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Lim MJH, Iyyalol R, Lee JWY, Martin-Iverson MT. Multi-modal and bi-directional effects of a synthetic Δ9-Tetrahydrocannabinol (THC) analogue, Nabilone, on spatio-temporal binding windows: Evidence from the projected hand illusion. PLoS One 2024; 19:e0309614. [PMID: 39250476 PMCID: PMC11383222 DOI: 10.1371/journal.pone.0309614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 08/14/2024] [Indexed: 09/11/2024] Open
Abstract
Abnormally widened spatial and temporal binding windows (SBW/TBWs; length of space/time whereby stimuli are considered part of the same percept) are observed in schizophrenia. TBW alterations have been associated with altered sense of agency (hereafter referred to as agency), and an associative relationship between embodiment (body ownership) and agency has been proposed. SBWs/TBWs are investigated separately, but no evidence exists of these being separate in mechanism, system or function. The underlying neural substrate of schizophrenia remains unclear. The literature claims either pro-psychotic or anti-psychotic effects of Δ9-Tetrahydrocannabinol (THC) in patients and healthy individuals, but major support for cannabis in the aetiology of schizophrenia is associative, not causal. To clarify if THC is pro- or anti-psychotic, this single-blind, placebo-controlled within-subjects cross-over study tested several hypotheses. 1) Competing hypotheses that a synthetic THC analogue, Nabilone (NAB, 1-2 mg), would alter measures of agency and embodiment in healthy volunteers (n = 32) similarly, or opposite, to that of in patients with schizophrenia. 2) That there would be significant associations between any NAB-induced alterations in individual agency and embodiment measures in the Projected Hand Illusion (PHI). 3) That there is a unitary spatio-temporal binding window (STBW). A large proportion of individuals did not experience the PHI. Multimodal and bi-directional effects of NAB on the PHI were observed. Evidence of a unitary spatio-temporal binding window (STBW) was observed. NAB widened the STBW in some but narrowed it in others as a function of space and delay. No associations were found between agency and embodiment.
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Affiliation(s)
- Mark J H Lim
- Pharmacology, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Rajan Iyyalol
- Psychiatry, School of Medicine, The University of Western Australia, Perth, WA, Australia
| | - Joseph W Y Lee
- Psychiatry, School of Medicine, The University of Western Australia, Perth, WA, Australia
| | - Mathew T Martin-Iverson
- Pharmacology, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
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2
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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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3
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Petros R, Walker DD, Pierce A, Monroe-DeVita M. Scoping Review of Cannabis-Reduction Psychosocial Interventions and Reasons for Use among Young Adults with Psychosis. J Dual Diagn 2023; 19:124-150. [PMID: 37391686 DOI: 10.1080/15504263.2023.2226024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Objective: No evidence-based intervention effectively reduces cannabis use in young adults with psychosis (YAP). To generate hypotheses about why, a scoping review was conducted to synthesize evidence about motivations for cannabis use and reduction/cessation for YAP and the psychosocial interventions trialed to identify possible gaps between motivations and interventive strategies. Methods: A systematic literature search was conducted in December, 2022. Reviews of titles and abstracts (N = 3,216) and full-texts (n = 136) resulted in 46 articles. Results: YAP use cannabis for pleasure, to reduce dysphoria, and for social and recreational reasons; motivations for cessation include insight about cannabis-psychosis interactions, incompatibility with goals and social roles, and support from social networks. Interventions with at least minimal evidence of efficacy include motivational interviewing, cognitive-behavioral strategies, and family skills training. Conclusions: Authors recommend additional research on mechanisms of change and motivational enhancement therapy, behavioral activation, and family-based skills interventions matched to YAP motivations for use/cessation.
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Affiliation(s)
- Ryan Petros
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Denise D Walker
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Adam Pierce
- Mental Health and Neurosciences Division, VA Portland Health Care System, Portland, Oregon, USA
| | - Maria Monroe-DeVita
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, Washington, USA
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Archie S, Palaniyappan L, Olagunju AT, Johnson N, Kozloff N, Sadeh E, Bardell A, Baines A, Anderson KK, Ayonrinde O, Ferrari M. Insights about Cannabis and Psychosis Using Video Games for Young People with a First Episode of Psychosis, particularly those from Black Racialized Backgrounds: Study Design. JMIR Res Protoc 2022; 11:e36758. [PMID: 35389874 PMCID: PMC9166641 DOI: 10.2196/36758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 12/01/2022] Open
Abstract
Background Cannabis use disorder among young people with a first episode of psychosis contributes to relapse, hospitalization, and impaired functioning. However, few studies have examined what young people with early phase psychosis, particularly those from Black racialized communities, understand or appreciate about this relationship, even though they may be at risk. There are no formally tested knowledge translation strategies that disseminate these research findings for young people with emerging psychosis from Black racialized communities. Objective This study aims to conceptualize what young people with early phase psychosis/cannabis use disorder understand about the relationship between cannabis and psychosis, focusing on people from racialized backgrounds. This study also aims to assess whether the knowledge translation product, the “Back to Reality Series,” increases awareness of the impact of cannabis use on psychosis from the perspectives of young people with emerging psychosis and cannabis use disorder from Black African and Caribbean communities. Methods Qualitative analysis will reveal themes from qualitative interviews about cannabis and psychosis from the perspectives of young people with emerging psychosis and cannabis use disorder from Black African and Caribbean communities. Perceptions before and after exposure to the Back to Reality Series will be qualitatively analyzed. A control game will be used for comparison, and scores on a quiz after playing the Back to Reality Series will be quantitatively analyzed to establish whether the Back to Reality Series raises awareness of the effects of cannabis on psychosis. An advisory council involving young people from Black communities, family members, and clinicians will bring community perspectives to this research. Results We began recruiting participants for this study in September 2021. We will complete data collection on demographic and clinical factors, qualitative interviews, and quantitative assessments of the Back to Reality Series. Conclusions The voices of young people from racialized backgrounds will generate preliminary data to inform early psychosis programs, addressing cannabis use in this population. The findings may advance the use of a new knowledge translation product that deals with gaps in knowledge about cannabis use for people experiencing early phase psychosis, particularly those from racialized communities. International Registered Report Identifier (IRRID) DERR1-10.2196/36758
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Affiliation(s)
| | - Lena Palaniyappan
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, CA.,Robarts Research Institute, Western University, London, CA.,Lawson Health Research Institute, London, CA
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, CA.,Discipline of Psychiatry, The University of Adelaide, Adelaide, AU
| | | | - Nicole Kozloff
- Slaight Family Centre for Youth in Transition, Centre for Addiction and Mental Health, Toronto, CA.,Department of Psychiatry, University of Toronto, Toronto, CA
| | - Elham Sadeh
- On Track, Champlain District Regional First Episode Psychosis Program, The Ottawa Hospital, Ottawa, CA
| | - Andrea Bardell
- On Track, Champlain District Regional First Episode Psychosis Program, The Ottawa Hospital, Ottawa, CA.,Canadian Consortium for Early Psychosis Intervention, Ottawa, CA.,Department of Psychiatry, University of British Columbia, Vancouver, CA.,Ottawa Hospital Research Institute, Ottawa, CA.,Department of Psychiatry, University of Ottawa, Ottawa, CA
| | - Alexandra Baines
- On Track, Champlain District Regional First Episode Psychosis Program, The Ottawa Hospital, Ottawa, CA.,Department of Psychiatry, University of Ottawa, Ottawa, CA.,Ottawa Hospital Research Institute, Ottawa, CA.,Integrated Schizophrenia and Recovery Program, The Royal Ottawa Hospital, Ottawa, CA
| | - Kelly K Anderson
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, CA
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5
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Kwagala B, Ndugga P, Nankinga O, Wamala T, Zarugaba IT, Richard S, Misinde C, Nansubuga E, Katende D, Mbonye M. Illicit Drug Use among Commercial 'Boda Boda' Motorcyclists in Uganda. Subst Use Misuse 2022; 57:1545-1551. [PMID: 35861665 DOI: 10.1080/10826084.2022.2096234] [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: 10/17/2022]
Abstract
Background: Illicit drug use is a global public health problem with grave health and socio-economic consequences. Related intoxication has been associated with accidental injuries and fatalities. In Uganda, 67% of road traffic accidents are attributed to motorcyclists. Methods: This study assessed the prevalence and determinants of illicit drug use among commercial motorcyclists in Uganda, using a cross-sectional survey research design. We interviewed 785 commercial motorcyclists in the divisions of Nakawa, Rubaga, Makindye, and Kawempe of Kampala district. We used an on-spot saliva drug test kit to screen and detect the presence of illicit drugs. Data were analyzed using frequency distributions, cross tabulations and multi variable logistic regression. Results: Findings show that 11% of the cyclists used illicit drugs. The use of illicit drugs was associated with division of operation, religiosity, and whether a cyclist resided with a family. The odds of use of illicit drugs were higher among cyclists from Nakawa division compared to cyclists from Kawempe. Cyclists who went to places of worship on a weekly basis compared to those who were less frequent, and cyclists who lived with their families compared to those who did not, had reduced odds of use of illicit drugs. There are variations in the distribution of cyclists that use illicit drugs in Kampala. Religious commitment and residence with families had a mitigating influence on illicit drug use among commercial cyclists. Conclusion: Illicit drug use prevention, treatment, and harm reduction programs among cyclists should collaborate with faith-based organizations and other key stakeholders, and promote stable family relations.
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Affiliation(s)
- Betty Kwagala
- Department of Population Studies, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - Patricia Ndugga
- Department of Population Studies, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - Olivia Nankinga
- Department of Population Studies, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | | | - Ignatius Tinka Zarugaba
- Anti-narcotics Department, Directorate of Criminal Investigations, Uganda Police Force, Kampala, Uganda
| | | | - Cyprian Misinde
- Department of Population Studies, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - Elizabeth Nansubuga
- Department of Population Studies, College of Business and Management Sciences, Makerere University, Kampala, Uganda
| | - Dan Katende
- Uganda Harm Reduction Network, Kampala, Uganda
| | - Martin Mbonye
- Department of Population Studies, College of Business and Management Sciences, Makerere University, Kampala, Uganda
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Jani P, Song N, Artna E, Lyeo J, Assam A, Maelzer F, Murphy A, Grant A, Archie S. Online Knowledge Translation Program involving Video Games and University Student-Led Tutorials about Cannabis and Psychosis for Black Youth: Mixed Method Feasibility Study (Preprint). JMIR Form Res 2021; 6:e33693. [PMID: 35315782 PMCID: PMC9253977 DOI: 10.2196/33693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/29/2022] [Accepted: 03/17/2022] [Indexed: 01/18/2023] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Payal Jani
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Nuri Song
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Erin Artna
- Department of Psychology, Neurosciences and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Joonsoo Lyeo
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Ashley Assam
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Faith Maelzer
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Andriene Murphy
- Department of Psychology, Neurosciences and Behaviour, McMaster University, Hamilton, ON, Canada
| | - Angelo Grant
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Suzanne Archie
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
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7
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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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8
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Arranz S, Mané A, Bergé D, Monserrat C, Cabezas A, Vilella E, Sanchez-Gistau V. The impact of sex and cannabis on clinical features in first-admitted patients with psychosis. Eur Neuropsychopharmacol 2020; 36:235-243. [PMID: 32291209 DOI: 10.1016/j.euroneuro.2020.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/26/2020] [Accepted: 03/06/2020] [Indexed: 12/22/2022]
Abstract
There is a scarcity of studies investigating the effect of sex on the clinical and treatment characteristics of first-admitted patients with first-episode psychosis (FEP). The reasons for using cannabis and the effect of cannabis on clinical features have not received enough attention either. We aim therefore, to investigate sex differences in the reasons for cannabis use and to determine the effects of sex, cannabis use and their interaction on clinical variables at admission and at discharge from the inpatient unit. 204 first-admitted FEPs in two inpatient units in Spain were included. The reasons for using cannabis were determined using the Dixon questionnaire. Clinical variables were compared between sexes and between cannabis users and non-users. Cannabis use was more frequent in males, but females were more likely to smoke cannabis to "feel relaxed". There was a main effect of sex on positive psychotic symptoms and antipsychotics dose and an interaction effect of cannabis and sex on global functioning at discharge .Our findings show sex differences in the reasons for cannabis use and in some clinical and treatment characteristics among FEP patients. More studies focusing on gender perspectives are needed to develop more individualized treatments.
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Affiliation(s)
- Sara Arranz
- Parc Sanitari Sant Joan de Dèu, Sant Boi de Llobregat, Barcelona, Spain; Hospital Universitari Institut Pere Mata of Reus, Medical Research Institute Pere Virgili (IISPV), and Rovira i Virgili University of Tarragona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Anna Mané
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Dani Bergé
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Clara Monserrat
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Spain
| | - Angel Cabezas
- Hospital del Mar Medical Research Institute (IMIM) of Barcelona, Autonomous University of Barcelona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata of Reus, Medical Research Institute Pere Virgili (IISPV), and Rovira i Virgili University of Tarragona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain
| | - Vanessa Sanchez-Gistau
- Hospital Universitari Institut Pere Mata of Reus, Medical Research Institute Pere Virgili (IISPV), and Rovira i Virgili University of Tarragona, Spain; Centro de Investigación en Red de Salud Mental (CIBERSAM), Spain.
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9
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Riera-López de Aguileta I, Vila-Badia R, Usall J, Butjosa A, Ochoa S. Coping strategies in first-episode psychosis: A systematic review. Early Interv Psychiatry 2020; 14:252-262. [PMID: 31318154 DOI: 10.1111/eip.12847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 06/09/2019] [Indexed: 12/12/2022]
Abstract
AIMS This paper reviews and discusses the published information on coping strategies in people with a first-episode psychosis (FEP). The objective is to update knowledge about coping strategies used by people with a FEP, to compare these strategies with those used by other mental disorders, and to examine the relationship between coping strategies and other variables in FEP. METHOD A search was conducted using PsycINFO, MEDLINE and PSICODOC between 1995 and 2018 using the following terms: coping strategies or Adaptation, Psychological and FEP. RESULTS A total of 167 studies were found, of which 14 were selected for review. The results suggest the need for a multiple and integrated approach, since there are several factors that are involved in the coping strategies (eg, socio-demographic, clinical and psychological variables) used in the different profiles of psychotic spectrum, specifically in FEP. CONCLUSIONS The role of coping skills is an important issue in psychopathological research in addition to clinical outcome, especially from the point of view of the patients, their social context and their recovery. Moreover, personalized therapies addressed to personal recovery should be considered to develop better coping specifically addressed to patients' needs.
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Affiliation(s)
| | | | - Judith Usall
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
| | - Anna Butjosa
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
| | - Susana Ochoa
- PARC SANITARI SANT JOAN DE DÉU. CIBERSAM, Barcelona, Spain
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10
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Tan JH, Shahwan S, Satghare P, Cetty L, Verma S, Sendren JR, Chong SA, Subramaniam M. Binge drinking: Prevalence, correlates, and expectancies of alcohol use among individuals with first-episode psychosis. Early Interv Psychiatry 2019; 13:1136-1145. [PMID: 30345621 PMCID: PMC6899451 DOI: 10.1111/eip.12744] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 08/06/2018] [Accepted: 09/09/2018] [Indexed: 12/30/2022]
Abstract
AIM This study examines the prevalence and correlates of binge drinking and its association with expectancies of alcohol use, within a sample of patients with first-episode psychosis enrolled in the Early Psychosis Intervention Programme (EPIP) in Singapore's Institute of Mental Health. METHODS A total of 280 patients from the EPIP were recruited for an on-going longitudinal study examining cigarette smoking and alcohol habits. Only baseline data were used, pertaining to socio-demographics, alcohol use, clinical symptomology, quality of life, and expectancies of alcohol use. RESULTS Overall 23.9% (N = 67) reported ever binge drinking in their lifetime, and 11.4% (N = 32) had binged in the past 2 weeks. Controlling for all other socio-demographic and clinical factors, binge drinking was significantly associated with higher education levels, having children, current or past history of cigarette smoking, and lower negative symptom scores. Binge drinkers were also more likely to endorse statements relating to the themes of enhancement seeking (ie, using alcohol to alter or enhance experiences in a pleasurable way), coping with distress, and socializing-related expectancies of alcohol use. CONCLUSION Similar to past studies, the prevalence of binge drinking among our first-episode sample was relatively high. Our findings suggest certain lifestyle and social factors associated with risky drinking behaviour that future prevention efforts may address. Additionally, the three motivations of enhancement seeking, coping, and socializing also suggest psychological processes and coping styles that could be targeted for interventions.
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Affiliation(s)
- Jit H Tan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Pratika Satghare
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Swapna Verma
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore, Singapore
| | - Jagan R Sendren
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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11
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Davies EL, Gordon AL, Pelentsov LJ, Esterman AJ. The supportive care needs of individuals recovering from first episode psychosis: A scoping review. Perspect Psychiatr Care 2019; 55:6-14. [PMID: 29427510 DOI: 10.1111/ppc.12259] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/28/2017] [Accepted: 01/01/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND First episode psychosis (FEP) can be a traumatic experience that may alter an individual's ability to meet their own needs. The Supportive Care Needs Framework (SCNF) could complement the recovery-oriented, person-centred approach that is the current foundation of mental health care. AIM To identify the supportive care needs (SCNs) of individuals recovering from a FEP. METHODS A scoping review of the literature was undertaken. Review questions were developed, and relevant studies were identified through database and hand searches of peer-reviewed journal articles. Data from selected articles were tabulated, and contextual meaning was given to the data through a process of collating, summarizing, and reporting. RESULTS A total of 14 peer-reviewed journal articles met inclusion criteria. SCNs were identified at different stages of recovery, ranging from initial treatment to 7 years postdiagnosis. Emotional, informational, practical, psychological, and social needs were identified in over half of the included articles, while needs in the physical and spiritual domains were identified in less than five. CONCLUSIONS Unmet needs in each of the seven domains of need of the SCNF were identified in this population. There are a number of gaps in the literature relating to the specific needs of this population and the timing for which individuals may require more supportive care in their recovery journey.
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Affiliation(s)
- Ellen L Davies
- School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
| | - Andrea L Gordon
- Department of Biosciences, Sansom Institute for Health Research and School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, Australia
| | - Lemuel J Pelentsov
- School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia
| | - Adrian J Esterman
- Department of Biostatistics, Sansom Institute of Health Service Research and School of Nursing and Midwifery, University of South Australia and Australian Institute for Health and Tropical Medicine, James Cook University, Cairns, QLD, Australia
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12
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Davies EL, Gordon AL, Pelentsov LJ, Hooper KJ, Esterman AJ. Needs of individuals recovering from a first episode of mental illness: A scoping review. Int J Ment Health Nurs 2018; 27:1326-1343. [PMID: 29975442 DOI: 10.1111/inm.12518] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 01/29/2023]
Abstract
Central to the role of mental health clinicians is the assessment of needs. A number of assessment tools have been used to evaluate the needs of individuals diagnosed with a mental illness. These tools have largely been developed for people with a severe and persistent mental illness and may not be suitable for individuals who are recovering from a first episode of mental illness. The aims of this review were therefore to identify the needs experienced by individuals recovering from a first episode of mental illness; determine what tools have been used to evaluate these needs; and explore whether existing tools adequately reflect the needs described in the literature. Twenty-one articles were included, comprising articles which identified needs (n = 10), needs assessment tools (n = 1), or articles which identified both needs and a needs assessment tool (n = 10). Results indicate that individuals who have been admitted to a specialized mental health unit and are recovering from a first episode of mental illness may experience an extensive range of needs, spanning emotional, psychological, social, informational, functional, practical, and relationship needs. Four established needs assessment tools were found to have been used to evaluate these needs; however, these do not appear to represent all needs discovered in this review, were mostly developed for populations with a long-term mental illness, and may not be suitable for assessing the needs of individuals recovering from a first episode of mental illness following a presentation to a specialized mental health unit.
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Affiliation(s)
- Ellen L Davies
- Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Andrea L Gordon
- School of Pharmacy and Biosciences, University of South Australia, Adelaide, South Australia, Australia
| | - Lemuel J Pelentsov
- Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Kenneth J Hooper
- Youth Mental Health Service, Southern Adelaide Local Health Network, Bedford Park, South Australia, Australia
| | - Adrian J Esterman
- Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.,The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
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Parks KA, Levonyan-Radloff K, Przybyla SM, Darrow S, Muraven M, Hequembourg A. University student perceptions about the motives for and consequences of nonmedical use of prescription drugs (NMUPD). JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2017; 65:457-465. [PMID: 28617176 PMCID: PMC7874525 DOI: 10.1080/07448481.2017.1341895] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The purpose of the current study was to increase qualitative understanding of student motives for and consequences associated with nonmedical use of prescription drugs. PARTICIPANTS Sixty-one students participated in eight focus groups between April and November 2013. METHODS Students described prescription drugs commonly used for nonmedical reasons, as well as the motives for and consequences associated with their use. Data were analyzed using thematic content analysis. RESULTS Students reported stimulants as the most commonly used prescription drug for nonmedical reasons, least expensive, and easiest to obtain on campus, followed by benzodiazepines. Opioids were less commonly used, more expensive, and difficult to acquire. Motives and consequences varied by prescription drug class. CONCLUSIONS Our qualitative findings extend previous research by suggesting differences in students' perceived motives for using and consequences associated with the different classes of prescription drugs. These findings provide implications for the development of preventive interventions.
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Affiliation(s)
- Kathleen A. Parks
- Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
| | | | - Sarahmona M. Przybyla
- Department of Community Health and Health Behavior, University of Buffalo, Amherst, New York, USA
| | - Sherri Darrow
- Wellness Education, University at Buffalo, Amherst, New York, USA
| | - Mark Muraven
- Department of Psychology, University at Albany, Albany, New York, USA
| | - Amy Hequembourg
- Research Institute on Addictions, University at Buffalo, Buffalo, New York, USA
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14
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Murray RM, Englund A, Abi-Dargham A, Lewis DA, Di Forti M, Davies C, Sherif M, McGuire P, D'Souza DC. Cannabis-associated psychosis: Neural substrate and clinical impact. Neuropharmacology 2017. [PMID: 28634109 DOI: 10.1016/j.neuropharm.2017.06.018] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Prospective epidemiological studies have consistently demonstrated that cannabis use is associated with an increased subsequent risk of both psychotic symptoms and schizophrenia-like psychoses. Early onset of use, daily use of high-potency cannabis, and synthetic cannabinoids carry the greatest risk. The risk-increasing effects are not explained by shared genetic predisposition between schizophrenia and cannabis use. Experimental studies in healthy humans show that cannabis and its active ingredient, delta-9-tetrahydrocannabinol (THC), can produce transient, dose-dependent, psychotic symptoms, as well as an array of psychosis-relevant behavioral, cognitive and psychophysiological effects; the psychotogenic effects can be ameliorated by cannabidiol (CBD). Findings from structural imaging studies in cannabis users have been inconsistent but functional MRI studies have linked the psychotomimetic and cognitive effects of THC to activation in brain regions implicated in psychosis. Human PET studies have shown that acute administration of THC weakly releases dopamine in the striatum but that chronic users are characterised by low striatal dopamine. We are beginning to understand how cannabis use impacts on the endocannabinoid system but there is much still to learn about the biological mechanisms underlying how cannabis increases risk of psychosis. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology".
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Affiliation(s)
- R M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.
| | - A Englund
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - A Abi-Dargham
- Department of Psychiatry, School of Medicine, Stony Brook University, New York, USA
| | - D A Lewis
- Department of Psychiatry, University of Pittsburg, PA, USA
| | - M Di Forti
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - C Davies
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - M Sherif
- Department of Psychiatry, Yale University School of Medicine, CT, USA
| | - P McGuire
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - D C D'Souza
- Department of Psychiatry, Yale University School of Medicine, CT, USA
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15
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Mané A, Fernández-Expósito M, Bergé D, Gómez-Pérez L, Sabaté A, Toll A, Diaz L, Diez-Aja C, Perez V. Relationship between cannabis and psychosis: Reasons for use and associated clinical variables. Psychiatry Res 2015; 229:70-4. [PMID: 26235479 DOI: 10.1016/j.psychres.2015.07.070] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 07/16/2015] [Accepted: 07/26/2015] [Indexed: 10/23/2022]
Abstract
The mechanism underneath the relationship between cannabis and psychosis remains controversial, for which several hypotheses have been proposed, including cannabis as self-medication and cannabis as a risk for the development of psychosis. The aim of this work was to study the relationship between cannabis and psychosis in first-episode psychosis cannabis users and non-users, and non-psychotic cannabis users. The age at the first psychotic episode, duration of untreated psychosis, psychopathology and reasons for cannabis use were assessed. First-episode psychosis cannabis users showed an earlier age at psychosis onset than non-user patients. No significant differences in symptomatology were found. The distinguishing reasons to use cannabis for patients with first-episode psychosis with respect to non-psychotic users were to arrange their thoughts and deal with hallucinations and suspiciousness. These findings are in agreement with both hypotheses: self-medication and secondary psychosis hypothesis. However, longitudinal prospective cohort studies assessing reasons for cannabis use are needed to investigate both hypotheses and their complementarity.
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Affiliation(s)
- Anna Mané
- IMIM (Hospital del Mar Medical Research Institute) - Neurosciences, Psychiatry, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | | | - Daniel Bergé
- IMIM (Hospital del Mar Medical Research Institute) - Neurosciences, Psychiatry, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Laura Gómez-Pérez
- IMIM (Hospital del Mar Medical Research Institute) - Neurosciences, Psychiatry, Barcelona, Spain
| | - Agnés Sabaté
- IMIM (Hospital del Mar Medical Research Institute) - Neurosciences, Psychiatry, Barcelona, Spain
| | - Alba Toll
- IMIM (Hospital del Mar Medical Research Institute) - Neurosciences, Psychiatry, Barcelona, Spain
| | - Laura Diaz
- IMIM (Hospital del Mar Medical Research Institute) - Neurosciences, Psychiatry, Barcelona, Spain
| | - Cristobal Diez-Aja
- IMIM (Hospital del Mar Medical Research Institute) - Neurosciences, Psychiatry, Barcelona, Spain
| | - Victor Perez
- IMIM (Hospital del Mar Medical Research Institute) - Neurosciences, Psychiatry, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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16
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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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17
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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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