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Moore J, Castro Y, DiNitto D, Hernandez M, Velasquez M. Sociodemographic and treatment-related determinants of recent substance use among adults with comorbid substance misuse and psychotic disorders discharged from substance use treatment. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 161:209349. [PMID: 38494053 DOI: 10.1016/j.josat.2024.209349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/04/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Rates of alcohol and illicit substance use are higher among persons with psychotic disorders relative to the general population. The adverse health and psychological effects of substance use behaviors disproportionately impact persons with psychotic disorders. Prior research has shown that persons with psychotic disorders experience increased difficulty in reducing substance use behaviors, and interventions targeting substance use behavior change among this population have demonstrated limited effectiveness. One reason for this is that little is known about the factors that influence substance use and behavior change among this population. To address these disparities, the present study investigated sociodemographic and treatment-related factors of substance use recurrence among persons with psychotic disorders who received substance use treatment services. METHODS Data came from the 2015-2018 Treatment Episode Dataset-Discharges (TEDS-D). TEDS-D collects annual data on adolescent and adult discharges from state-certified substance use treatment centers in the United States. The study conducted all analyses with a subsample of 1956 adult discharges with a psychotic disorder who received services from an outpatient substance use treatment center for at least one month. χ2 tests of independence and multivariable logistic regression analyses were used to examine associations of sociodemographic and treatment-related characteristics with substance use recurrence while in treatment (α < 0.05 analyses). The study presents results from multivariable logistic regression models as adjusted odds ratios (AORs) with 95 % confidence intervals (CI). RESULTS Those who were age 50 or older, were referred to treatment by the criminal justice system, and attended substance use self-help groups had lower odds of substance use recurrence while in treatment. Sex, educational attainment, employment status, living situation, type of substance use, and treatment history were not significantly associated with substance use recurrence. CONCLUSIONS In designing treatment services, providers should consider whether focusing on sociodemographic, including cultural, factors can affect more positive substance use behavior change and other desired treatment outcomes among those with psychotic disorders and comorbid substance misuse. Further study is needed to identify these factors among specific subpopulations of those with psychotic disorders and substance misuse.
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Affiliation(s)
- John Moore
- Florida State University, College of Social Work, 296 Champions Way, Tallahassee, FL 32304, United States of America.
| | - Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Diana DiNitto
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Mercedes Hernandez
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
| | - Mary Velasquez
- Steve Hicks School of Social Work, The University of Texas at Austin, 1925 San Jacinto Blvd, Austin, TX 78712, United States of America
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Sheitman A, Bello I, Montague E, Scodes J, Dambreville R, Wall M, Nossel I, Dixon L. Observed Trajectories of Cannabis Use and Concurrent Longitudinal Outcomes in Youth and Young Adults Receiving Coordinated Specialty Care for Early Psychosis. Schizophr Res 2024; 267:313-321. [PMID: 38608418 DOI: 10.1016/j.schres.2024.04.005] [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: 09/27/2023] [Revised: 01/31/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024]
Abstract
Cannabis use is present and persistent in young adults with early psychosis receiving Coordinated Specialty Care (CSC) in the United States. While CSC programs are effective in improving quality of life, helping individuals reach goals, and promoting recovery, cannabis use may limit the extent of these improvements. This study extended upon previous findings to examine trajectories of cannabis use among individuals with early psychosis. The sample consisted of 1325 CSC participants enrolled for more than one year at OnTrackNY and followed up to two years, categorized into three groups: no use, reduced use, and persistent use. Baseline demographic and clinical differences were compared across groups and associations between clinical and psychosocial outcomes at 12 months and 24 months were examined across groups. Of the sample, 40 % remained persistent users over two years while 12.8 % reduced their use. At baseline, persistent users were younger (p = 0.011), more likely to be male (p < 0.001), had lower education levels (p = 0.019), and were more likely to have had past legal issues prior to admission (p < 0.001) than non-users. At 2 years, persistent users had significantly worse symptom scores than non-users (p = 0.0003) and reduced users (p = 0.0004). These findings highlight the presence of persistent cannabis use being common in this population and the need to improve substance use treatment offered to allow more CSC participants to achieve improved outcomes.
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Affiliation(s)
- A Sheitman
- New York State Psychiatric Institute, 1051 Riverside Drive, New York 10032, NY, USA.
| | - I Bello
- New York State Psychiatric Institute, 1051 Riverside Drive, New York 10032, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - E Montague
- Zucker Hillside Hospital, Northwell Health, 75-59 263rd St, Queens, NY 11004, USA
| | - J Scodes
- New York State Psychiatric Institute, 1051 Riverside Drive, New York 10032, NY, USA
| | - R Dambreville
- New York State Psychiatric Institute, 1051 Riverside Drive, New York 10032, NY, USA
| | - M Wall
- New York State Psychiatric Institute, 1051 Riverside Drive, New York 10032, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - I Nossel
- New York State Psychiatric Institute, 1051 Riverside Drive, New York 10032, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| | - L Dixon
- New York State Psychiatric Institute, 1051 Riverside Drive, New York 10032, NY, USA; Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
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Hyatt A, Mullin B, Hasler V, Madore D, Progovac AM, Cook BL, DeLisi LE. Predictors of relapse and engagement in care one year after ending services in an urban safety net coordinated specialty care program for first episode psychosis. Schizophr Res 2024; 264:140-146. [PMID: 38128345 PMCID: PMC10983670 DOI: 10.1016/j.schres.2023.12.022] [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: 06/23/2023] [Revised: 11/08/2023] [Accepted: 12/17/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE This study aimed to identify risk factors for relapse (psychiatric emergency department visits or hospitalization) and lack of follow-up with outpatient psychiatric care in the 12 months after ending services in an urban safety net coordinated specialty care (CSC) program for first episode psychosis (FEP). METHODS The study population (n = 143) were individuals with FEP who had any CSC care between 2014 and 2021. To identify risk factors for relapse and follow up after exit, multivariable logistic regression was performed using data from electronic health records and linked insurance claims data. RESULTS Individuals with any emergency department visit or hospitalization 12 months prior to ending CSC (aOR = 4.69, 95 % CI 1.78-12.34) and those who were using cannabis at last CSC contact (aOR = 4.06, 95 % CI 1.56-10.56) had a higher risk of relapse after ending CSC services. Cannabis use at last contact was also associated with lower rates of outpatient psychiatric follow-up (aOR = 0.32, 95 % CI 0.12-0.94), while CSC duration in months had a small positive association with post-CSC psychiatric follow-up. There were no differences in relapse or follow-up by race or ethnicity, primary diagnosis, or medication usage. CONCLUSIONS Prior relapse during CSC predicted relapse in the 12 months after ending CSC services, but not outpatient follow up. Cannabis use predicted both a higher rate of relapse and a lower rate of follow up after ending services. There were no differences by race or ethnicity in our sample, suggesting that once individuals engaged in FEP care there were no evident disparities in the observed outcomes.
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Affiliation(s)
- Andrew Hyatt
- Cambridge Health Alliance, Department of Psychiatry, 1493 Cambridge Street, Cambridge 02139, MA, United States; Harvard Medical School, Department of Psychiatry, 25 Shattuck Street, Boston 02115, MA, United States.
| | - Brian Mullin
- Cambridge Health Alliance, Department of Psychiatry, 1493 Cambridge Street, Cambridge 02139, MA, United States
| | - Victoria Hasler
- Cambridge Health Alliance, Department of Psychiatry, 1493 Cambridge Street, Cambridge 02139, MA, United States; Harvard Medical School, Department of Psychiatry, 25 Shattuck Street, Boston 02115, MA, United States
| | - Drew Madore
- Cambridge Health Alliance, Department of Psychiatry, 1493 Cambridge Street, Cambridge 02139, MA, United States; Harvard Medical School, Department of Psychiatry, 25 Shattuck Street, Boston 02115, MA, United States
| | - Ana M Progovac
- Cambridge Health Alliance, Department of Psychiatry, 1493 Cambridge Street, Cambridge 02139, MA, United States; Harvard Medical School, Department of Psychiatry, 25 Shattuck Street, Boston 02115, MA, United States
| | - Benjamin Lê Cook
- Cambridge Health Alliance, Department of Psychiatry, 1493 Cambridge Street, Cambridge 02139, MA, United States; Harvard Medical School, Department of Psychiatry, 25 Shattuck Street, Boston 02115, MA, United States
| | - Lynn E DeLisi
- Cambridge Health Alliance, Department of Psychiatry, 1493 Cambridge Street, Cambridge 02139, MA, United States; Harvard Medical School, Department of Psychiatry, 25 Shattuck Street, Boston 02115, MA, United States
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Myers N, Hutnyan M, Daley TC, Bello I, Chacon M, Currie A, Davis BJ, Dixon LB, George PE, Giannicchi A, Kwashie AN, McCormick KA, Meyer-Kalos P, Nagendra A, Nayar S, Sarpal DK, Sepahpour TY, Shapiro DI, Taylor-Zoghby J. Pathways Through Early Psychosis Care for U.S. Youths From Ethnically and Racially Minoritized Groups: A Systematic Review. Psychiatr Serv 2023; 74:859-868. [PMID: 36789610 PMCID: PMC10425565 DOI: 10.1176/appi.ps.20220121] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE The authors of this systematic review examined service utilization and outcomes among youths from ethnoracially minoritized groups after the youths initiated treatment for a psychotic disorder-that is, the youths' "pathway through care." Also examined were potential moderating variables in pathways through care for these youths at the clinic, family, and cultural levels. The goal was to describe methodologies, summarize relevant findings, highlight knowledge gaps, and propose future research on pathways through care for young persons from ethnoracially minoritized groups who experience early psychosis. METHODS The PubMed, PsycInfo, and Web of Science literature databases were systematically searched for studies published between January 1, 2010, and June 1, 2021. Included articles were from the United States and focused on young people after they initiated treatment for early psychosis. Eighteen studies met inclusion criteria. RESULTS Sixteen of the 18 studies were published in the past 5 years, and 11 had an explicit focus on race and ethnicity as defined by the studies' authors. Studies varied in terminology, outcomes measures, methodologies, and depth of analysis. Being an individual from an ethnoracially minoritized group appeared to affect care utilization and outcomes. Insufficient research was found about potential moderating variables at the clinic, family, and cultural levels. CONCLUSIONS Studies of pathways through care for persons from minoritized groups warrant further funding and attention.
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Affiliation(s)
- Neely Myers
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Matthew Hutnyan
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Tamara C Daley
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Iruma Bello
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Marne Chacon
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Ariel Currie
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Beshaun J Davis
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Lisa B Dixon
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Preethy E George
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Anna Giannicchi
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Anita N Kwashie
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Katie A McCormick
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Piper Meyer-Kalos
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Arundati Nagendra
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Swati Nayar
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Deepak K Sarpal
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Tiana Y Sepahpour
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Daniel I Shapiro
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
| | - Jessica Taylor-Zoghby
- Department of Anthropology, Southern Methodist University, Dallas (Myers, Hutnyan, Chacon); Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas (Myers); Abt Associates, Durham, North Carolina (Daley); New York State Psychiatric Institute (Bello, Dixon, Giannicchi) and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons (Bello, Dixon), New York City; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis (Currie, Meyer-Kalos); Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Davis, Taylor-Zoghby); Westat, Rockville, Maryland (George); Department of Psychology, University of Minnesota, Minneapolis (Kwashie); Steve Hicks School of Social Work, University of Texas at Austin, Austin (McCormick); Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston (Nagendra); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Nayar, Sarpal); Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, and Department of Medical Humanities and Ethics, Columbia University Vagelos College of Physicians and Surgeons, New York City (Sepahpour); Department of Psychiatry and Behavioral Sciences, University of California, Davis, Davis (Shapiro)
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5
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Segura AG, Mané A, Prohens L, Rodriguez N, Mezquida G, Cuesta MJ, Vieta E, Amoretti S, Lobo A, González-Pinto A, Diaz-Caneja CM, Roldán-Bejarano A, Jimenez E, Baeza I, Legido T, Saiz-Ruiz J, Bernardo M, Mas S. Exploration of cannabis use and polygenic risk scores on the psychotic symptom progression of a FEP cohort. Psychiatry Res 2023; 325:115249. [PMID: 37178502 DOI: 10.1016/j.psychres.2023.115249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/05/2023] [Accepted: 05/07/2023] [Indexed: 05/15/2023]
Abstract
Cannabis use is highly prevalent in first-episode psychosis (FEP) and plays a critical role in its onset and prognosis, but the genetic underpinnings promoting both conditions are poorly understood. Current treatment strategies for cannabis cessation in FEP are clearly inefficacious. Here, we aimed to characterize the association between cannabis-related polygenic risk scores (PRS) on cannabis use and clinical course after a FEP. A cohort of 249 FEP individuals were evaluated during 12 months. Symptom severity was measured with the Positive and Negative Severity Scale and cannabis use with the EuropASI scale. Individual PRS for lifetime cannabis initiation (PRSCI) and cannabis use disorder (PRSCUD) were constructed. Current cannabis use was associated with increased positive symptoms. Cannabis initiation at younger ages conditioned the 12-month symptom progression. FEP patients with higher cannabis PRSCUD reported increased baseline cannabis use. PRSCI was associated with the course of negative and general symptomatology over follow-up. Cannabis use and symptom progression after a FEP were modulated by cannabis PRS, suggesting that lifetime initiation and use disorders may have partially independent genetic factors. These exploratory results may be the first step to identify those FEP patients more vulnerable to cannabis use and worse outcomes to ultimately develop tailored treatments.
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Affiliation(s)
- Alex G Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Anna Mané
- Hospital del Mar Medical Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Llucia Prohens
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Natalia Rodriguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Gisela Mezquida
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Bipolar and Depressive Disorder Unit, Neuroscience Institute, Hospital Clínic de Barcelona, Barcelona, Spain; Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital Universitario de Alava, Vitoria-Gasteiz, Spain; Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Spain; University of the Basque Country, Vizcaya, Spain
| | - Covadonga M Diaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain; School of Medicine, Universidad Complutense, Madrid, Spain
| | - Alexandra Roldán-Bejarano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANTPAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Esther Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Immaculada Baeza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Teresa Legido
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Jeronimo Saiz-Ruiz
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Universidad de Alcala, Alcalá de Henares, Spain; Hospital Ramon y Cajal, Madrid, Spain; Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Madrid, Spain
| | - Miguel Bernardo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain; Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain.
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6
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Oscoz-Irurozqui M, Almodóvar-Payá C, Guardiola-Ripoll M, Guerrero-Pedraza A, Hostalet N, Salvador R, Carrión MI, Maristany T, Pomarol-Clotet E, Fatjó-Vilas M. Cannabis Use and Endocannabinoid Receptor Genes: A Pilot Study on Their Interaction on Brain Activity in First-Episode Psychosis. Int J Mol Sci 2023; 24:ijms24087501. [PMID: 37108689 PMCID: PMC10142622 DOI: 10.3390/ijms24087501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 04/29/2023] Open
Abstract
The role of both cannabis use and genetic background has been shown in the risk for psychosis. However, the effect of the interplay between cannabis and variability at the endocannabinoid receptor genes on the neurobiological underpinnings of psychosis remains inconclusive. Through a case-only design, including patients with a first-episode of psychosis (n = 40) classified as cannabis users (50%) and non-users (50%), we aimed to evaluate the interaction between cannabis use and common genetic variants at the endocannabinoid receptor genes on brain activity. Genetic variability was assessed by genotyping two Single Nucleotide Polymorphisms (SNP) at the cannabinoid receptor type 1 gene (CNR1; rs1049353) and cannabinoid receptor type 2 gene (CNR2; rs2501431). Functional Magnetic Resonance Imaging (fMRI) data were obtained while performing the n-back task. Gene × cannabis interaction models evidenced a combined effect of CNR1 and CNR2 genotypes and cannabis use on brain activity in different brain areas, such as the caudate nucleus, the cingulate cortex and the orbitofrontal cortex. These findings suggest a joint role of cannabis use and cannabinoid receptor genetic background on brain function in first-episode psychosis, possibly through the impact on brain areas relevant to the reward circuit.
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Affiliation(s)
- Maitane Oscoz-Irurozqui
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Salud Mental Errenteria-Osakidetza, Av Galtzaraborda 69-75, 20100 Errenteria, Guipúzcoa, Spain
| | - Carmen Almodóvar-Payá
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Maria Guardiola-Ripoll
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Amalia Guerrero-Pedraza
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Hospital Benito Menni CASM, C/Doctor Antoni Pujadas 38, 08830 Sant Boi de Llobregat, Barcelona, Spain
| | - Noemí Hostalet
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
| | - Raymond Salvador
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | | | - Teresa Maristany
- Diagnostic Imaging Department, Hospital Sant Joan de Déu Research Foundation, Passeig de Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Mar Fatjó-Vilas
- FIDMAG Germanes Hospitalàries Research Foundation, Av Jordà 8, 08035 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Av Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Avinguda Diagonal, 643, 08028 Barcelona, Spain
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7
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Palma-Álvarez RF, Daigre C, Ros-Cucurull E, Perea-Ortueta M, Ortega-Hernández G, Ríos-Landeo A, Roncero C, Ramos-Quiroga JA, Grau-López L. Clinical features and factors related to lifetime suicidal ideation and suicide attempts in patients who have had substance-induced psychosis across their lifetime. Psychiatry Res 2023; 323:115147. [PMID: 36913874 DOI: 10.1016/j.psychres.2023.115147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/15/2023]
Abstract
Suicidal behaviors are common among patients with substance use disorders (SUD). However, the prevalence and clinical factors related to suicide behaviors among patients who have had substance-induced psychosis (SIP) is unknown. This study aims to explore the prevalence, clinical features, and factors related to lifetime suicidal ideation (SI) and suicide attempts (SA) in patients who have had SIP across their lifetime. A cross-sectional study was conducted in an outpatient center for addiction treatment between 01/01/2010 and 12/31/2021. 601 patients were evaluated with validated scales and questionnaires (79.03% males; M age 38.11±10.11 years). The prevalence of SI and SA was 55.4% and 33.6%, respectively. SI was independently related to any type of lifetime abuse, depressive spectrum disorders, benzodiazepine use disorder, borderline personality disorder, and the level of depressive symptoms. SA was independently associated with lifetime physical abuse, benzodiazepine use disorder, the number of psychotic symptoms, borderline personality disorder, and the level of depressive symptoms. The main factors related to SI and SA in those patients should be evaluated in daily clinical practice and considered in any approach to clinical practice as well as in health policies targeting suicide prevention.
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Affiliation(s)
- Raul Felipe Palma-Álvarez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.
| | - Constanza Daigre
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Elena Ros-Cucurull
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Marta Perea-Ortueta
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Germán Ortega-Hernández
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Ana Ríos-Landeo
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Carlos Roncero
- Psychiatry Service, University of Salamanca Health Care Complex, Insitute of Biomedicine, Salamanca, Spain; Psychiatry Unit, School of Medicine, University of Salamanca, Salamanca, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Lara Grau-López
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
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8
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Fraser ER, Kordas G, Stokes B, McDonell MG, Oluwoye O. Recent substance use among clients with early psychosis and the potential to graduate from New Journeys. Early Interv Psychiatry 2023. [PMID: 36641810 DOI: 10.1111/eip.13386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/11/2022] [Accepted: 01/01/2023] [Indexed: 01/16/2023]
Abstract
AIM This study examined the relationship between recent substance use prior to intake and program graduation among young adults with early psychosis enrolled in coordinated specialty care. METHODS Participants (N = 248) were from New Journeys, a network of coordinated specialty care programs in Washington State. Recent (i.e., past 30 days) alcohol, cannabis, and other substance use was collected at intake and process data (e.g., contact) was collected by clinicians across a 2-year period. RESULTS At intake, 32% of participants reported alcohol use only, 26% cannabis use only, and 15% both alcohol and cannabis use. Participants who reported alcohol use only (p = .02), cannabis use only (p = .03), and any substance use (p = .02) had significantly lower chances of graduating from coordinated specialty care than individuals who do not use substances. CONCLUSIONS Unlike prior work, recent substance use influences clients' potential to graduate from New Journeys. Additional focus on the implementation of substance use treatment, with an emphasis on alcohol use, in coordinated specialty care programs is needed improve program completion rates.
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Affiliation(s)
- Elizabeth R Fraser
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | - Gordon Kordas
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | - Bryony Stokes
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA.,Prevention Science Graduate Program, Washington State University, Pullman, Washington, USA
| | - Michael G McDonell
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
| | - Oladunni Oluwoye
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
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9
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Tatar O, Abdel-Baki A, Wittevrongel A, Lecomte T, Copeland J, Lachance-Touchette P, Coronado-Montoya S, Côté J, Crockford D, Dubreucq S, L'Heureux S, Ouellet-Plamondon C, Roy MA, Tibbo PG, Villeneuve M, Jutras-Aswad D. Reducing Cannabis Use in Young Adults With Psychosis Using iCanChange, a Mobile Health App: Protocol for a Pilot Randomized Controlled Trial (ReCAP-iCC). JMIR Res Protoc 2022; 11:e40817. [PMID: 36427227 PMCID: PMC9736767 DOI: 10.2196/40817] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Cannabis use is the most prevalent among adolescents and young adults; frequent consumption is associated with cannabis use disorder (CUD) and psychosis, with a high prevalence (up to 50%) of CUD in individuals with first-episode psychosis (FEP). Early Intervention Services (EIS) for psychosis include face-to-face psychosocial interventions for CUD, because reducing or discontinuing cannabis use improves clinical and health care service use outcomes. However, multiple barriers (eg, staff availability and limited access to treatment) can hinder the implementation of these interventions. Mobile health (mHealth) interventions may help circumvent some of these barriers; however, to date, no study has evaluated the effects of mHealth psychological interventions for CUD in individuals with FEP. OBJECTIVE This study describes the protocol for a pilot randomized controlled trial using a novel mHealth psychological intervention (iCanChange [iCC]) to address CUD in young adults with FEP. iCC was developed based on clinical evidence showing that in individuals without psychosis, integrating the principles of cognitive behavioral therapy, motivational interviewing, and behavioral self-management approaches are effective in improving cannabis use-related outcomes. METHODS Consenting individuals (n=100) meeting the inclusion criteria (eg, aged 18-35 years with FEP and CUD) will be randomly allocated in a 1:1 ratio to the intervention (iCC+modified EIS) or control (EIS) group. The iCC is fully automatized and contains 21 modules that are completed over a 12-week period and 3 booster modules available during the 3-month follow-up period. Validated self-report measures will be taken via in-person assessments at baseline and at 6, 12 (end point), and 24 weeks (end of trial); iCC use data will be collected directly from the mobile app. Primary outcomes are intervention completion and trial retention rates, and secondary outcomes are cannabis use quantity, participant satisfaction, app use, and trial recruiting parameters. Exploratory outcomes include severity of psychotic symptoms and CUD severity. For primary outcomes, we will use the chi-square test using data collected at week 12. We will consider participation in iCC acceptable if ≥50% of the participants complete at least 11 out of 21 intervention modules and the trial feasible if attrition does not reach 50%. We will use analysis of covariance and mixed-effects models for secondary outcomes and generalized estimating equation multivariable analyses for exploratory outcomes. RESULTS Recruitment began in July 2022, and data collection is anticipated to be completed in July 2024. The main results are expected to be submitted for publication in 2024. We will engage patient partners and other stakeholders in creating a multifaceted knowledge translation plan to reach a diverse audience. CONCLUSIONS If feasible, this study will provide essential data for a larger-scale efficacy trial of iCC on cannabis use outcomes in individuals with FEP and CUD. TRIAL REGISTRATION ClinicalTrials.gov NCT05310981; https://www.clinicaltrials.gov/ct2/show/NCT05310981. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/40817.
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Affiliation(s)
- Ovidiu Tatar
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Amal Abdel-Baki
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Anne Wittevrongel
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Tania Lecomte
- Department of Psychology, University of Montreal, Montreal, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada
| | - Jan Copeland
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sunshine Coast, Australia
| | | | - Stephanie Coronado-Montoya
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - José Côté
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
| | - David Crockford
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Simon Dubreucq
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Sophie L'Heureux
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Laval University, Québec, QC, Canada
- Clinique Notre-Dame des Victoires, Institut universitaire en santé mentale, Centre intégré universitaire de soins et services sociaux de la Capitale Nationale, Québec, QC, Canada
| | - Clairélaine Ouellet-Plamondon
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Marc-André Roy
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Laval University, Québec, QC, Canada
- Clinique Notre-Dame des Victoires, Institut universitaire en santé mentale, Centre intégré universitaire de soins et services sociaux de la Capitale Nationale, Québec, QC, Canada
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Nova Scotia Early Psychosis Program, Halifax, NS, Canada
| | - Marie Villeneuve
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | - Didier Jutras-Aswad
- Research Center, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
- Institut universitaire sur les dépendances, Montreal, QC, Canada
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10
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Polillo A, Voineskos AN, Foussias G, Kidd SA, Bromley S, Soklaridis S, Wang W, Stergiopoulos V, Kozloff N. Disengagement from early psychosis intervention services: an observational study informed by a survey of patient and family perspectives. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:94. [PMID: 36369306 PMCID: PMC9651118 DOI: 10.1038/s41537-022-00300-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
Approximately one-third of patients with early psychosis disengage from services before the end of treatment. We sought to understand patient and family perspectives on early psychosis intervention (EPI) service engagement and use these findings to elucidate factors associated with early disengagement, defined as dropout from EPI in the first 9 months. Patients aged 16-29 referred to a large EPI program between July 2018-February 2020 and their family members were invited to complete a survey exploring facilitators and barriers to service engagement. A prospective chart review was conducted for 225 patients consecutively enrolled in the same EPI program, receiving the NAVIGATE model of coordinated specialty care, between July 2018-May 2019. We conducted a survival analysis, generating Kaplan-Meier curves depicting time to disengagement and Cox proportional hazards models to determine rate of disengagement controlling for demographic, clinical, and program factors. The survey was completed by 167 patients and 79 family members. The top endorsed engagement facilitator was related to the therapeutic relationship in both patients (36.5%) and families (43.0%). The top endorsed barrier to engagement was medication side effects in both patients (28.7%) and families (39.2%). In Cox proportional hazards models, medication nonadherence (HR = 2.37, 95% CI = 1.17-4.80) and use of individual psychotherapy (HR = .460, 95% CI = 0.220-0.962) were associated with early disengagement, but some of the health equity factors expected to affect engagement were not. Findings suggest that delivery of standardized treatment may buffer the effects of health disparities on service disengagement in early psychosis.
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Affiliation(s)
- Alexia Polillo
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Aristotle N Voineskos
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - George Foussias
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sean A Kidd
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Sarah Bromley
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Sophie Soklaridis
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Nicole Kozloff
- Centre for Addiction and Mental Health, Toronto, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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11
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Wright AC, Browne J, Cather C, Meyer-Kalos P, Mueser KT. Relationship between patterns of cannabis use and functional and symptomatic trajectories in first-episode psychosis. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01441-5. [PMID: 35900474 DOI: 10.1007/s00406-022-01441-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 05/29/2022] [Indexed: 02/04/2023]
Abstract
Cannabis use is common in first-episode psychosis (FEP) but evidence is mixed about the extent to which cannabis use predicts symptoms and functional outcomes among those who seek treatment. This study sought to characterize cannabis use patterns and examine the relationship with clinical outcomes, including interactions with early intervention services (EIS). Data were drawn from the Recovery After an Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study including FEP individuals receiving treatment at sites randomized to provide either EIS (NAVIGATE) or community care (CC). Cannabis use was assessed monthly and symptom and functioning data were collected at baseline, 6, 12, 18, and 24 months. Among the 404 participants enrolled, 334 were classified into four cannabis use groups (consistent, sporadic, stopped, and never users) based on their use during the first year. Consistent and sporadic cannabis users were younger, whereas those who had stopped using were older. Sporadic users had the highest depression and the lowest functioning at baseline and improved less during treatment in negative emotions and intrapsychic foundations (e.g., motivation and sense of purpose) than non-users. However, sporadic users who received NAVIGATE improved more in overall symptoms and functioning than those who received CC. Consistent users did not tend to differ in their trajectories from non-users. Individuals with FEP who use cannabis sporadically showed less clinical improvement than non-users. However, EIS treatment reduced the negative effects of sporadic cannabis use on clinical outcomes. Those who use cannabis sporadically may have unique needs that require attention in EIS.
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Affiliation(s)
- Abigail C Wright
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Julia Browne
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Corinne Cather
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Piper Meyer-Kalos
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kim T Mueser
- Center for Psychiatric Rehabilitation, Boston University, Boston, MA, USA.
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12
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Kline ER, Ferrara M, Li F, Cyril D’Souza D, Keshavan M, Srihari VH. Timing of cannabis exposure relative to prodrome and psychosis onset in a community-based first episode psychosis sample. J Psychiatr Res 2022; 147:248-253. [PMID: 35066293 PMCID: PMC8882157 DOI: 10.1016/j.jpsychires.2022.01.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/10/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
Abstract
Cannabis has been implicated as both a potential cause and adverse prognostic factor in psychotic disorders. Investigating the contributory role of cannabis toward the overall burden of psychotic illnesses may represent an important step toward psychosis prevention and treatment. The current study samples consecutive admissions (N = 246) to two community based first-episode psychosis services to characterize timing of cannabis use relative to psychosis and attenuated symptom onset, differences between those with and without cannabis exposure, and the association of age at first cannabis exposure with clinical and demographic variables. Both cannabis exposure (78%) and cannabis use disorders (47%) were highly prevalent at admission. In 94% of participants, cannabis use preceded the onset of both attenuated and full-threshold psychosis symptoms by several years. Earlier age at first exposure to cannabis was associated with younger age at prodrome and psychosis onset, worse premorbid functioning, and greater severity of cannabis use disorder at admission. The timing of first exposure to cannabis may have individual prognostic as well as public health significance. Documenting the prevalence and impact of cannabis use in early psychosis samples, as well as the overall incidence of psychotic disorders, will be of vital public health significance as the United States enacts cannabis legalization and cannabis products become more widely available.
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Affiliation(s)
- Emily R. Kline
- Harvard Medical School, Department of Psychiatry,Beth Israel Deaconess Medical Center, Department of Psychiatry,Boston University School of Medicine, Department of Psychiatry,Boston Medical Center
| | - Maria Ferrara
- Yale University School of Medicine, Department of Psychiatry
| | - Fangyong Li
- Yale University School of Medicine, Department of Psychiatry
| | | | - Matcheri Keshavan
- Harvard Medical School, Department of Psychiatry,Beth Israel Deaconess Medical Center, Department of Psychiatry
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13
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Moulin V, Framorando D, Gasser J, Dan-Glauser E. The Link Between Cannabis Use and Violent Behavior in the Early Phase of Psychosis: The Potential Role of Impulsivity. Front Psychiatry 2022; 13:746287. [PMID: 35392388 PMCID: PMC8980530 DOI: 10.3389/fpsyt.2022.746287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Recently, the literature has shown that Cannabis Use (CU) was a risk factor for Violent Behavior (VB) in patients with psychosis, and those in the early phase of psychosis (EPP). These findings are relevant because of the high prevalence of CU in this EPP, and the potential for prevention during this phase of illness. However, there is still a lack of clear explanations, supported by empirical evidence, about what underlies the link between CU and VB against other. METHOD This viewpoint reviews the scientific literature on the link between CU and VB, and the involvement of impulsivity in this relationship. This last point will be addressed at clinical and neurobiological levels. RESULTS Recent studies confirmed that CU is particularly high in the EPP, and is a risk factor for VB in the EPP and schizophrenia. Studies have also shown that impulsivity is a risk factor for VB in psychosis, is associated with CU, and may mediate the link between CU and VB. Research suggests a neurobiological mechanism, as CU affects the structures and function of frontal areas, known to play a role in impulsive behavior. CONCLUSION Scientific evidence support the hypothesis of an involvement of impulsivity as a variable that could mediate the link between CU and aggression, particularly, when CU has an early onset. However, this hypothesis should be confirmed with longitudinal studies and by taking into account confounding factors. The studies highlight the relevance of early prevention in the EPP, in addition to interventions focusing on psychotic disorders.
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Affiliation(s)
- Valerie Moulin
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - David Framorando
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Jacques Gasser
- Unit for Research in Legal Psychiatry and Psychology, Institute of Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Elise Dan-Glauser
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
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14
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Athanassiou M, Dumais A, Gnanhoue G, Abdel-Baki A, Jutras-Aswad D, Potvin S. A systematic review of longitudinal studies investigating the impact of cannabis use in patients with psychotic disorders. Expert Rev Neurother 2021; 21:779-791. [PMID: 34120548 DOI: 10.1080/14737175.2021.1942845] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Research has established a link between cannabis use and adverse psychotic outcomes in psychosis patients. However, we have yet to determine if this relationship is maintained when controlling for important confounding variables. The following systematic review aims to investigate if the association between cannabis use and psychotic outcomes is preserved when accounting for important confounders, and if discontinued use mitigates any potential negative impacts.Areas covered: The authors conducted an exhaustive search of the MEDLINE database and Google Scholar to identify articles pertaining to the systematic review. Thirty-three articles were retained for meeting the eligibility criteria.Expert opinion: The evidence confirms an overarching pattern of negative psychotic outcomes of cannabis intake in psychosis populations, even when accounting for crucial confounders. Psychosis patients should be informed with evidence-based health information regarding the effects of cannabis use. Clinicians should systematically evaluate cannabis intake patterns in psychosis patients and offer intervention services geared toward reducing problematic consumption. Researchers should record confounding factors in a more systematic manner in future longitudinal investigations while paying careful attention to the potency and dose-response effects of the ingested cannabis. Deciders will need to investigate the impact of cannabis regulations on psychosis populations.
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Affiliation(s)
- Maria Athanassiou
- Centre De Recherche De l'Institut Universitaire En Santé Mentale De Montréal, Montreal, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Alexandre Dumais
- Centre De Recherche De l'Institut Universitaire En Santé Mentale De Montréal, Montreal, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada.,Philippe-Pinel National Institute of Legal Psychiatry, Montreal, Canada
| | - Gismonde Gnanhoue
- Centre De Recherche De l'Institut Universitaire En Santé Mentale De Montréal, Montreal, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada.,Centre De Recherche Du Centre Hospitalier De l'Université De Montréal, Montreal, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada.,Centre De Recherche Du Centre Hospitalier De l'Université De Montréal, Montreal, Canada
| | - Stéphane Potvin
- Centre De Recherche De l'Institut Universitaire En Santé Mentale De Montréal, Montreal, Canada.,Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, Canada
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