a psychotic disorder than those reporting 'because of friends'.
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Affiliation(s)
- Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- National Institute for Health Research, Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne, University Hospital (CHUV), Lausanne, Switzerland
- Centro Investigacion Biomedica en Red de Salud Mental (CIBERSAM); Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio, Departamento de Psiquiatria, Universidad de Sevilla, Sevilla, Spain
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Simona Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Caterina La Cascia
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Biomedicine, Neuroscience and Advanced Diagnostic Department, Psychiatry Section, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Giuseppe D'Andrea
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Michela Galatolo
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Andrea Tortelli
- Institut Mondor de recherché biomedicale, Creteil, France
- Etablissement Public de Sante Maison Blanche, Paris, France
| | - Ilaria Tagliabue
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
- Department of Mental Health and Addiction Services, ASST Lecco, Lecco, Italy
| | - Marco Turco
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- 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
| | - Lieuwe de Haan
- Early Psychosis Section, AmsterdamUMC, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Cristina M Del Ben
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - 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, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | - James B Kirkbride
- Reader; Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Bart P 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
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
- Rivierduinen Institute for Mental Health Care, Leiden, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pak C Sham
- Department of Psychiatry, Centre for PanorOmic Sciences, and State Key Laboratory of Brain and Cognitive Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Isabelle Austin-Zimmerman
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Zhikun Li
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
| | - EU-GEI WP2 Group
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College of London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
- Research Foundation, National Institute for Health Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and the NIHR BRC at University College London, London, UK
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5
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Chester LA, Valmaggia LR, Kempton MJ, Chesney E, Oliver D, Hedges EP, Klatsa E, Stahl D, van der Gaag M, de Haan L, Nelson B, McGorry P, Amminger GP, Riecher-Rössler A, Studerus E, Bressan R, Barrantes-Vidal N, Krebs MO, Glenthøj B, Nordentoft M, Ruhrmann S, Sachs G, McGuire P. Influence of cannabis use on incidence of psychosis in people at clinical high risk. Psychiatry Clin Neurosci 2023; 77:469-477. [PMID: 37070555 PMCID: PMC7615575 DOI: 10.1111/pcn.13555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/15/2023] [Accepted: 03/30/2023] [Indexed: 04/19/2023]
Abstract
AIMS Evidence for case-control studies suggests that cannabis use is a risk factor for the development of psychosis. However, there have been limited prospective studies and the direction of this association remains controversial. The primary aim of the present study was to examine the association between cannabis use and the incidence of psychotic disorders in people at clinical high risk of psychosis. Secondary aims were to assess associations between cannabis use and the persistence of psychotic symptoms, and with functional outcome. METHODS Current and previous cannabis use were assessed in individuals at clinical high risk of psychosis (n = 334) and healthy controls (n = 67), using a modified version of the Cannabis Experience Questionnaire. Participants were assessed at baseline and followed up for 2 years. Transition to psychosis and persistence of psychotic symptoms were assessed using the Comprehensive Assessment of At-Risk Mental States criteria. Level of functioning at follow up was assessed using the Global Assessment of Functioning disability scale. RESULTS During follow up, 16.2% of the clinical high-risk sample developed psychosis. Of those who did not become psychotic, 51.4% had persistent symptoms and 48.6% were in remission. There was no significant association between any measure of cannabis use at baseline and either transition to psychosis, the persistence of symptoms, or functional outcome. CONCLUSIONS These findings contrast with epidemiological data that suggest that cannabis use increases the risk of psychotic disorder.
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Affiliation(s)
- Lucy A. Chester
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Lucia R. Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Matthew J. Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Edward Chesney
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Dominic Oliver
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, UK
| | - Emily P. Hedges
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Elise Klatsa
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Daniel Stahl
- Department of Biostatistics, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Mark van der Gaag
- Faculty of Behavioural and Movement Sciences, Department of Clinical Psychology and EMGO+ Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of Psychosis Research, Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Lieuwe de Haan
- Department Early Psychosis, Amsterdam UMC, Amsterdam, The Netherlands
- Arkin Amsterdam, Amsterdam, The Netherlands
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - Patrick McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | - G. Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Orygen, Parkville, Victoria, Australia
| | | | - Erich Studerus
- Department of Psychology, Division of Personality and Developmental Psychology, University of Basel, Basel, Switzerland
| | - Rodrigo Bressan
- LiNC—Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo – UNIFESP, Sao Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Fundació, Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Marie-Odile Krebs
- Hôpital Sainte-Anne, C’JAAD, Service Hospitalo-Universitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557), University Paris Descartes, Paris, France
| | - Birte Glenthøj
- Centre for Neuropsychiatric Schizophrenia Research (CNSR) & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Centre Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Kobenhavn, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Wien, Austria
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, UK
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6
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Adewuya AO, Oladipo OE, Imarah T, Asmal L, Emsley R. The 3-year progression of clinically significant psychotic-like experiences in a general adult population in Lagos, Nigeria. Soc Psychiatry Psychiatr Epidemiol 2023; 58:91-103. [PMID: 36098756 DOI: 10.1007/s00127-022-02358-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/24/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE The study assessed the 3-year progression of clinically significant psychotic-like experience (CS-PLE) symptoms in an adult general population in terms of stability or remission of symptoms and transition to psychosis. METHODS Participants (n = 1292) aged 18-65 years with CS-PLE were assessed at baseline for sociodemographic details, family history of mental illness, functioning status, common mental disorders, alcohol, and substance use disorders. Three years later they were reassessed for diagnosis of psychosis, presence or remission of PLE symptoms, and contact with mental health services. RESULTS The mean age of the participants at baseline in years was 36.56 (SD = 11.66) and there were 855 (66.2%) females. By the 3rd year follow-up, 95 (7.3%) had transited to psychosis, while 850 (65.5%) had persistent CS-PLE symptoms and the rest 347 (27.2%) were in remission. Only history of mental illness in the immediate family (HR 4.81, 95% CI 1.40-16.47, P = 0.013) and regular use of cannabis at less than 18 years of age (HR 0.65, 95% CI 0.55-0.77, P < 0.001) were the independent predictors of conversion to psychosis at 3 years. CONCLUSION The rate of TTP in the non-clinical population with elevated risk may be lower than that earlier reported in the western literature. Interventions aimed at preventing transition to psychosis in high risk groups must pay attention to early onset users of cannabis and those with family history of mental illness.
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Affiliation(s)
- Abiodun O Adewuya
- Department of Behavioral Medicine, Lagos State University College of Medicine, 1-5, Oba Akinjobi Way, GRA, Ikeja, Lagos, Nigeria.
- Centre for Mental Health Research and Initiative, Lagos, Nigeria.
| | | | - Tomilola Imarah
- Centre for Mental Health Research and Initiative, Lagos, Nigeria
| | - Laila Asmal
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - Robin Emsley
- Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
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7
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Lamberti JS, Katsetos V, Jacobowitz DB, Weisman RL. Psychosis, Mania and Criminal Recidivism: Associations and Implications for Prevention. Harv Rev Psychiatry 2021; 28:179-202. [PMID: 32251070 DOI: 10.1097/hrp.0000000000000251] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
People with mental illness are overrepresented throughout the criminal justice system, including jail, prison, probation, and parole populations. Yet much disagreement remains about why this problem exists and how best to address it. This article specifically examines empirical evidence regarding the question of whether psychosis and mania are associated with criminal recidivism, and whether this association is predictive or causal in nature. Review of the current literature suggests that psychotic and manic symptoms are associated with increased likelihood of arrest and incarceration. In addition, current evidence shows that pharmacotherapy can reduce criminal recidivism among justice-involved adults with psychosis or mania. However, the extent to which the association between psychosis, mania, and criminal justice system involvement is causal remains uncertain. Also, the literature suggests that most crimes committed by people with schizophrenia spectrum disorders or bipolar I disorder may be driven by factors other than their psychotic or manic symptoms. These established "criminogenic needs" are more common among people with severe mental disorders than in the general population. For optimal prevention, those who serve justice-involved adults with psychosis or mania in community settings should consider addressing the full range of factors that potentially drive their criminal justice system involvement.
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Affiliation(s)
- J Steven Lamberti
- From the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY
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Hu J, Zhang J, Hu L, Yu H, Xu J. Art Therapy: A Complementary Treatment for Mental Disorders. Front Psychol 2021; 12:686005. [PMID: 34456801 PMCID: PMC8397377 DOI: 10.3389/fpsyg.2021.686005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/28/2021] [Indexed: 01/05/2023] Open
Abstract
Art therapy, as a non-pharmacological medical complementary and alternative therapy, has been used as one of medical interventions with good clinical effects on mental disorders. However, systematically reviewed in detail in clinical situations is lacking. Here, we searched on PubMed for art therapy in an attempt to explore its theoretical basis, clinical applications, and future perspectives to summary its global pictures. Since drawings and paintings have been historically recognized as a useful part of therapeutic processes in art therapy, we focused on studies of art therapy which mainly includes painting and drawing as media. As a result, a total of 413 literature were identified. After carefully reading full articles, we found that art therapy has been gradually and successfully used for patients with mental disorders with positive outcomes, mainly reducing suffering from mental symptoms. These disorders mainly include depression disorders and anxiety, cognitive impairment and dementias, Alzheimer's disease, schizophrenia, and autism. These findings suggest that art therapy can not only be served as an useful therapeutic method to assist patients to open up and share their feelings, views, and experiences, but also as an auxiliary treatment for diagnosing diseases to help medical specialists obtain complementary information different from conventional tests. We humbly believe that art therapy has great potential in clinical applications on mental disorders to be further explored.
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Affiliation(s)
- Jingxuan Hu
- College of Creative Design, Shenzhen Technology University, Shenzhen, China
| | - Jinhuan Zhang
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China.,Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Liyu Hu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Haibo Yu
- The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Jinping Xu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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Pardo M, Matalí JL, Sivoli J, Regina VB, Butjosa A, Dolz M, Sánchez B, Barajas A, Del Cacho N, Baños I, Ochoa S, Usall J. Early onset psychosis and cannabis use: Prevalence, clinical presentation and influence of daily use. Asian J Psychiatr 2021; 62:102714. [PMID: 34090251 DOI: 10.1016/j.ajp.2021.102714] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/12/2021] [Accepted: 05/21/2021] [Indexed: 01/16/2023]
Abstract
Most of the studies examining the impact of cannabis use in first episode psychosis (FEP) have been carried out in samples with adult-onset FEP. Data in persons with early onset psychosis (EOP) is scarce. The aims of the study were: To describe the prevalence of lifetime cannabis use, current use, and daily use in patients with EOP compared to healthy controls. To study the differences in clinical presentation between cannabis users and non-users. To examine the risk of presenting an EOP associated with cannabis use and the effect of doses and age of onset of use. An observational cross-sectional study was performed in 90 EOP cases and 62 healthy controls, aged between 7 and 17 years. Our results show a higher prevalence of lifetime use (p = 0002), current use (p < 0.001), and daily use (p < 0.001) in EOP cases in comparison with healthy controls. Regarding clinical presentation, we did not find significant differences in any subscale of the Positive and Negative Syndrome Scale (PANSS). Non-user patients presented more severe depressive symptoms (p = 0002) and worse social functioning than cannabis users (p = 0026). Compared with subjects who never used cannabis, the risk of an EOP was significantly higher for those with a lifetime use (OR = 2.88, p = 0.002)current use (O.R = 6.09, p < 0001), and especially in those with daily use (O.R = 42.77, p = <0001). We found a higher risk of EOP in patients that have used cannabis before 15 years of age. In conclusion, it is necessary to develop early- detection and specific treatment programs for adolescents with cannabis use.
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Affiliation(s)
- Marta Pardo
- Hospital Sant Joan de Déu, Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Barcelona, Spain.
| | - Jose L Matalí
- Hospital Sant Joan de Déu, Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Barcelona, Spain
| | | | - Vila-Badia Regina
- Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain
| | - Anna Butjosa
- Hospital Sant Joan de Déu, Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Barcelona, Spain; Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain
| | - Montse Dolz
- Hospital Sant Joan de Déu, Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Barcelona, Spain
| | - Bernardo Sánchez
- Hospital Sant Joan de Déu, Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Ana Barajas
- Serra Húnter Fellow, Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain; Research Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Edifici Sant Rafael, 1a planta, 08330, Barcelona, Sant Boi de Llobregat, Spain
| | - Nuria Del Cacho
- Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain
| | - Iris Baños
- Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain
| | - Susana Ochoa
- Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Barcelona, Spain; Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain; Research Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Edifici Sant Rafael, 1a planta, 08330, Barcelona, Sant Boi de Llobregat, Spain
| | - Judith Usall
- Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; CIBERSAM, Barcelona, Spain; Department of Research, Centre D'Higiene Mental Les Corts, Barcelona, Spain
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10
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Sideli L, Trotta G, Spinazzola E, La Cascia C, Di Forti M. Adverse effects of heavy cannabis use: even plants can harm the brain. Pain 2021; 162:S97-S104. [PMID: 32804835 PMCID: PMC8216111 DOI: 10.1097/j.pain.0000000000001963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/08/2020] [Accepted: 06/12/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Lucia Sideli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, Palermo University, Palermo, Italy
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- 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, United Kingdom
- South London and Maudsley NHS Mental Health Foundation Trust, London, United Kingdom
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11
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Newman-Taylor K, Richardson T, Sood M, Sopp M, Perry E, Bolderston H. Cognitive mechanisms in cannabis-related paranoia; Initial testing and model proposal. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2020. [DOI: 10.1080/17522439.2020.1757742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Thomas Richardson
- Psychology Department, University of Southampton, Southampton, UK
- Mental Health Recovery Teams, St Mary’s Community Health Campus, Solent NHS Trust, Portsmouth, UK
| | - Monica Sood
- Psychology Department, University of Southampton, Southampton, UK
| | - Mat Sopp
- Psychology Department, University of Southampton, Southampton, UK
| | - Emma Perry
- Mental Health Recovery Teams, St Mary’s Community Health Campus, Solent NHS Trust, Portsmouth, UK
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Seillier A, Martinez AA, Giuffrida A. Differential effects of Δ9-tetrahydrocannabinol dosing on correlates of schizophrenia in the sub-chronic PCP rat model. PLoS One 2020; 15:e0230238. [PMID: 32163506 PMCID: PMC7067407 DOI: 10.1371/journal.pone.0230238] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/25/2020] [Indexed: 01/01/2023] Open
Abstract
Social withdrawal in the sub-chronic phencyclidine (PCP) rat model, a behavioral correlate of the negative symptoms of schizophrenia, results from deficits in brain endocannabinoid transmission. As cannabis intake has been shown to affect negatively the course and expression of psychosis, we tested whether the beneficial effects of endocannabinoid-mediated CB1 activation on social withdrawal in PCP-treated rats (5 mg/kg, twice daily for 7 days)also occurred after administration of Δ9-tetrahydrocannabinol (THC; 0.1, 0.3, 1.0 mg/kg, i.p.). In addition, we assessed whether THC affected two correlates of positive symptoms: 1) motor activity induced by d-amphetamine (0.5 mg/kg, i.p.), and 2) dopamine neuron population activity in the ventral tegmental area (VTA). After the motor activity test, the brains from d-amphetamine-treated animals were collected and processed for measurements of endocannabinoids and activation of Akt/GSK3β, two molecular markers involved in the pathophysiology of schizophrenia. In control rats, THC dose-dependently produced social interaction deficits and aberrant VTA dopamine neuron population activity similar to those observed in PCP-treated animals. In PCP-treated rats, only the lowest dose of THC reversed PCP-induced deficits, as well as PCP-induced elevation of the endocannabinoid anandamide (AEA) in the nucleus accumbens. Last, THC activated the Akt/GSK3β pathway dose-dependently in both control and PCP-treated animals. Taken together, these data suggest that only low doses of THC have beneficial effects on behavioral, neurochemical and electrophysiological correlates of schizophrenia symptoms. This observation may shed some light on the controversial hypothesis of marijuana use as self-medication in schizophrenic patients.
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Affiliation(s)
- Alexandre Seillier
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
- * E-mail:
| | - Alex A. Martinez
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
| | - Andrea Giuffrida
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States of America
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13
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The Role of Individual and Social Mediators in the Association Between Drug Consumption and Mental Health Among Adolescents in Barcelona. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-018-9879-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Paruk S, Jhazbhay K, Singh K, Sartorius B, Burns JK. A comparative study of socio-demographic and substance use correlates in early-onset psychosis. Early Interv Psychiatry 2018; 12:339-347. [PMID: 27038079 PMCID: PMC5045739 DOI: 10.1111/eip.12330] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/14/2016] [Accepted: 02/18/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND Comorbid substance use, particularly cannabis among adolescents with mental illness, is a major public health concern in developing countries with limited mental health resources. Better understanding of the association between cannabis use and other polysubstance use and early mental illness will provide for more targeted early interventions. AIM This aim of this study was to examine the socio-demographic profile and cannabis use characteristics among adolescents with first-episode early-onset psychosis (EOP) and compare with age-matched and gender-matched adolescents with first-episode non-psychotic mental illness (controls). METHOD Forty-five adolescents with first-episode EOP and 45 controls were assessed using a clinical interview, Positive and Negative Syndrome Scale and World Health Organization Alcohol, Smoking and Substance Involvement Screening test (ASSIST) for substance-related problems. RESULTS There were significant socio-demographic differences among the adolescents with EOP (73% Black, 64% from low family income, 44% from rural areas) compared with controls (24% Black, 53% from low family income, 2% from rural areas). Although there was no difference in lifetime cannabis use, EOP adolescents differed in motivation for cannabis use, had increased current cannabis use (38%, P = 0.01) and more frequent use (52%, P = 0.04) compared with controls (16% current and 18% frequent use). EOP adolescents reported more hazardous use with higher ASSIST mean cannabis-specific involvement scores (EOP 10,2; controls 2,3; P = 0.004). CONCLUSION The differences in socio-demographic variables may reflect the marked disparity in access to mental health care for rural Black youth. Psychotic youth may be more vulnerable to comorbid cannabis-related problems than other mentally ill adolescents. The study highlights the need for early introduction of substance use interventions among adolescents with mental illness.
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Affiliation(s)
- Saeeda Paruk
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Khatija Jhazbhay
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Keshika Singh
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Benn Sartorius
- Department of Public Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Jonathan K Burns
- Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
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15
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Oliveira PMDS, Morais ASF, Madeira NGGF. Synthetic Cannabis Analogues and Suicidal Behavior: Case Report. J Addict Med 2018; 11:408-410. [PMID: 28796120 DOI: 10.1097/adm.0000000000000335] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Despite growing legal control, a wide range of synthetic cannabis analogues is currently used for recreational purposes, notwithstanding their well adverse outcomes, which appear to be more frequent and more serious than those associated with cannabis use. We present the case report of a patient with paranoid schizophrenia, who attempted suicide by serious bodily harm after a single use of "Shiva Ultra Strong," a compound of several synthetic cannabis analogues. CASE SUMMARY A 32-year-old male patient with paranoid schizophrenia was brought to the emergency department presenting with a severe self-inflicted wound to the neck which lacerated the right jugular vein and ipsilateral airway, and narrowly missed the carotid bifurcation. On examination, the patient exhibited psychomotor agitation and anxiety. Laboratory tests, which included routine substance use screening, proved unremarkable. The patient was admitted to the ENT Department for surgical treatment, after which he was transferred to our Psychiatry Department, exhibiting consistent improvement with his usual antipsychotic regimen, to which he had good previous adherence. Later, after discharge, he admitted to having used a smartshop drug, so-called "Shiva Ultra Strong," shortly before the suicide attempt. CONCLUSION Although current data on the suicide risk of synthetic cannabis analogues are limited, there is growing evidence of relevant psychiatric effects after their use. Patients with serious mental disorders could prove particularly vulnerable to these drugs, resulting in severe behavioral changes and self-harm.
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Affiliation(s)
- Pedro Miguel Dos Santos Oliveira
- Department of Psychiatry, Coimbra Hospital and University Centre (CHUC), Praceta Mota Pinto, Coimbra, Portugal (PMSO, ASFM, NGGFM); Faculty of Medicine, University of Coimbra (FMUC), Rua Larga, Coimbra, Portugal (ASFM, NGGFM)
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Taukoor B, Paruk S, Karim E, Burns JK. Substance use in adolescents with mental illness in Durban, South Africa. J Child Adolesc Ment Health 2018. [PMID: 28639495 DOI: 10.2989/17280583.2017.1318395] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Comorbid substance use in adolescents with mental illness is often an indicator of poor treatment outcome. This study aims to determine the prevalence of, and associated risk factors for, substance use in adolescents with mental illness attending a mental health service. Data was collected from hospital records of 162 adolescents, using a structured data sheet, over a two-year period. Substance use was more significant in older adolescents and those with severe mental illness. Sixty-two (38.3%) adolescents used substances. Thirty-seven (38.1%) male adolescents reported substance use compared to 25 (38.5%) female adolescents. Alcohol was the most commonly used substance (n = 48; 29.6%), followed by cannabis (n = 32; 19.8%). There were significant direct associations between substance use and history of abuse or neglect, forensic history, educational setting, admission status, and the psychiatric diagnoses of schizophrenia, other psychotic disorders, and bipolar mood disorder. Inverse associations were found between substance use and adjustment disorders, attention deficit hyperactivity disorder, and intellectual disability. The results of this study indicate an urgent need for substance misuse programmes for at risk youth, and the introduction of dual diagnosis intervention programmes in this age group.
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Affiliation(s)
- Bhoodeo Taukoor
- a Department of Psychiatry, Nelson R. Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
| | - Saeeda Paruk
- a Department of Psychiatry, Nelson R. Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
| | - Enver Karim
- a Department of Psychiatry, Nelson R. Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
| | - Jonathan K Burns
- a Department of Psychiatry, Nelson R. Mandela School of Medicine , University of KwaZulu-Natal , Durban , South Africa
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Schnell T, Gliese R, Schröter R, Kasten E, Gouzoulis-Mayfrank E. Motivational changes of cannabis use prior to and during the course of schizophrenia. Am J Addict 2016; 26:122-128. [PMID: 28004866 DOI: 10.1111/ajad.12494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/14/2016] [Accepted: 12/11/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We investigated subjective reasons/motivation for cannabis use in patients with schizophrenia (n = 51) compared to otherwise healthy cannabis users (n = 109). Moreover, we explored possible changes in the motivational patterns of both groups over time. METHODS A questionnaire was developed with six dimensions of motivations to use cannabis: affect regulation, relaxation, habit, structuring everyday life, creativity, and sociability. Participants filled out the instrument regarding their present and initial use of cannabis. RESULTS At the time of onset of consumption, groups only differed significantly in habit with higher ratings for patients with schizophrenia and cannabis use (SCH+CAN group) and in sociability with higher ratings for otherwise healthy users (CAN group). In respect of present use, the motivation to consume cannabis was significantly higher for affect regulation and structuring everyday life in the SCH+CAN group and for relaxation and sociability in the CAN group. With reference to time-based variations, the SCH+CAN group reported increased relevance of structuring everyday life over time. Furthermore, the CAN group reported increased importance of habit over time, whereas the SCH+CAN patients showed decreased ratings of habit over time. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Our findings must be considered preliminary because of the retrospective nature of the assessment. Nevertheless, the present study provides an indication of the time-dependent variation of cannabis-use motivation in schizophrenia, which may provide a better understanding of the functions of cannabis use within the population. Results argue for specific motivational based interventions for the group of schizophrenia patients with regular cannabis use. (Am J Addict 2017;26:122-128).
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Affiliation(s)
- Thomas Schnell
- LVR Clinics Cologne, Cologne, Germany.,Medical School Hamburg (MSH), University of Applied Sciences and Medical University, Hamburg, Germany
| | - Rajac Gliese
- Medical School Hamburg (MSH), University of Applied Sciences and Medical University, Hamburg, Germany
| | - Romy Schröter
- Medical School Hamburg (MSH), University of Applied Sciences and Medical University, Hamburg, Germany
| | - Erich Kasten
- Medical School Hamburg (MSH), University of Applied Sciences and Medical University, Hamburg, Germany
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Ringen PA, Nesvåg R, Helle S, Lagerberg TV, Lange EH, Løberg EM, Agartz I, Andreassen OA, Melle I. Premorbid cannabis use is associated with more symptoms and poorer functioning in schizophrenia spectrum disorder. Psychol Med 2016; 46:3127-3136. [PMID: 27534999 DOI: 10.1017/s0033291716001999] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cannabis use disorder is associated with an earlier age at onset and a more severe outcome of schizophrenia spectrum disorders. The role of cannabis use before the onset of illness (premorbid cannabis use) has not been fully investigated. We here examined how amount and type of premorbid cannabis use was associated with the later course of illness including current substance use, symptoms and level of functioning in schizophrenia spectrum disorder. METHOD We used a naturalistic sample of patients with DSM-IV schizophrenia spectrum disorders with a comprehensive history of illness and substance use. Data on premorbid substance use was obtained from comprehensive self-report. The relationship to outcome was investigated using regression models that included current substance use and premorbid functioning. RESULTS Pre-schizophrenia cannabis use was significantly associated with more severe psychotic symptoms and impaired functioning. Higher levels of premorbid cannabis use were associated with higher levels of current psychotic symptoms. These associations were independent of current substance use and premorbid functioning. Early use of cannabis (age <17 years) was associated with earlier age at onset of psychosis, independently of potential confounders. CONCLUSIONS Pre-psychosis cannabis use affects illness outcome in schizophrenia spectrum disorders, and is associated with lower age at onset of psychosis. These findings of independent negative effects of premorbid cannabis use in schizophrenia suggest that a limitation of the general use of cannabis may have beneficial health effects.
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Affiliation(s)
- P A Ringen
- Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - R Nesvåg
- Department of mental disorders,Norwegian Institute of Public Health,Oslo,Norway
| | - S Helle
- Division of Psychiatry,Haukeland University Hospital,Bergen,Norway
| | - T V Lagerberg
- Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - E H Lange
- NORMENT, K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo,Oslo,Norway
| | - E M Løberg
- Division of Psychiatry,Haukeland University Hospital,Bergen,Norway
| | - I Agartz
- Department of Psychiatric Research,Diakonhjemmet Hospital,Oslo,Norway
| | - O A Andreassen
- Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
| | - I Melle
- Division of Mental Health and Addiction,Oslo University Hospital,Oslo,Norway
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Baudin G, Godin O, Lajnef M, Aouizerate B, Berna F, Brunel L, Capdevielle D, Chereau I, Dorey JM, Dubertret C, Dubreucq J, Faget C, Fond G, Gabayet F, Laouamri H, Lancon C, Le Strat Y, Tronche AM, Misdrahi D, Rey R, Passerieux C, Schandrin A, Urbach M, Vidalhet P, Llorca PM, Schürhoff F. Differential effects of childhood trauma and cannabis use disorders in patients suffering from schizophrenia. Schizophr Res 2016; 175:161-167. [PMID: 27209524 DOI: 10.1016/j.schres.2016.04.042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 04/20/2016] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Childhood trauma (CT) and cannabis use are both environmental and modifier risk factors for schizophrenia. However, little is known about how they interact in schizophrenia. We examined the main effect of each of these two environmental factors on the clinical expression of the disease using a large set of variables, and we tested whether and how cannabis and CT interact to influence the course and the presentation of the illness. METHODS A sample of 366 patients who met the DSM-IV-TR criteria for schizophrenia was recruited through the FACE-SCZ (Fondamental Advanced Centre of Expertise - Schizophrenia) network. Patients completed a large standardized clinical evaluation including Structured Clinical Interview for DSM Disorders-I (SCID-I), Positive and Negative Symptoms Scale (PANSS), Columbia-Suicide Severity Rating Scale (C-SSRS), Global Assessment of Functioning (GAF), Short-Quality of Life-18 (S-QoL-18), and Medication Adherence Rating Scale (MARS). We assessed CT with the Childhood Trauma Questionnaire and cannabis status with SCID-I. RESULTS CT significantly predicted the number of hospitalizations, GAF, and S-QoL-18 scores, as well as the PANSS total, positive, excitement, and emotional distress scores. Cannabis use disorders significantly predicted age of onset, and MARS. There was no significant interaction between CT and cannabis use disorders. However, we found evidence of a correlation between these two risk factors. CONCLUSIONS CT and cannabis both have differential deleterious effects on clinical and functional outcomes in patients with schizophrenia. Our results highlight the need to systematically assess the presence of these risk factors and adopt suitable therapeutic interventions.
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Affiliation(s)
- G Baudin
- Fondation FondaMental, Créteil F94000, France; INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil F94000, France; AP-HP, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil F94000, France; Université François-Rabelais de Tours, PAV EA 2114, Tours F37000, France
| | - O Godin
- Fondation FondaMental, Créteil F94000, France; Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), F75013 Paris, France
| | - M Lajnef
- INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil F94000, France
| | - B Aouizerate
- Fondation FondaMental, Créteil F94000, France; Centre Hospitalier Charles Perrens, F-33076, Bordeaux, France; Université de Bordeaux, France; Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000, Bordeaux, France
| | - F Berna
- Fondation FondaMental, Créteil F94000, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - L Brunel
- Fondation FondaMental, Créteil F94000, France; INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil F94000, France; AP-HP, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil F94000, France; Université Paris-Est Créteil F94000, France
| | - D Capdevielle
- Fondation FondaMental, Créteil F94000, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - I Chereau
- Fondation FondaMental, Créteil F94000, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, 63003 Clermont-Ferrand Cedex 1, France
| | - J M Dorey
- Fondation FondaMental, Créteil F94000, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est BP 300 39, 95 bd Pinel, 69678 Bron Cedex, France
| | - C Dubertret
- Fondation FondaMental, Créteil F94000, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, France
| | - J Dubreucq
- Fondation FondaMental, Créteil F94000, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - C Faget
- Fondation FondaMental, Créteil F94000, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France
| | - G Fond
- Fondation FondaMental, Créteil F94000, France; INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil F94000, France; AP-HP, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil F94000, France; Université Paris-Est Créteil F94000, France
| | - F Gabayet
- Fondation FondaMental, Créteil F94000, France; Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - H Laouamri
- Fondation FondaMental, Créteil F94000, France
| | - C Lancon
- Fondation FondaMental, Créteil F94000, France; Assistance Publique des Hôpitaux de Marseille (AP-HM), Pôle Universitaire de Psychiatrie, Marseille, France
| | - Y Le Strat
- Fondation FondaMental, Créteil F94000, France; AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine, France
| | - A M Tronche
- Fondation FondaMental, Créteil F94000, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, 63003 Clermont-Ferrand Cedex 1, France
| | - D Misdrahi
- Fondation FondaMental, Créteil F94000, France; Université de Bordeaux, France; Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France; CNRS UMR 5287-INCIA, France
| | - R Rey
- Fondation FondaMental, Créteil F94000, France; Université Claude Bernard Lyon 1, Centre Hospitalier Le Vinatier, Pole Est BP 300 39, 95 bd Pinel, 69678 Bron Cedex, France
| | - C Passerieux
- Fondation FondaMental, Créteil F94000, France; Service de Psychiatrie d'Adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - A Schandrin
- Fondation FondaMental, Créteil F94000, France; Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - M Urbach
- Fondation FondaMental, Créteil F94000, France; Service de Psychiatrie d'Adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - P Vidalhet
- Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - P M Llorca
- Fondation FondaMental, Créteil F94000, France; CMP B, CHU, EA 7280 Faculté de Médecine, Université d'Auvergne, BP 69, 63003 Clermont-Ferrand Cedex 1, France
| | - F Schürhoff
- Fondation FondaMental, Créteil F94000, France; INSERM U955, Équipe de Psychiatrie Translationnelle, Créteil F94000, France; AP-HP, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil F94000, France; Université Paris-Est Créteil F94000, France.
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Thomas P, Amad A, Fovet T. Schizophrénie et addictions : les liaisons dangereuses. Encephale 2016; 42 Suppl 3:S18-S22. [DOI: 10.1016/s0013-7006(16)30218-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bianconi F, Bonomo M, Marconi A, Kolliakou A, Stilo SA, Iyegbe C, Gurillo Muñoz P, Homayoun S, Mondelli V, Luzi S, Dazzan P, Prata D, La Cascia C, O'Connor J, David A, Morgan C, Murray RM, Lynskey M, Di Forti M. Differences in cannabis-related experiences between patients with a first episode of psychosis and controls. Psychol Med 2016; 46:995-1003. [PMID: 26670601 DOI: 10.1017/s0033291715002494] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Many studies have reported that cannabis use increases the risk of a first episode of psychosis (FEP). However, only a few studies have investigated the nature of cannabis-related experiences in FEP patients, and none has examined whether these experiences are similar in FEP and general populations. The aim of this study was to explore differences in self-reported cannabis experiences between FEP and non-psychotic populations. METHOD A total of 252 subjects, who met International Classification of Diseases (ICD)-10 criteria for FEP, and 217 controls who reported cannabis use were selected from the Genetics and Psychosis (GAP) study. The Medical Research Council Social Schedule and the Cannabis Experience Questionnaire were used to collect sociodemographic data and cannabis use information, respectively. RESULTS Both 'bad' and 'enjoyable' experiences were more commonly reported by FEP subjects than controls. Principal components factor analysis identified four components which explained 62.3% of the variance. Linear regression analysis on the whole sample showed that the type of cannabis used and beliefs about the effect of cannabis on health all contributed to determining the intensity and frequency of experiences. Linear regression analysis on FEP subjects showed that the duration of cannabis use and amount of money spent on cannabis were strongly related to the intensity and frequency of enjoyable experiences in this population. CONCLUSIONS These results suggest a higher sensitivity to cannabis effects among people who have suffered their first psychotic episode; this hypersensitivity results in them reporting both more 'bad' and 'enjoyable' experiences. The greater enjoyment experienced may provide an explanation of why FEP patients are more likely to use cannabis and to continue to use it despite experiencing an exacerbation of their psychotic symptoms.
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Affiliation(s)
- F Bianconi
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - M Bonomo
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - A Marconi
- Department of Paediatrics and Child and Adolescent Neuropsychiatry,'Sapienza' University of Rome,Rome,Italy
| | - A Kolliakou
- Biomedical Research Centre Nucleus,King's College London,London,UK
| | - S A Stilo
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - C Iyegbe
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | | | - S Homayoun
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - V Mondelli
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - S Luzi
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - P Dazzan
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - D Prata
- Department of Neuroimaging,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - C La Cascia
- Department of Experimental Biomedicine and Clinical Neuroscience,University of Palermo,Palermo,Italy
| | - J O'Connor
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - A David
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - C Morgan
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - R M Murray
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - M Lynskey
- Addiction Department,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
| | - M Di Forti
- Department of Psychosis Studies,Institute of Psychiatry, Psychology and Neuroscience, King's College London,London,UK
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Belghazi D, Moussaoui D, Kadri N. Spécificités épidémiologiques, cliniques et culturelles des patients hospitalisés au centre psychiatrique universitaire Ibn-Rochd de Casablanca. ANNALES MEDICO-PSYCHOLOGIQUES 2016. [DOI: 10.1016/j.amp.2013.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
BACKGROUND Quantitative studies dominate research exploring reasons for substance use and experiences of substance use by people with mental health difficulties. This limits the depth of understanding which can be gained about these experiences. OBJECTIVES In the present article, we synthesized current qualitative research in this area to provide enhanced theoretical knowledge of these experiences. METHODS Following a systematic literature search, we identified 12 studies which explored how people with mental health difficulties experienced using substances, and which met additional inclusion criterion. We used Noblit and Hare's metaethnographic approach to qualitatively synthesize these studies. RESULTS Synthesis led to the development of two themes; "substance use mediates acceptance and social inclusion" and "substance use provides perceived opportunities for control and power." CONCLUSIONS/IMPORTANCE The findings suggest that in the studies reviewed people's motivation for substance use was embedded in social and psychological contexts. It indicated that substance use could provide perceived benefits such as mediating the impact of mental health stigma, enabling the development of alternative identities, increasing their sense of power and providing opportunities for social inclusion. Mental health and substance use workers should therefore aim to develop alternative opportunities for people with co-occurring disorders to gain such benefits, and seek to challenge mental health stigma.
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Affiliation(s)
- Emma Chorlton
- a Division of Health Research, Lancaster University , Lancaster , United Kingdom
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25
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Affiliation(s)
- Matthew Hill
- The Hotchkiss Brain Institute, University of Calgary, Alberta, Canada
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Buchy L, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Heinssen R, Bearden CE, Mathalon D, Addington J. Substance use in individuals at clinical high risk of psychosis. Psychol Med 2015; 45:2275-84. [PMID: 25727300 PMCID: PMC8182984 DOI: 10.1017/s0033291715000227] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND A series of research reports has indicated that the use of substances such as cannabis, alcohol and tobacco are higher in youth at clinical high risk (CHR) of developing psychosis than in controls. Little is known about the longitudinal trajectory of substance use, and findings on the relationship between substance use and later transition to psychosis in CHR individuals are mixed. METHOD At baseline and 6- and 12-month follow-ups, 735 CHR and 278 control participants completed the Alcohol and Drug Use Scale and a cannabis use questionnaire. The longitudinal trajectory of substance use was evaluated with linear mixed models. RESULTS CHR participants endorsed significantly higher cannabis and tobacco use severity, and lower alcohol use severity, at baseline and over a 1-year period compared with controls. CHR youth had higher lifetime prevalence and frequency of cannabis, and were significantly younger upon first use, and were more likely to use alone and during the day. Baseline substance use did not differentiate participants who later transitioned to psychosis (n = 90) from those who did not transition (n = 272). Controls had lower tobacco use than CHR participants with a prodromal progression clinical outcome and lower cannabis use than those with a psychotic clinical outcome at the 2-year assessment. CONCLUSIONS In CHR individuals cannabis and tobacco use is higher than in controls and this pattern persists across 1 year. Evaluation of clinical outcome may provide additional information on the longitudinal impact of substance use that cannot be detected through evaluation of transition/non-transition to psychosis alone.
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Affiliation(s)
- L. Buchy
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | | | - T. D. Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
| | - B. A. Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, USA
| | - T. H. McGlashan
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - D. O. Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - L. J. Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - M. T. Tsuang
- Department of Psychology, Yale University, New Haven, CT, USA
| | - E. F. Walker
- Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
| | - S. W. Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - R. Heinssen
- Schizophrenia Spectrum Research Program, Division of Adult Translational Research, National Institute of Mental Health, Bethesda, MD, USA
| | - C. E. Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, USA
| | - D. Mathalon
- Departments of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - J. Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
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van Amsterdam J, Brunt T, van den Brink W. The adverse health effects of synthetic cannabinoids with emphasis on psychosis-like effects. J Psychopharmacol 2015; 29:254-63. [PMID: 25586398 DOI: 10.1177/0269881114565142] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cannabis use is associated with an increased risk of psychosis in vulnerable individuals. Cannabis containing high levels of the partial cannabinoid receptor subtype 1 (CB1) agonist tetrahydrocannabinol (THC) is associated with the induction of psychosis in susceptible subjects and with the development of schizophrenia, whereas the use of cannabis variants with relatively high levels of cannabidiol (CBD) is associated with fewer psychotic experiences. Synthetic cannabinoid receptor agonists (SCRAs) are full agonists and often more potent than THC. Moreover, in contrast to natural cannabis, SCRAs preparations contain no CBD so that these drugs may have a higher psychosis-inducing potential than cannabis. This paper reviews the general toxicity profile and the adverse effects of SCRAs with special emphasis on their psychosis-inducing risk. The review shows that, compared with the use of natural cannabis, the use of SCRAs may cause more frequent and more severe unwanted negative effects, especially in younger, inexperienced users. Psychosis and psychosis-like conditions seem to occur relatively often following the use of SCRAs, presumably due to their high potency and the absence of CBD in the preparations. Studies on the relative risk of SCRAs compared with natural cannabis to induce or evoke psychosis are urgently needed.
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Affiliation(s)
- Jan van Amsterdam
- Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tibor Brunt
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Wim van den Brink
- Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Gomes FV, Guimarães FS, Grace AA. Effects of pubertal cannabinoid administration on attentional set-shifting and dopaminergic hyper-responsivity in a developmental disruption model of schizophrenia. Int J Neuropsychopharmacol 2015; 18:pyu018. [PMID: 25522381 PMCID: PMC4368886 DOI: 10.1093/ijnp/pyu018] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Adolescent exposure to cannabinoids in vulnerable individuals is proposed to be a risk factor for psychiatric conditions later in life, particularly schizophrenia. Evidence from studies in animals has indicated that a combination of repeated pubertal cannabinoid administration with either neonatal prefrontocortical lesion, isolation rearing, or chronic NMDA receptor antagonism administration induces enhanced schizophrenia-like behavioral disruptions. The effects of adolescent exposure to CB1 receptor agonists, however, have not been tested in a developmental disruption model of schizophrenia. METHODS This was tested in the methylazoxymethanol (MAM) model, in which repeated treatment with the synthetic cannabinoid agonist WIN 55,212-2 (WIN; 1.2mg/kg) was extended over 25 days throughout puberty (postnatal days 40-65) in control and MAM rats. The rats received 20 injections, which were delivered irregularly to mimic the human condition. Adult rats were tested for attentional set-shifting task and locomotor response to amphetamine, which was compared with in vivo recording from ventral tegmental area (VTA) dopamine (DA) neurons. RESULTS MAM-treated rats showed impairment in the attentional set-shifting task, augmented locomotor response to amphetamine administration, and an increased number of spontaneously active DA neurons in the VTA. Interestingly, pubertal WIN treatment in normal animals induced similar changes at adulthood as those observed in MAM-treated rats, supporting the notion that adolescence exposure to cannabinoids may represent a risk factor for developing schizophrenia-like signs at adulthood. However, contrary to expectations, pubertal WIN administration did not exacerbate the behavioral and electrophysiological changes in MAM-treated rats beyond that observed in WIN-treated saline rats (Sal). Indeed, WIN treatment actually attenuated the locomotor response to amphetamine in MAM rats without impacting DA neuron activity states. CONCLUSIONS Taken together, the present results indicate that the impact of cannabinoids during puberty/adolescence on schizophrenia models is more complex than may be predicted.
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Affiliation(s)
- Felipe V Gomes
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (Drs Gomes and Guimarães); Center for Interdisciplinary Research on Applied Neurosciences, University of São Paulo, Brazil (Drs Gomes and Guimarães); Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, A210 Langley Hall, Pittsburgh, PA 15260 (Dr Grace).
| | - Francisco S Guimarães
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (Drs Gomes and Guimarães); Center for Interdisciplinary Research on Applied Neurosciences, University of São Paulo, Brazil (Drs Gomes and Guimarães); Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, A210 Langley Hall, Pittsburgh, PA 15260 (Dr Grace)
| | - Anthony A Grace
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo, Brazil (Drs Gomes and Guimarães); Center for Interdisciplinary Research on Applied Neurosciences, University of São Paulo, Brazil (Drs Gomes and Guimarães); Departments of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, A210 Langley Hall, Pittsburgh, PA 15260 (Dr Grace)
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Kolliakou A, Castle D, Sallis H, Joseph C, O'Connor J, Wiffen B, Gayer-Anderson C, McQueen G, Taylor H, Bonaccorso S, Gaughran F, Smith S, Greenwood K, Murray RM, Di Forti M, Atakan Z, Ismail K. Reasons for cannabis use in first-episode psychosis: does strength of endorsement change over 12 months? Eur Psychiatry 2014; 30:152-9. [PMID: 25541346 DOI: 10.1016/j.eurpsy.2014.10.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 10/29/2014] [Accepted: 10/29/2014] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Why patients with psychosis use cannabis remains debated. The self-medication hypothesis has received some support but other evidence points towards an alleviation of dysphoria model. This study investigated the reasons for cannabis use in first-episode psychosis (FEP) and whether strength in their endorsement changed over time. METHODS FEP inpatients and outpatients at the South London and Maudsley, Oxleas and Sussex NHS Trusts UK, who used cannabis, rated their motives at baseline (n=69), 3 months (n=29) and 12 months (n=36). A random intercept model was used to test the change in strength of endorsement over the 12 months. Paired-sample t-tests assessed the differences in mean scores between the five subscales on the Reasons for Use Scale (enhancement, social motive, coping with unpleasant affect, conformity and acceptance and relief of positive symptoms and side effects), at each time-point. RESULTS Time had a significant effect on scores when controlling for reason; average scores on each subscale were higher at baseline than at 3 months and 12 months. At each time-point, patients endorsed 'enhancement' followed by 'coping with unpleasant affect' and 'social motive' more highly for their cannabis use than any other reason. 'Conformity and acceptance' followed closely. 'Relief of positive symptoms and side effects' was the least endorsed motive. CONCLUSIONS Patients endorsed their reasons for use at 3 months and 12 months less strongly than at baseline. Little support for the self-medication or alleviation of dysphoria models was found. Rather, patients rated 'enhancement' most highly for their cannabis use.
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Affiliation(s)
- A Kolliakou
- Department of Psychological Medicine, PO92, Institute of Psychiatry, King's College London, De Crespigny Park, SE5 8AF London, UK.
| | - D Castle
- Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - H Sallis
- MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - C Joseph
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - J O'Connor
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - B Wiffen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - C Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK
| | - G McQueen
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - H Taylor
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - S Bonaccorso
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - F Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - S Smith
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King's College London, London, UK
| | - K Greenwood
- School of Psychology, University of Sussex, Sussex, UK
| | - R M Murray
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - M Di Forti
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Z Atakan
- Department of Neuroimaging, Institute of Psychiatry, King's College London, London, UK
| | - K Ismail
- Department of Psychological Medicine, PO92, Institute of Psychiatry, King's College London, De Crespigny Park, SE5 8AF London, UK
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González-Blanch C, Gleeson JF, Cotton SM, Crisp K, McGorry PD, Alvarez-Jimenez M. Longitudinal relationship between expressed emotion and cannabis misuse in young people with first-episode psychosis. Eur Psychiatry 2014; 30:20-5. [PMID: 25174270 DOI: 10.1016/j.eurpsy.2014.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/26/2014] [Accepted: 07/01/2014] [Indexed: 11/16/2022] Open
Abstract
Carers' expressed emotion (EE) and patients' cannabis misuse are two of the most robust predictors of psychotic relapse. We aimed to examine the temporal relationship between EE and cannabis misuse. Sixty-three key carers of young people with first-episode psychosis (FEP) were assessed at baseline and 7-month follow-up. EE was measured in carers using the Family Questionnaire (FQ) and cannabis misuse in patients using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Correlational and hierarchical logistic regression analyses were conducted to examine the temporal relationship between EE components (i.e. criticism and emotional over involvement) and cannabis misuse. Carers' criticism at baseline significantly predicted cannabis misuse according to the ASSIST at 7-month follow-up. The association remained significant after controlling for baseline symptom severity and social functioning (B=0.15, P=.02). Conversely, baseline cannabis misuse was not associated with carers' criticism at 7-month follow-up. Patients in families with high criticism showed a tendency to increase cannabis misuse over time whereas the opposite trend was observed in those with carers with low criticism. A family environment characterized by high criticism may become a key risk factor for worsening cannabis misuse over time in young people with FEP. Further studies should investigate the potential mechanisms (e.g., patient's anxiety or perceived stress) through which criticism increases cannabis misuse in FEP.
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Affiliation(s)
- C González-Blanch
- Mental Health Centre, University Hospital "Marqués de Valdecilla", Santander, Spain.
| | - J F Gleeson
- School of Psychology, Australian Catholic University, Melbourne, Australia
| | - S M Cotton
- Centre for Youth Mental Health, University of Melbourne, Australia; Orygen Youth Health Research Centre, Melbourne, Australia
| | - K Crisp
- Orygen Youth Health, Melbourne, Australia
| | - P D McGorry
- Centre for Youth Mental Health, University of Melbourne, Australia; Orygen Youth Health Research Centre, Melbourne, Australia
| | - M Alvarez-Jimenez
- Centre for Youth Mental Health, University of Melbourne, Australia; Orygen Youth Health Research Centre, Melbourne, Australia
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Samaha AN. Can antipsychotic treatment contribute to drug addiction in schizophrenia? Prog Neuropsychopharmacol Biol Psychiatry 2014; 52:9-16. [PMID: 23793001 DOI: 10.1016/j.pnpbp.2013.06.008] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 06/02/2013] [Accepted: 06/11/2013] [Indexed: 12/27/2022]
Abstract
Individuals with schizophrenia are at very high risk for drug abuse and addiction. Patients with a coexisting drug problem fare worse than patients who do not use drugs, and are also more difficult to treat. Current hypotheses cannot adequately account for why patients with schizophrenia so often have a co-morbid drug problem. I present here a complementary hypothesis based on evidence showing that chronic exposure to antipsychotic medications can induce supersensitivity within the brain's dopamine systems, and that this in turn can enhance the rewarding and incentive motivational effects of drugs and reward cues. At the neurobiological level, these effects of antipsychotics are potentially linked to antipsychotic-induced increases in the striatal levels of dopamine D2 receptors and D2 receptors in a high-affinity state for dopamine, particularly at postsynaptic sites. Antipsychotic-induced dopamine supersensitivity and enhanced reward function are not inevitable consequences of prolonged antipsychotic treatment. At least two parameters appear to promote these effects; the use of antipsychotics of the typical class, and continuous rather than intermittent antipsychotic exposure, such that silencing of dopaminergic neurotransmission via D2/3 receptors is unremitting. Thus, by inducing forms of neural plasticity that facilitate the ability of drugs and reward cues to gain control over behaviour, some currently used treatment strategies with typical antipsychotics might contribute to compulsive drug seeking and drug taking behaviours in vulnerable schizophrenia patients.
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Affiliation(s)
- Anne-Noël Samaha
- Department of Pharmacology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada, H3C 3J7; CNS Research Group, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada, H3C 3J7.
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Cassidy CM, Lepage M, Malla A. Do motivation deficits in schizophrenia-spectrum disorders promote cannabis use? An investigation of behavioural response to natural rewards and drug cues. Psychiatry Res 2014; 215:522-7. [PMID: 24398065 DOI: 10.1016/j.psychres.2013.12.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 12/03/2013] [Accepted: 12/14/2013] [Indexed: 01/14/2023]
Abstract
Deficits in incentive motivation are often present in both Schizophrenia Spectrum Disorders (SSD) and substance-use disorders. The current study aims to test whether the presence of such deficits confers vulnerability to cannabis use in individuals with SSD. SSD patients (n=35) and healthy controls (n=35) were each divided into a group with (n=20) and a group without (n=15) current cannabis use disorder. Subjects performed a behavioural task designed for schizophrenia patients in which they could seek exposure to pleasant and cannabis visual stimuli on the basis of internal representations of these stimuli. Intensity of cannabis use was assessed by self-report. SSD patients were significantly less likely than controls to exert effort to try to re-view pleasant stimuli but were not significantly less likely to work to avoid unpleasant stimuli. Lack of response to re-view pleasant stimuli significantly predicted higher subsequent cannabis self-administration in patients but not controls, after controlling for degree of prior exposure to cannabis. Deficits in incentive motivation may be an aspect of SSD which promotes cannabis use in this population.
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Affiliation(s)
- Clifford M Cassidy
- McGill University, Douglas Mental Health University Institute, 6875 Boul., Lasalle, Montreal, Qc, Canada H4H 1R3
| | - Martin Lepage
- McGill University, Douglas Mental Health University Institute, 6875 Boul., Lasalle, Montreal, Qc, Canada H4H 1R3
| | - Ashok Malla
- McGill University, Douglas Mental Health University Institute, 6875 Boul., Lasalle, Montreal, Qc, Canada H4H 1R3.
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Stevens JR, Prince JB, Prager LM, Stern TA. Psychotic disorders in children and adolescents: a primer on contemporary evaluation and management. Prim Care Companion CNS Disord 2014; 16:13f01514. [PMID: 25133052 DOI: 10.4088/pcc.13f01514] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 11/26/2013] [Indexed: 10/25/2022] Open
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Kuepper R, Oorschot M, Myin-Germeys I, Smits M, van Os J, Henquet C. Is psychotic disorder associated with increased levels of craving for cannabis? An Experience Sampling study. Acta Psychiatr Scand 2013; 128:448-56. [PMID: 23330571 DOI: 10.1111/acps.12078] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Although cannabis use among individuals with psychotic disorder is considerable, little is known about patterns of use and factors contributing to continuation of use. Therefore, we investigated craving in relation to cannabis use in patients with psychotic disorder and healthy controls. METHOD The study included 58 patients with non-affective psychotic disorder and 63 healthy controls; all were frequent cannabis users. Craving was assessed with the Obsessive Compulsive Drug Use Scale (OCDUS) for cannabis, as well as in daily life using the Experience Sampling Method (ESM). RESULTS Patients scored higher on the OCDUS (B = 1.18, P = 0.022), but did not differ from controls in ESM indices of craving (all P > 0.05). In daily life, ESM craving predicted cannabis use and this was stronger in controls (χ(2) = 4.5, P = 0.033; Bcontrols = 0.08, P < 0.001; Bpatients = 0.06, P < 0.001). In both groups ESM craving was predicted by negative affect, paranoia, and hallucinations (Bnegativeaffect = 0.12, P = 0.009; Bparanoia = 0.13, P = 0.013; Bhallucinations = 0.13, P = 0.028), and followed by an increase in negative affect at non-cannabis-using moments (B = 0.03, P = 0.002). CONCLUSION The temporal dynamics of craving as well as craving intensity in daily life appear to be similar in patients and controls. Further research is needed to elucidate the inconsistencies between cross-sectional and daily-life measures of craving in psychosis.
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Affiliation(s)
- R Kuepper
- Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Center, Maastricht, the Netherlands
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Huddy VC, Clark L, Harrison I, Ron MA, Moutoussis M, Barnes TRE, Joyce EM. Reflection impulsivity and response inhibition in first-episode psychosis: relationship to cannabis use. Psychol Med 2013; 43:2097-2107. [PMID: 23339857 DOI: 10.1017/s0033291712003054] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND People with psychosis demonstrate impaired response inhibition on the Stop Signal Task (SST). It is less clear if this impairment extends to reflection impulsivity, a form of impulsivity that has been linked to substance use in non-psychotic samples. METHOD We compared 49 patients with first-episode psychosis (FEP) and 30 healthy control participants on two forms of impulsivity measured using the Information Sampling Test (IST) and the SST, along with clinical and IQ assessments. We also compared those patients who used cannabis with those who had either given up or never used. RESULTS Patients with FEP had significantly greater impairment in response inhibition but not in reflection impulsivity compared with healthy controls. By contrast, patients who reported current cannabis use demonstrated greater reflection impulsivity than those that had either given up or never used, whereas there were no differences in response inhibition. CONCLUSIONS These data suggest that abnormal reflection impulsivity is associated with substance use in psychosis but not psychosis itself ; the opposite relationship may hold for response inhibition.
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Affiliation(s)
- V C Huddy
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
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Vitacco MJ, Buckley PF. Substance Use Comorbidity in Patients with Schizophrenia. Psychiatr Ann 2013. [DOI: 10.3928/00485713-20131003-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Archie S, Boydell KM, Stasiulis E, Volpe T, Gladstone BM. Reflections of young people who have had a first episode of psychosis: what attracted them to use alcohol and illicit drugs? Early Interv Psychiatry 2013; 7:193-9. [PMID: 22404861 DOI: 10.1111/j.1751-7893.2012.00355.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To identify factors that contribute to the initiation of alcohol and street drug use from the perspective of people who were enrolled in early intervention programmes for a first episode of psychosis. METHOD Eight focus groups were conducted involving an average of four to six participants per group, with each group consisting of young people who met provincial inclusion criteria for early intervention programmes. Thematic analysis was used to systematically code transcripts from the focus groups for concepts, patterns and themes related to early use of illicit substances. RESULTS Participants included 45 young people diagnosed with affective psychosis or non-affective spectrum disorders. Seventy-three percent were male, with a median age of 23 years. In general, substance use was an important topic that emerged across all focus groups. Participants talked about three main factors attracting them to initiate use of substances, most predominantly cannabis: (i) using within a social context; (ii) using as a self-medication strategy; and (iii) using to alter their perceptions. CONCLUSIONS The need for social relationships, coping strategies and pleasurable experiences appear to be important reasons for initiating substance use. Additional research is needed to identify whether prodromal youth report the same factors that attract them to initiate use in order to develop more effective prevention strategies.
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Affiliation(s)
- Suzanne Archie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.
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Cachope R. Functional diversity on synaptic plasticity mediated by endocannabinoids. Philos Trans R Soc Lond B Biol Sci 2013; 367:3242-53. [PMID: 23108543 DOI: 10.1098/rstb.2011.0386] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Endocannabinoids (eCBs) act as modulators of synaptic transmission through activation of a number of receptors, including, but not limited to, cannabinoid receptor 1 (CB1). eCBs share CB1 receptors as a common target with Δ(9)-tetrahydrocannabinol (THC), the main psychoactive ingredient in marijuana. Although THC has been used for recreational and medicinal purposes for thousands of years, little was known about its effects at the cellular level or on neuronal circuits. Identification of CB1 receptors and the subsequent development of its specific ligands has therefore enhanced our ability to study and bring together a substantial amount of knowledge regarding how marijuana and eCBs modify interneuronal communication. To date, the eCB system, composed of cannabinoid receptors, ligands and the relevant enzymes, is recognized as the best-described retrograde signalling system in the brain. Its impact on synaptic transmission is widespread and more diverse than initially thought. The aim of this review is to succinctly present the most common forms of eCB-mediated modulation of synaptic transmission, while also illustrating the multiplicity of effects resulting from specializations of this signalling system at the circuital level.
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Affiliation(s)
- Roger Cachope
- Department of Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Griffith-Lendering MFH, Wigman JTW, Prince van Leeuwen A, Huijbregts SCJ, Huizink AC, Ormel J, Verhulst FC, van Os J, Swaab H, Vollebergh WAM. Cannabis use and vulnerability for psychosis in early adolescence--a TRAILS study. Addiction 2013; 108:733-40. [PMID: 23216690 DOI: 10.1111/add.12050] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 12/06/2011] [Accepted: 10/23/2012] [Indexed: 11/30/2022]
Abstract
AIMS To examine the direction of the longitudinal association between vulnerability for psychosis and cannabis use throughout adolescence. DESIGN Cross-lagged path analysis was used to identify the temporal order of vulnerability for psychosis and cannabis use, while controlling for gender, family psychopathology, alcohol use and tobacco use. SETTING A large prospective population study of Dutch adolescents [the TRacking Adolescents' Individual Lives Survey (TRAILS) study]. PARTICIPANTS A total of 2120 adolescents with assessments at (mean) age 13.6, age 16.3 and age 19.1. MEASUREMENTS Vulnerability for psychosis at the three assessment points was represented by latent factors derived from scores on three scales of the Youth Self-Report and the Adult Self-Report, i.e. thought problems, social problems and attention problems. Participants self-reported on cannabis use during the past year at all three waves. FINDINGS Significant associations (r = 0.12-0.23) were observed between psychosis vulnerability and cannabis use at all assessments. Also, cannabis use at age 16 predicted psychosis vulnerability at age 19 (Z = 2.6, P < 0.05). Furthermore, psychosis vulnerability at ages 13 (Z = 2.0, P < 0.05) and 16 (Z = 3.0, P < 0.05) predicted cannabis use at, respectively, ages 16 and 19. CONCLUSIONS Cannabis use predicts psychosis vulnerability in adolescents and vice versa, which suggests that there is a bidirectional causal association between the two.
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Affiliation(s)
- Merel F H Griffith-Lendering
- Department of Clinical Child and Adolescent Studies, Faculty of Social Sciences, Leiden University, Leiden, the Netherlands.
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Tosato S, Lasalvia A, Bonetto C, Mazzoncini R, Cristofalo D, De Santi K, Bertani M, Bissoli S, Lazzarotto L, Marrella G, Lamonaca D, Riolo R, Gardellin F, Urbani A, Tansella M, Ruggeri M. The impact of cannabis use on age of onset and clinical characteristics in first-episode psychotic patients. Data from the Psychosis Incident Cohort Outcome Study (PICOS). J Psychiatr Res 2013; 47:438-44. [PMID: 23290558 DOI: 10.1016/j.jpsychires.2012.11.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 10/15/2012] [Accepted: 11/14/2012] [Indexed: 11/26/2022]
Abstract
Cannabis use is frequent among first-episode psychosis (FEP) patients and has been associated with several clinical features. This study aimed in an FEP sample to determine whether cannabis use is associated with (1) a higher level of positive symptoms, a lower level of depression and a better premorbid adjustment, (2) an earlier age of onset, and a better premorbid IQ. The study was conducted within the framework of the Psychosis Incident Cohort Outcome Study (PICOS), a multisite collaborative research on FEP patients who attended the psychiatric services in Veneto Region, Italy. Standardized instruments were used to collect sociodemographic, clinical, and drug use data. A total of 555 FEP patients met the inclusion criteria, 517 of whom received an ICD-10 diagnosis of psychosis; 397 (55% males; mean age: 32 yrs ± 9.5) were assessed. Out of these, 311 patients agreed to be interviewed on drug and alcohol misuse; 20.3% was positive for drug misuse: cannabis (19.0%), cocaine (3.9%), and hallucinogens (3.9%). Cannabis use was not associated with a higher level of positive symptoms, but correlated with less severe depressive symptoms. No relationship was observed between premorbid adjustment or IQ and cannabis use. FEP patients who used cannabis had an earlier age of onset than abstinent patients, even after adjusting for gender and diagnosis. Our results suggest a possible causal role of cannabis in triggering psychosis in certain vulnerable subjects. Particular attention must be paid to this behaviour, because reducing cannabis use can delay or prevent some cases of psychosis.
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Affiliation(s)
- Sarah Tosato
- Department of Public Health and Community Medicine, Section of Psychiatry, University of Verona, 37134 Verona, Italy.
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Gender-dependent behavioral and biochemical effects of adolescent delta-9-tetrahydrocannabinol in adult maternally deprived rats. Neuroscience 2012; 204:245-57. [DOI: 10.1016/j.neuroscience.2011.11.038] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 11/15/2011] [Accepted: 11/17/2011] [Indexed: 01/06/2023]
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