1
|
Hjorthøj C, Stürup A, Karlsen M, Speyer H, Osler M, Ongur D, Nordentoft M. Use of antipsychotic medication, benzodiazepines, and psychiatric hospitalization in cannabis-related versus cannabis-unrelated schizophrenia - a nationwide, register-based cohort study. Psychol Med 2024:1-10. [PMID: 38571303 DOI: 10.1017/s0033291724000758] [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: 04/05/2024]
Abstract
BACKGROUND Evidence suggests that cannabis may be a causal factor for development of schizophrenia. We aimed to investigate whether use of antipsychotic medication, benzodiazepines, and psychiatric service use differs among patients with schizophrenia depending on whether psychosis was precipitated by a diagnosis of cannabis use disorder (CUD). METHODS We utilized the nationwide Danish registries to identify all individuals with an incident diagnosis of schizophrenia from 1995 to 2016. We also collected information on whether first CUD diagnosis preceded schizophrenia and thus defined a group of potentially cannabis-related schizophrenia. We compared the cannabis-related schizophrenia group both with all non-cannabis-related patients with schizophrenia and with non-cannabis-related patients with schizophrenia that were propensity-score matched to cases using a range of potentially confounding variables. RESULTS We included 35 714 people with incident schizophrenia, including 4116 (11.5%) that were cannabis-related. In the unmatched-comparison analyses, there were no clear differences over time in use of antipsychotics and benzodiazepines related to whether the diagnosis of schizophrenia was cannabis-related. After propensity-score matching, use of antipsychotics and benzodiazepines was significantly lower among cannabis-related cases of schizophrenia. In the unmatched comparison, the cannabis-related group had significantly more days admitted than the non-cannabis-related group. This was markedly attenuated after propensity-score matching. CONCLUSIONS Our findings indicate the importance of considering cannabis-related cases of schizophrenia as a potentially distinct disorder in terms of prognosis. It is unclear, however, if these differences are due to different biological types of schizophrenia being compared or if they rather indicate behavioral differences such as reduced adherence and treatment-seeking.
Collapse
Affiliation(s)
- Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Section of Epidemiology, Copenhagen, Denmark
| | - Anne Stürup
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Denmark
| | - Mette Karlsen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Denmark
| | - Helene Speyer
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Denmark
| | - Merete Osler
- Department of Public Health, University of Copenhagen, Section of Epidemiology, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Dost Ongur
- Psychotic Disorders Division, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Denmark
| |
Collapse
|
2
|
Lesh TA, Rhilinger J, Brower R, Mawla AM, Ragland JD, Niendam TA, Carter CS. Using Task-fMRI to Explore the Relationship Between Lifetime Cannabis Use and Cognitive Control in Individuals With First-Episode Schizophrenia. SCHIZOPHRENIA BULLETIN OPEN 2024; 5:sgae016. [PMID: 39144106 PMCID: PMC11317632 DOI: 10.1093/schizbullopen/sgae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
While continued cannabis use and misuse in individuals with schizophrenia is associated with a variety of negative outcomes, individuals with a history of use tend to show higher cognitive performance compared to non-users. While this is replicated in the literature, few studies have used task-based functional magnetic resonance imaging (fMRI) to evaluate whether the brain networks underpinning these cognitive features are similarly impacted. Forty-eight first-episode individuals with schizophrenia (FES) with a history of cannabis use (FES + CAN), 28 FES individuals with no history of cannabis use (FES-CAN), and 59 controls (CON) performed the AX-Continuous Performance Task during fMRI. FES+CAN showed higher cognitive control performance (d'-context) compared to FES-CAN (P < .05, ηp 2 = 0.053), and both FES+CAN (P < .05, ηp 2 = 0.049) and FES-CAN (P < .001, ηp 2 = 0.216) showed lower performance compared to CON. FES+CAN (P < .05, ηp 2 = 0.055) and CON (P < 0.05, ηp 2 = 0.058) showed higher dorsolateral prefrontal cortex (DLPFC) activation during the task compared to FES-CAN, while FES+CAN and CON were not significantly different. Within the FES+CAN group, the younger age of initiation of cannabis use was associated with lower IQ and lower global functioning. More frequent use was also associated with higher reality distortion symptoms at the time of the scan. These data are consistent with previous literature suggesting that individuals with schizophrenia and a history of cannabis use have higher cognitive control performance. For the first time, we also reveal that FES+CAN have higher DLPFC brain activity during cognitive control compared to FES-CAN. Several possible explanations for these findings are discussed.
Collapse
Affiliation(s)
- Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Joshua Rhilinger
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Rylee Brower
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Alex M Mawla
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - J Daniel Ragland
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Tara A Niendam
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Cameron S Carter
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| |
Collapse
|
3
|
Argote M, Sescousse G, Brunelin J, Baudin G, Schaub MP, Rabin R, Schnell T, Ringen PA, Andreassen OA, Addington JM, Brambilla P, Delvecchio G, Bechdolf A, Wobrock T, Schneider-Axmann T, Herzig D, Mohr C, Vila-Badia R, Rodie JU, Mallet J, Ricci V, Martinotti G, Knížková K, Rodriguez M, Cookey J, Tibbo P, Scheffler F, Asmal L, Garcia-Rizo C, Amoretti S, Huber C, Thibeau H, Kline E, Fakra E, Jardri R, Nourredine M, Rolland B. Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals. EClinicalMedicine 2023; 64:102199. [PMID: 37731936 PMCID: PMC10507201 DOI: 10.1016/j.eclinm.2023.102199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
Background The association between cannabis use and positive symptoms in schizophrenia spectrum disorders is well documented, especially via meta-analyses. Yet, findings are inconsistent regarding negative symptoms, while other dimensions such as disorganization, depression, and excitement, have not been investigated. In addition, meta-analyses use aggregated data discarding important confounding variables which is a source of bias. Methods PubMed, ScienceDirect and PsycINFO were used to search for publications from inception to September 27, 2022. We contacted the authors of relevant studies to extract raw datasets and perform an Individual Participant Data meta-analysis (IPDMA). Inclusion criteria were: psychopathology of individuals with schizophrenia spectrum disorders assessed by the Positive and Negative Syndrome Scale (PANSS); cannabis-users had to either have a diagnosis of cannabis use disorder or use cannabis at least twice a week. The main outcomes were the PANSS subscores extracted via the 3-factor (positive, negative and general) and 5-factor (positive, negative, disorganization, depression, excitement) structures. Preregistration is accessible via Prospero: ID CRD42022329172. Findings Among the 1149 identified studies, 65 were eligible and 21 datasets were shared, totaling 3677 IPD and 3053 complete cases. The adjusted multivariate analysis revealed that relative to non-use, cannabis use was associated with higher severity of positive dimension (3-factor: Adjusted Mean Difference, aMD = 0.34, 95% Confidence Interval, CI = [0.03; 0.66]; 5-factor: aMD = 0.38, 95% CI = [0.08; 0.63]), lower severity of negative dimension (3-factor: aMD = -0.49, 95% CI [-0.90; -0.09]; 5-factor: aMD = -0.50, 95% CI = [-0.91; -0.08]), higher severity of excitement dimension (aMD = 0.16, 95% CI = [0.03; 0.28]). No association was found between cannabis use and disorganization (aMD = -0.13, 95% CI = [-0.42; 0.17]) or depression (aMD = -0.14, 95% CI = [-0.34; 0.06]). Interpretation No causal relationship can be inferred from the current results. The findings could be in favor of both a detrimental and beneficial effect of cannabis on positive and negative symptoms, respectively. Longitudinal designs are needed to understand the role of cannabis is this association. The reported effect sizes are small and CIs are wide, the interpretation of findings should be taken with caution. Funding This research did not receive any specific grant or funding. Primary financial support for authors was provided by Le Vinatier Psychiatric Hospital.
Collapse
Affiliation(s)
- Mathilde Argote
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Guillaume Sescousse
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Jérôme Brunelin
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Grégoire Baudin
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100, France
| | - Michael Patrick Schaub
- Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Zurich, Switzerland
| | - Rachel Rabin
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Thomas Schnell
- Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
| | - Petter Andreas Ringen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Ole Andreas Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy und Psychosomatic, Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
- Department of Psychiatry and Psychotherapy, CCM, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Thomas Wobrock
- Centre for Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
- Department of Psychiatry and Psychotherapy, Georg-August University Göttingen, Germany
| | - Thomas Schneider-Axmann
- Department of Psychiatry and Psychotherapy, Ludwig Maximillian University Munich, Munich, Germany
| | - Daniela Herzig
- Clienia Littenheid AG, Psychiatrische Tagesklinik Frauenfeld, 8500, Frauenfeld, Switzerland
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
| | - Christine Mohr
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
| | - Regina Vila-Badia
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Judith Usall Rodie
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Jasmina Mallet
- Université Paris Cité, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris France, France
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
| | - Valerio Ricci
- Department of Neuroscience, San Luigi Gonzaga University Hospital, 10043, Orbassano, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University of Chieti-Pescara, Italy
| | - Karolína Knížková
- National Institute of Mental Health, Klecany, Czech Republic
- Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
- General University Hospital in Prague, Czech Republic
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic
| | - Jacob Cookey
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Philip Tibbo
- Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
- Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Freda Scheffler
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
| | - Silvia Amoretti
- Psychiatric Genetics Unit, Vall d’Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
| | - Christian Huber
- Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Wilhelm Klein-Str. 27, 4002 Basel, Switzerland
| | - Heather Thibeau
- Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
| | - Emily Kline
- Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
- Department of Psychiatry, Boston University School of Medicine, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
| | - Eric Fakra
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Pôle Universitaire de Psychiatrie, CHU Saint-Etienne, Saint-Etienne, France
| | - Renaud Jardri
- Lille University, Inserm U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France
- CHU Lille, Fontan Hospital, Child & Adolescent Psychiatry Department & CURE Research Platform, Lille, France
| | - Mikail Nourredine
- Université Claude Bernard Lyon 1, Lyon, France
- Service de biostatistique, Hospices Civils de Lyon, Lyon, France
- Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon, France
| | - Benjamin Rolland
- PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
- Centre Hospitalier Le Vinatier, Bron, France
- Service Universitaire d’Addictologie de Lyon (SUAL), HCL, CH Le Vinatier, Lyon, France
| |
Collapse
|
4
|
Waterreus A, Di Prinzio P, Ambrosi T, Morgan VA. Discontinuing cannabis use: Symptomatic and functional outcomes in people with an established psychotic disorder. Schizophr Res 2023; 254:118-124. [PMID: 36842223 DOI: 10.1016/j.schres.2023.02.016] [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: 10/11/2022] [Revised: 01/29/2023] [Accepted: 02/09/2023] [Indexed: 02/27/2023]
Abstract
For people with psychotic disorders, the negative outcomes associated with continuing cannabis use would suggest that discontinuing such use may be beneficial for their symptomatic and functional recovery. However, existing evidence that discontinuation is associated with better clinical outcomes is inconsistent and it remains unclear whether discontinuing use is associated with improvements in outcomes for people with an established psychotic disorder. In this 3-5-year longitudinal study we examined baseline and follow-up symptomatic and functional profiles of 371 people with an established psychotic disorder, comparing those who continued to use cannabis with those who discontinued use after baseline assessment. At follow-up, one third (33.3 %) of baseline cannabis users had discontinued use. Discontinuation was associated with significantly lower odds of past-year hallucinations and a mean improvement in level of functioning (Personal and Social Performance Scale) compared to a decline in functioning in continuing users. No significant differences in severity of negative symptoms were observed. With few longitudinal studies examining symptomatic and functional outcomes for people with established psychotic disorders who continue to use cannabis compared to those who discontinue use, our findings that discontinuing cannabis was associated with significant clinical improvements fill gaps in the evidence-base.
Collapse
Affiliation(s)
- A Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Perth, Australia.
| | - P Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - T Ambrosi
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, The University of Western Australia, Perth, Australia
| |
Collapse
|
5
|
Association Between Cannabis and Violence in Community-Dwelling Patients With Severe Mental Disorders: A Cross-sectional Study Using Machine Learning. J Nerv Ment Dis 2023; 211:88-94. [PMID: 36716062 DOI: 10.1097/nmd.0000000000001604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The objective of this cross-sectional study was to identify cannabis-related features and other characteristics predictive of violence using a data-driven approach in patients with severe mental disorders (SMDs). A Least Absolute Shrinkage and Selection Operator regularization regression model was used on the database consisting of 97 patients with SMD who completed questionnaires measuring substance use and violence. Cannabis use, particularly related to patients' decision to consume or time spent using, was a key predictor associated with violence. Other patterns of substance use and personality traits were identified as strong predictors. Regular patterns of cannabis use and interpersonal issues related to cannabis/stimulant abuse were inversely correlated to violence. This study identified the effect of several predictors correlated to violence in patients with SMD using a regularization regression model. Findings open the door to better identify the profiles of patients that may be more susceptible to perpetrate violent behaviors.
Collapse
|
6
|
Mona K, Ntlantsana V, Tomita AM, Paruk S. Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa. S Afr J Psychiatr 2022; 28:1927. [PMID: 36340643 PMCID: PMC9634825 DOI: 10.4102/sajpsychiatry.v28i0.1927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/22/2022] [Indexed: 11/06/2022] Open
Abstract
Background There is a high prevalence of cannabis use in patients with schizophrenia spectrum and other psychotic disorders, with comorbid cannabis use in this population being associated with poorer long-term outcomes. Aim To determine the prevalence of cannabis use in patients with a schizophrenia spectrum and other psychotic disorders. Setting The study was conducted at a psychiatric hospital in Durban, KwaZulu-Natal Province, South Africa. Methods A review of clinical records of patients admitted to the hospital for the period, June 2018 to June 2020, was conducted. Results A total of 370 clinical records were reviewed, of which 48.9% reported current and 51.1% lifetime cannabis use. Being male was significantly associated with current and lifetime cannabis use (OR = 4.90, 95% CI 2.49–9.62 and OR = 6.27, 95% CI 3.28–11.95, respectively). Current alcohol use was also associated with current cannabis use (CCU) (OR = 3.06, 95% CI 1.78–5.28), and age 45 years and older was associated with a lower odds of cannabis use (OR = 0.30, 95% CI 0.09–0.96). Forty-eight per cent of participants were admitted three or more times, and readmission was associated with cannabis use (p = 0.01). There was a lack of association between cannabis use, readmission and human immunodeficiency virus (HIV) status, after controlling for variables such as alcohol use and gender. Conclusion Almost 50% of people admitted with schizophrenia spectrum and other psychotic disorders have comorbid current and lifetime cannabis use. There is a need for dual diagnosis units to address comorbid substance use in people with psychotic disorders, as it leads to poorer outcomes. Contribution The study found that there is a high prevalence of cannabis use in people with psychosis. Therefore, it is imperative that we revise treatment programs in our psychiatric units and there is an urgent need for dual diagnosis programs that address substance use in this group of patients.
Collapse
Affiliation(s)
- Khanya Mona
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Vuyokazi Ntlantsana
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew M. Tomita
- Department of Psychiatry, KwaZulu Natal Research Innovation and Sequencing Platform (KRISP), College of Health Sciences, University of KwaZulu- Natal, Durban, South Africa
- Discipline of Psychiatry, Centre of Rural Health, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Saeeda Paruk
- Discipline of Psychiatry, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
7
|
Argote M, Sescousse G, Brunelin J, Fakra E, Nourredine M, Rolland B. Association between formal thought disorder and cannabis use: a systematic review and meta-analysis. SCHIZOPHRENIA 2022; 8:78. [PMID: 36175509 PMCID: PMC9523063 DOI: 10.1038/s41537-022-00286-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/10/2022] [Indexed: 10/26/2022]
Abstract
AbstractFormal thought disorder (FTD) is a multidimensional syndrome mainly occurring along the psychosis continuum. Cannabis use is known to increase symptoms of psychosis, particularly positive symptoms. However, the impact of cannabis use on FTD in individuals presenting symptoms along the psychosis continuum remains unclear. To address this knowledge gap, we conducted a meta-analysis examining the association between cannabis use and FTD in those individuals. We hypothesized that cannabis would worsen FTD. We conducted a systematic search of the PubMed, ScienceDirect, PsycINFO, Web of Science, Embase and Google Scholar databases up to July 2022. The results were collated through a random-effects model using the statistical software R. Reference lists of included studies were searched for additional relevant publications. Nineteen studies were included, totalling 1840 cannabis users and 3351 non-cannabis users. The severity of FTD was found to be higher in cannabis users (SMD = 0.21, 95%CI [0.12–0.29], p = 0.00009). Subgroup analyses revealed that FTD severity was increased among cannabis users, regardless of the disorder severity: healthy individuals (SMD = 0.19, 95%CI [0.05–0.33], p = 0.02); patients with first-episode psychosis (SMD = 0.21, 95%CI [0.01–0.41], p = 0.04); patients with schizophrenia (SMD = 0.25, 95%CI [0.11–0.38], p = 0.005). Between-group differences were not significant. In line with its already known effect on positive symptoms in psychosis, cannabis use appears to be associated with increased FTD severity all along the psychosis continuum. Future research should consider potential confounding variables such as other substance use disorders and explore how FTD dimensions are impacted by cannabis use.
Collapse
|
8
|
Dellazizzo L, Potvin S, Giguère S, Dumais A. The Potential Paradoxical Neurocognitive Effects of Cannabis Use in Patients with Psychotic Disorders: A Critical Meta-Review of Meta-Analytical Evidence. Cannabis Cannabinoid Res 2022. [PMID: 35666226 DOI: 10.1089/can.2021.0163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: The association between cannabis and cognitive functions has been thoroughly studied in psychotic disorders, but conflictual/paradoxical results have emerged. This critical meta-review examined the magnitude of effects of cannabis on neurocognitive functions in patients with psychotic disorders provided by meta-analyses and evaluated the quality of evidence. Methods: A systematic search of meta-analyses was performed in PubMed, PsycINFO, Web of Science, and Google Scholar. Results: The search retrieved six meta-analyses. Quality of evidence varied from very low to moderate quality. No neurocognitive difference was observed between cannabis users and nonusers in first episode of psychosis samples. Limited evidence showed no significant difference in language, psychomotor functioning, and verbal/visual learning/memory, apart from improvements in verbal and visual memory (recognition). Findings showed better neurocognitive performances in cannabis-using patients for planning/reasoning and working memory. There were tendencies toward significance for processing speed and attention. Most effect sizes showed small to moderate degrees of outperformances in cannabis users. Individuals with lifetime use appeared to show better neurocognitive functions. Conclusion: Evidence indicated nonuniform effects of cannabis use across cognitive domains, with some areas suggesting better cognitive performances in cannabis users, entitled the paradoxical effect of the dually diagnosed. Clinical significance of these findings should be interpreted cautiously.
Collapse
Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Sabrina Giguère
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Institut National de Psychiatrie Légale Philippe-Pinel, Montreal, Canada
| |
Collapse
|
9
|
Jones HJ, Hammerton G, McCloud T, Hines LA, Wright C, Gage SH, Holmans P, Jones PB, Smith GD, Linden DEJ, O'Donovan MC, Owen MJ, Walters JT, Munafò MR, Heron J, Zammit S. Examining pathways between genetic liability for schizophrenia and patterns of tobacco and cannabis use in adolescence. Psychol Med 2022; 52:132-139. [PMID: 32515721 PMCID: PMC7614952 DOI: 10.1017/s0033291720001798] [Citation(s) in RCA: 2] [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: 11/05/2022]
Abstract
BACKGROUND It is not clear to what extent associations between schizophrenia, cannabis use and cigarette use are due to a shared genetic etiology. We, therefore, examined whether schizophrenia genetic risk associates with longitudinal patterns of cigarette and cannabis use in adolescence and mediating pathways for any association to inform potential reduction strategies. METHODS Associations between schizophrenia polygenic scores and longitudinal latent classes of cigarette and cannabis use from ages 14 to 19 years were investigated in up to 3925 individuals in the Avon Longitudinal Study of Parents and Children. Mediation models were estimated to assess the potential mediating effects of a range of cognitive, emotional, and behavioral phenotypes. RESULTS The schizophrenia polygenic score, based on single nucleotide polymorphisms meeting a training-set p threshold of 0.05, was associated with late-onset cannabis use (OR = 1.23; 95% CI = 1.08,1.41), but not with cigarette or early-onset cannabis use classes. This association was not mediated through lower IQ, victimization, emotional difficulties, antisocial behavior, impulsivity, or poorer social relationships during childhood. Sensitivity analyses adjusting for genetic liability to cannabis or cigarette use, using polygenic scores excluding the CHRNA5-A3-B4 gene cluster, or basing scores on a 0.5 training-set p threshold, provided results consistent with our main analyses. CONCLUSIONS Our study provides evidence that genetic risk for schizophrenia is associated with patterns of cannabis use during adolescence. Investigation of pathways other than the cognitive, emotional, and behavioral phenotypes examined here is required to identify modifiable targets to reduce the public health burden of cannabis use in the population.
Collapse
Affiliation(s)
- Hannah J. Jones
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- Medical Research Centre (MRC) Integrative Epidemiology Unit (IEU) at the University of Bristol, UK
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Gemma Hammerton
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- Medical Research Centre (MRC) Integrative Epidemiology Unit (IEU) at the University of Bristol, UK
| | - Tayla McCloud
- Division of Psychiatry, University College London, London, UK
| | - Lindsey A. Hines
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Caroline Wright
- Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Suzanne H. Gage
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Peter Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - George Davey Smith
- Medical Research Centre (MRC) Integrative Epidemiology Unit (IEU) at the University of Bristol, UK
| | - David E. J. Linden
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Michael C. O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Michael J. Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - James T. Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Marcus R. Munafò
- Medical Research Centre (MRC) Integrative Epidemiology Unit (IEU) at the University of Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, UK
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- Medical Research Centre (MRC) Integrative Epidemiology Unit (IEU) at the University of Bristol, UK
| | - Stanley Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| |
Collapse
|
10
|
Coronado-Montoya S, Morissette F, Abdel-Baki A, Fischer B, Côté J, Ouellet-Plamondon C, Tremblay L, Jutras-Aswad D. Preventive interventions targeting cannabis use and related harms in people with psychosis: A systematic review. Early Interv Psychiatry 2021; 15:1439-1453. [PMID: 33283448 DOI: 10.1111/eip.13081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 10/06/2020] [Accepted: 11/13/2020] [Indexed: 11/30/2022]
Abstract
AIM While most users will not experience severe adverse health outcomes from cannabis, it can be associated with negative outcomes in people with psychosis. People with psychosis who use cannabis have more severe psychiatric symptoms, higher rates of hospitalization, and diminished psychosocial functioning compared to those who do not use cannabis. Most studies of people with psychotic disorders have focused on cannabis use treatments and only a few on preventive interventions for cannabis. This systematic review aims to evaluate the effectiveness of preventive interventions focusing on cannabis use for people with psychosis. METHODS We searched CINAHL Plus, EBM reviews, EMBASE, MEDLINE, PsycInfo and PubMed databases for controlled studies assessing the effects of preventive interventions on cannabis use and related harms in people with psychosis. We conducted the search using a combination of the following concepts: cannabis, psychosis, intervention and prevention. Risk of bias was assessed. RESULTS The search yielded 11 460 unique studies. Of these, five studies met our eligibility criteria. None of the studies demonstrated clear efficacy of prevention interventions in reducing cannabis use, and none measured cannabis-related harms. All studies had high risk of bias. CONCLUSION The small number of studies and the considerable risk of bias made it difficult to conclude whether any of the existing interventions were promising. With increased acceptance and accessibility of cannabis due to liberalizing cannabis policies, it is imperative to improve the evidence base for preventive interventions, in particular their effectiveness in decreasing the risk of cannabis-related harms in people with psychosis.
Collapse
Affiliation(s)
- Stephanie Coronado-Montoya
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Research Center, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - Florence Morissette
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Amal Abdel-Baki
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Research Center, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - Benedikt Fischer
- Schools of Population Health & Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Centre for Applied Research in Mental Health & Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.,Department of Psychiatry, Universidade Federal de (Federal University of) São Paulo (UNIFESP), Sao Paulo, Brazil
| | - José Côté
- Research Center, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada.,Faculty of Nursing, Université de Montréal, Montreal, Canada
| | - Clairélaine Ouellet-Plamondon
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Research Center, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada
| | - Laurence Tremblay
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, Montreal, Canada.,Research Center, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Canada.,University Institute on Addictions, Montreal, Canada
| |
Collapse
|
11
|
Köck P, Lang E, Trulley VN, Dechent F, Mercer-Chalmers-Bender K, Frei P, Huber C, Borgwardt S. Cannabidiol Cigarettes as Adjunctive Treatment for Psychotic Disorders - A Randomized, Open-Label Pilot-Study. Front Psychiatry 2021; 12:736822. [PMID: 34803760 PMCID: PMC8599279 DOI: 10.3389/fpsyt.2021.736822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Psychotic disorders are associated with high rates of comorbid substance use disorders. Use of cannabis rich in tetrahydrocannabinol (THC) is linked to an increased risk of psychosis, worsening of psychotic symptoms, and an adverse course of psychotic disorders. Previous studies suggest oral cannabidiol (CBD) as possible novel antipsychotic agent; however, no studies evaluated the effects of smoked CBD. Objective: The main aim of the study was to clarify the antipsychotic potential of CBD used as adjunctive therapy simulating a naturalistic setting. Our trial is the first study evaluating the effects of smoked CBD-cigarettes as adjunctive therapy for psychotic symptoms. Methods: A randomized, placebo-controlled open-label trial of cigarettes containing CBD-rich cannabis (THC < 1%) as adjunctive therapy to standard psychiatric treatment was conducted (ClinicalTrials.gov identifier NCT04700930). Primary outcomes were mean scores of Positive and Negative Syndrome Scale (PANSS), Brøset Violence Checklist, the Beck's Depression Inventory (BDI), the Subjective Well-Being Under Neuroleptics Scale short form (SWN-K), and antipsychotic medication equivalent doses. Outcomes were assessed after 4 weeks of acute treatment and long-term follow-up after discontinuation of CBD-cigarettes after 25 weeks. Participants were 31 acutely psychotic patients with tobacco use disorder and a mean age of 35.1 ± 10.58 years (71% male). Comorbid cannabis use was diagnosed in 51.6%. Results: A discontinuous multilevel model revealed no significant group differences for primary outcomes. After 4 weeks of acute treatment, mean PANSS and BDI decreased in both groups, while an increase of antipsychotic medication equivalent was observed in the placebo group. Conclusions: The presented findings might suggest an antipsychotic medication sparing effect of CBD-cigarettes as adjunctive treatment of acute psychosis. However, the low number of participants did not allow for further statistical analysis. Hence, a larger study sample and a more rigorous study design (blinding of the interventional product, fixed dosing regimen) may reveal different results. Clinical Trial Registration: ClinicalTrials.gov, identifier: NCT04700930.
Collapse
Affiliation(s)
- Patrick Köck
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Elisabeth Lang
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Valerie-Noelle Trulley
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Frieder Dechent
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | | | - Priska Frei
- Department of Biomedical Engineering, Institute of Forensic Medicine, University of Basel, Basel, Switzerland
| | - Christian Huber
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Stefan Borgwardt
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| |
Collapse
|
12
|
Ahmed S, Roth RM, Stanciu CN, Brunette MF. The Impact of THC and CBD in Schizophrenia: A Systematic Review. Front Psychiatry 2021; 12:694394. [PMID: 34366924 PMCID: PMC8343183 DOI: 10.3389/fpsyt.2021.694394] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/25/2021] [Indexed: 12/27/2022] Open
Abstract
Background: People with schizophrenia are more likely to develop cannabis use disorder (CUD) and experience worse outcomes with use. Yet as cannabis is legalized for medical and recreational use, there is interest in its therapeutic potential. Objectives: To conduct a systematic review summarizing the design and results of controlled trials using defined doses of THC and CBD in schizophrenia. Method: A keyword search of eight online literature databases identified 11 eligible reports. Results: One placebo controlled trial (13 stable patients without CUD) found that intravenous THC increased psychosis and worsened learning/recall. Two reports of a functional magnetic resonance (fMRI) study of smoked or oral THC in 12 abstinent patients with schizophrenia and CUD found no change in symptoms and cognition, and an amelioration of impaired resting state brain function in areas implicated in reward function and the default mode network. One 4 week trial in acutely psychotic inpatients without CUD (mean age 30 y) found 800 mg CBD to be similarly efficacious to amisupride in improving psychosis and cognition. Two 6 week studies of CBD augmentation of antipsychotics in stable outpatients reported mixed results: CBD 600 mg was not more effective than placebo; CBD 1,000 mg reduced symptoms in a sample that did not exclude cannabis use and CUD. A brain fMRI and proton magnetic resonance spectroscopy study of single dose CBD in a sample that did not exclude CUD and cannabis use found that CBD improved symptoms and brain function during a learning/recall task and was associated with increased hippocampal glutamate. Discussion: There is substantial heterogeneity across studies in dose, method of drug delivery, length of treatment, patient age, whether patients with cannabis use/CUD were included or excluded, and whether patients were using antipsychotic medication. Conclusion: There is insufficient evidence for an effect of THC or CBD on symptoms, cognition, and neuroimaging measures of brain function in schizophrenia. At this time, research does not support recommending medical cannabis (THC or CBD) for treating patients with schizophrenia. Further research should examine THC and CBD in schizophrenia with and without comorbid CUD and consider the role of CBD in mitigating symptom exacerbation from THC.
Collapse
Affiliation(s)
- Saeed Ahmed
- Department of Psychiatry, Rutland Regional Medical Center, Rutland, VT, United States
- Vermont Hub-and-Spoke System of Care, West Ridge Center at Rutland Regional Medical Center, Rutland, VT, United States
| | - Robert M. Roth
- New Hampshire Hospital, Concord, NH, United States
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
- Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Corneliu N. Stanciu
- New Hampshire Hospital, Concord, NH, United States
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
- Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Mary F. Brunette
- Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
- Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
- Bureau of Mental Health Services, Concord, NH, United States
| |
Collapse
|
13
|
Kiburi SK, Molebatsi K, Ntlantsana V, Lynskey MT. Cannabis use in adolescence and risk of psychosis: Are there factors that moderate this relationship? A systematic review and meta-analysis. Subst Abus 2021; 42:527-542. [DOI: 10.1080/08897077.2021.1876200] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Sarah Kanana Kiburi
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Mbagathi Hospital, Nairobi, Kenya
| | - Keneilwe Molebatsi
- Department of Psychiatry, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Department of Psychiatry, Nelson Mandela School of Clinical Medicine, University of Kwa-Zulu Natal, Durban, South Africa
| | - Vuyokazi Ntlantsana
- Department of Psychiatry, Nelson Mandela School of Clinical Medicine, University of Kwa-Zulu Natal, Durban, South Africa
| | - Michael T. Lynskey
- Addiction Department, Institute of Psychiatry, Psychology and Neuroscience, Kings college London, London, UK
| |
Collapse
|
14
|
de Vos C, Leopold K, Blanke ES, Siebert S, Baumgardt J, Burkhardt E, Bechdolf A. The relationship between cannabis use and cognition in people diagnosed with first-episode psychosis. Psychiatry Res 2020; 293:113424. [PMID: 32862065 DOI: 10.1016/j.psychres.2020.113424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 08/21/2020] [Accepted: 08/22/2020] [Indexed: 01/18/2023]
Abstract
Cannabis use is highly prevalent among young people diagnosed with first-episode psychosis (FEP), however, its impact on cognition is still unclear. The aim of the present study was to examine the association of cannabis use with cognition in people diagnosed with FEP. We extended previous research findings by operationalising the comorbid cannabis use, considering recency of cannabis use and use of other illicit substances and including people with a broad spectrum of psychotic diagnoses. A total of 89 people diagnosed with FEP were interviewed about their history of substance use and completed a cognitive test battery assessing verbal memory, verbal fluency and attention. Sixty-one participants were lifetime cannabis users (CU; ≥three times per week for ≥four weeks; 68.5%) and 28 were cannabis non-users (CNU; 31.5%). CU were significantly more likely to be male and exhibited significantly more positive symptoms than CNU. In contrast, CNU displayed significantly more negative symptoms than CU. There were no differences between CU and CNU on neurocognitive tasks of verbal memory, verbal fluency and attention. In conclusion, there was no indication that cannabis use was associated with cognitive impairments in people diagnosed with FEP.
Collapse
Affiliation(s)
- Chloé de Vos
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Department of Psychiatry and Psychotherapy, University Hospital Cologne, Germany.
| | - Karolina Leopold
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany
| | - Elisabeth S Blanke
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Institute of Psychology, Humboldt-University Berlin, Germany
| | - Stefan Siebert
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany
| | - Johanna Baumgardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Department of Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Germany
| | - Eva Burkhardt
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Orygen, Parkville, Victoria, Australia
| | - Andreas Bechdolf
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Vivantes Hospital Am Urban and Vivantes Hospital Im Friedrichshain, Charité-Universitätsmedizin Berlin, Germany; Department of Psychiatry and Psychotherapy, University Hospital Cologne, Germany; Orygen, Parkville, Victoria, Australia
| |
Collapse
|
15
|
Cannabis, nicotine and the negative symptoms of schizophrenia: Systematic review and meta-analysis of observational studies. Neurosci Biobehav Rev 2020; 116:415-425. [DOI: 10.1016/j.neubiorev.2020.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/14/2022]
|
16
|
Abboussi O, Andaloussi ZIL, Chris AD, Taghzouti K. Chronic Exposure to WIN55,212-2 During Adolescence Alters Prefrontal Dopamine Turnover and Induces Sensorimotor Deficits in Adult Rats. Neurotox Res 2020; 38:682-690. [PMID: 32757167 DOI: 10.1007/s12640-020-00266-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 01/01/2023]
Abstract
Several lines of evidence suggest that chronic exposure to cannabinoids during adolescence may increase the risk of schizophrenia. Studies of the disorder have identified altered cortical dopaminergic neurotransmission. In this study, we hypothesised that heightened endocannabinoid system activation via chronic exposure to a highly potent cannabinoid receptors agonist in adolescent rats would cause long-lasting neurobiological changes that may dramatically alter expression and functions of dopamine metabolising enzymes, comethyl-o-transferase (COMT) and monoamine oxidases MAO-A and MAO-B. To test this hypothesis, adult male rats (70 PND) undergoing chronic treatment of the highly potent and non-selective CB agonist WIN55,212-2 (1.2 mg/kg) during adolescence (PND 30-50) were subjected after 20 days washout period to prepulse inhibition of acoustic startle test (PPI) to confirm cannabinoid-induced sensorimotor-gating impairments and afterwards examined for COMT, MAO-A and MAO-B expression and activity in the prefrontal cortex. Chronic WIN55,212-2 exposure during adolescence caused disruption of PPI, increased cortical dopamine level, decreased COMT mRNA expression and decreased MAO-A and MAO-B enzymatic activities. These results indicate that chronic exposure to cannabinoids during adolescence induces sensorimotor-gating alterations which likely result from changes in the prefrontal cortex dopaminergic signalling. This has important implications for developing methods of targeting dopamine metabolising enzymes and/or sequelae of its dysregulation in cannabinoid-induced schizoaffective-like behaviour.
Collapse
Affiliation(s)
- Oualid Abboussi
- Division of Neuroscience, Ninewells Hospital and Medical School, Institute of Academic Anaesthesia, University of Dundee, Dundee, UK.
| | - Zineb Ibn Lahmar Andaloussi
- Physiology and Physiopathology Team, Faculty of Sciences, Genomic of Human Pathologies Research Centre, Mohammed V University in Rabat, Rabat, Morocco
| | - Ajonijebu Duyilemi Chris
- Department of Physiology, School of Biomolecular and Chemical Sciences, Faculty of Science, Nelson Mandela University, Port Elizabeth, South Africa
| | - Khalid Taghzouti
- Physiology and Physiopathology Team, Faculty of Sciences, Genomic of Human Pathologies Research Centre, Mohammed V University in Rabat, Rabat, Morocco
| |
Collapse
|
17
|
Fisher E, Wood SJ, Elsworthy RJ, Upthegrove R, Aldred S. Exercise as a protective mechanism against the negative effects of oxidative stress in first-episode psychosis: a biomarker-led study. Transl Psychiatry 2020; 10:254. [PMID: 32709912 PMCID: PMC7382474 DOI: 10.1038/s41398-020-00927-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 06/25/2020] [Accepted: 07/03/2020] [Indexed: 12/23/2022] Open
Abstract
First-episode psychosis (FEP) is a psychiatric disorder, characterised by positive and negative symptoms, usually emerging during adolescence and early adulthood. FEP represents an early intervention opportunity for intervention in psychosis. Redox disturbance and subsequent oxidative stress have been linked to the pathophysiology of FEP. Exercise training can perturb oxidative stress and rebalance the antioxidant system and thus represents an intervention with the potential to interact with a mechanism of disease. The aim of this study was to assess the effect of exercise on markers of redox status in FEP. Twenty-two young men were recruited from Birmingham Early Intervention services and randomised to either a 12-week exercise programme or treatment as usual (control). Measures of blood and brain glutathione (GSH), markers of oxidative damage, inflammation, neuronal health, symptomology and habitual physical activity were assessed. Exercise training was protective against changes related to continued psychosis. Symptomatically, those in the exercise group showed reductions in positive and general psychopathology, and stable negative symptoms (compared to increased negative symptoms in the control group). Peripheral GSH was increased by 5.6% in the exercise group, compared to a significant decrease (24.4%) (p = 0.04) in the control group. Exercise attenuated negative changes in markers of neuronal function (brain-derived neurotrophic factor), lipid damage (thiobarbituric acid-reactive substances) and total antioxidant capacity. C-reactive protein and tumour necrosis factor-α also decreased in the exercise group, although protein and DNA oxidation were unchanged. Moderate-intensity exercise training has the ability to elicit changes in markers of oxidative stress and antioxidant concentration, with subsequent improvements in symptoms of psychosis.
Collapse
Affiliation(s)
- Emily Fisher
- grid.6572.60000 0004 1936 7486School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT UK
| | - Stephen J. Wood
- grid.488501.0Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Melbourne, VIC 3052 Australia ,grid.1008.90000 0001 2179 088XSchool of Psychology, University of Melbourne, Melbourne, VIC 3010 Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, University of Melbourne, Melbourne, VIC 3010 Australia
| | - Richard J. Elsworthy
- grid.6572.60000 0004 1936 7486School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT UK
| | - Rachel Upthegrove
- grid.6572.60000 0004 1936 7486Institute for Mental Health, University of Birmingham, Edgbaston, B15 2TT UK ,grid.6572.60000 0004 1936 7486Department of Psychiatry, University of Birmingham, Edgbaston, B15 2TT UK
| | - Sarah Aldred
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, B15 2TT, UK. .,Institute for Mental Health, University of Birmingham, Edgbaston, B15 2TT, UK.
| |
Collapse
|
18
|
Fisher E, Gillam J, Upthegrove R, Aldred S, Wood SJ. Role of magnetic resonance spectroscopy in cerebral glutathione quantification for youth mental health: A systematic review. Early Interv Psychiatry 2020; 14:147-162. [PMID: 31148383 PMCID: PMC7065077 DOI: 10.1111/eip.12833] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/27/2019] [Accepted: 04/14/2019] [Indexed: 01/01/2023]
Abstract
AIM Oxidative stress is strongly implicated in many psychiatric disorders, which has resulted in the development of new interventions to attempt to perturb this pathology. A great deal of attention has been paid to glutathione, which is the brain's dominant antioxidant and plays a fundamental role in removing free radicals and other reactive oxygen species. Measurement of glutathione concentration in the brain in vivo can provide information on redox status and potential for oxidative stress to develop. Glutathione might also represent a marker to assess treatment response. METHODS This paper systematically reviews studies that assess glutathione concentration (measured using magnetic resonance spectroscopy) in various mental health conditions. RESULTS There is limited evidence showing altered brain glutathione concentration in mental disorders; the best evidence suggests glutathione is decreased in depression, but is not altered in bipolar disorder. The review then outlines the various methodological options for acquiring glutathione data using spectroscopy. CONCLUSIONS Analysis of the minimum effect size measurable in existing studies indicates that increased number of participants is required to measure subtle but possibly important differences and move the field forward.
Collapse
Affiliation(s)
- Emily Fisher
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamEdgbastonUK
| | - John Gillam
- Orygenthe National Centre of Excellence in Youth Mental HealthMelbourneVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
| | - Rachel Upthegrove
- Institute for Mental HealthUniversity of BirminghamEdgbastonUK
- Department of PsychiatryUniversity of BirminghamBirminghamUK
| | - Sarah Aldred
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamEdgbastonUK
| | - Stephen J. Wood
- Orygenthe National Centre of Excellence in Youth Mental HealthMelbourneVictoriaAustralia
- Centre for Youth Mental HealthUniversity of MelbourneMelbourneVictoriaAustralia
- Institute for Mental HealthUniversity of BirminghamEdgbastonUK
| |
Collapse
|
19
|
Olesen JA, Posselt CM, Poulsen CH, Nordentoft M, Hjorthøj C. Cannabis use disorders may protect against certain disorders of the digestive organs in people with schizophrenia but not in healthy controls. Psychol Med 2020; 50:499-506. [PMID: 30880659 DOI: 10.1017/s0033291719000370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Previous studies have shown a potential for cannabis in disorders of the digestive organs. We aimed to investigate whether cannabis use disorders (CUD) would decrease the risk of incident disorders of the digestive organs, in people with schizophrenia and population controls. METHODS We combined nationwide Danish registers to identify 21 066 cases with schizophrenia and 176 935 sex-and-age-matched controls. Two models were analyzed for the associations between CUD and digestive disorders in time-varying Cox regressions: one adjusted for sex, year of birth, and calendar year; and one further adjusted for alcohol and other substance use disorders and parental education. RESULTS CUD was associated with a decreased risk of developing disorders of gut-brain interaction (e.g. irritable bowel syndrome, dyspepsia, etc.) among cases with schizophrenia (HR = 0.84, 95% CI 0.74-0.94, p = 0.003). CUD was associated with decreased risk of inflammatory bowel disease (HR = 0.70, 95% CI 0.49-0.99, p = 0.045) in the basically adjusted model, dropping just below statistical significance in the fully adjusted model (HR = 0.71, 95% CI 0.48-1.03, p = 0.07). CUD displayed a tendency toward a decreased risk of serious disorders of the digestive organs among cases with schizophrenia (HR = 0.89, 95% CI 0.77-1.02, p = 0.09) in the fully adjusted model. No associations were observed among controls. CONCLUSIONS In people with schizophrenia, but not in controls, CUD is associated with decreased risk of disorders of gut-brain interaction and inflammatory bowel disease, and possibly other serious disorders of the digestive organs. Our findings could lead to new targets for treatment and prevention of disorders of the digestive organs.
Collapse
Affiliation(s)
- Julie Aamand Olesen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
- University of Copenhagen, The Research Unit for General Practice, Copenhagen, Denmark
| | - Christine Merrild Posselt
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
| | - Chalotte Heinsvig Poulsen
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
| | - Merete Nordentoft
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
| | - Carsten Hjorthøj
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPsych, Aarhus and Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Section of Epidemiology, Copenhagen, Denmark
| |
Collapse
|
20
|
Haass-Koffler CL, Schank JR. Translational Research in the Neurobiological Mechanisms of Alcohol and Substance Use Disorders. Neurotherapeutics 2020; 17:1-3. [PMID: 31965552 PMCID: PMC7007449 DOI: 10.1007/s13311-020-00833-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Carolina L Haass-Koffler
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Providence, USA.
- Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, USA.
- Section on Clinical Psychoneuroendocrinology and Neuropsychopharmacology, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, MD, USA.
| | - Jesse R Schank
- Department of Physiology and Pharmacology, University of Georgia, Athens, Georgia
| |
Collapse
|
21
|
Vázquez-Bourgon J, Ortiz-García de la Foz V, Suarez-Pereira I, Iruzubieta P, Arias-Loste MT, Setién-Suero E, Ayesa-Arriola R, Gómez-Revuelta M, Crespo J, Crespo Facorro B. Cannabis consumption and non-alcoholic fatty liver disease. A three years longitudinal study in first episode non-affective psychosis patients. Prog Neuropsychopharmacol Biol Psychiatry 2019; 95:109677. [PMID: 31228640 DOI: 10.1016/j.pnpbp.2019.109677] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/28/2019] [Accepted: 06/17/2019] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Increased incidence of obesity and excess weight lead to an increased incidence of non-alcoholic fatty liver disease (NAFLD). Recent evidence indicates a protective effect of cannabis consumption on weight gain and related metabolic alterations in psychosis patients. Overall, patients are at greater risk of presenting fatty diseases, such as NAFLD, partly due to lipid and glycemic metabolic disturbances. However, there are no previous studies on the likely effect of cannabis on liver steatosis. We aimed to explore if cannabis consumption had an effect on hepatic steatosis, in a sample of first-episode (FEP) non-affective psychosis. MATERIAL AND METHODS A total of 390 patients were evaluated at baseline and after 3 years of initiating the antipsychotic treatment. Anthropometric measurements and liver, lipid, and glycemic parameters were obtained at both time points. All but 6.7% of patients were drug-naïve at entry, and they self-reported their cannabis use at both time points. Liver steatosis and fibrosis were evaluated through validated clinical scores (Fatty Liver Index [FLI], Fibrosis-4 [FIB-4], and NAFLD). RESULTS At 3-year follow-up, cannabis users presented significantly lower FLI scores than non-users (F = 13.874; p < .001). Moreover, cannabis users less frequently met the criteria for liver steatosis than non-users (X2 = 7.97, p = .019). Longitudinally, patients maintaining cannabis consumption after 3 years presented the smallest increment in FLI over time, which was significantly smaller than the increment in FLI presented by discontinuers (p = .022) and never-users (p = .016). No differences were seen in fibrosis scores associated with cannabis. CONCLUSIONS Cannabis consumption may produce a protective effect against liver steatosis in psychosis, probably through the modulation of antipsychotic-induced weight gain.
Collapse
Affiliation(s)
- Javier Vázquez-Bourgon
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
| | - Víctor Ortiz-García de la Foz
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain.
| | - Irene Suarez-Pereira
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Neuropsychopharmacology & Psychobiology Research Group, University of Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz, INiBICA, Edificio "Andrés Segovia", Cádiz, Spain.
| | - Paula Iruzubieta
- Gastroenterology and Hepatology Unit, University Hospital de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
| | - María Teresa Arias-Loste
- Gastroenterology and Hepatology Unit, University Hospital de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
| | - Esther Setién-Suero
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
| | - Rosa Ayesa-Arriola
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
| | - Marcos Gómez-Revuelta
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
| | - Javier Crespo
- Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; Gastroenterology and Hepatology Unit, University Hospital de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain.
| | - Benedicto Crespo Facorro
- Department of Psychiatry, University Hospital Marqués de Valdecilla, Instituto de Investigación Sanitaria Valdecilla, Santander, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.
| |
Collapse
|
22
|
de la Salle S, Inyang L, Impey D, Smith D, Choueiry J, Nelson R, Heera J, Baddeley A, Ilivitsky V, Knott V. Acute separate and combined effects of cannabinoid and nicotinic receptor agonists on MMN-indexed auditory deviance detection in healthy humans. Pharmacol Biochem Behav 2019; 184:172739. [PMID: 31283908 DOI: 10.1016/j.pbb.2019.172739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 12/21/2022]
Abstract
The high prevalence of concomitant cannabis and nicotine use has implications for sensory and cognitive processing. While nicotine tends to enhance function in these domains, cannabis use has been associated with both sensory and cognitive impairments, though the underlying mechanisms are unclear. Additionally, the interaction of the nicotinic (nAChR) and cannabinoid (CB1) receptor systems has received limited study in terms of sensory/cognitive processes. This study involving healthy volunteers assessed the acute separate and combined effects of nabilone (a CB1 agonist) and nicotine on sensory processing as assessed by auditory deviance detection and indexed by the mismatch negativity (MMN) event-related potential. It was hypothesized that nabilone would impair auditory discriminability as shown by diminished MMN amplitudes, but not when administered in combination with nicotine. 20 male non-smokers and non-cannabis-users were assessed using a 5-stimulus 'optimal' multi-feature MMN paradigm within a randomized, placebo controlled design (placebo; nabilone [0.5 mg]; nicotine [6 mg]; and nicotine + nabilone). Treatment effects were region- and deviant-dependent. At the temporal regions (mastoid sites), MMN was reduced by nabilone and nicotine separately, whereas co-administration resulted in no impairment. At the frontal region, MMN was enhanced by co-administration of nicotine and nabilone, with no MMN effects being found with separate treatment. These neural effects have relevance for sensory/cognitive processes influenced by separate and simultaneous use of cannabis and tobacco and may have treatment implications for disorders associated with sensory dysfunction and impairments in endocannabinoid and nicotinic cholinergic neurotransmission.
Collapse
Affiliation(s)
- Sara de la Salle
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Lawrence Inyang
- Interdisciplinary Sciences, Carleton University, Ottawa, ON, Canada
| | - Danielle Impey
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Dylan Smith
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Joelle Choueiry
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Renee Nelson
- Biomedical Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Jasmit Heera
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Ashley Baddeley
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Vadim Ilivitsky
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Verner Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
| |
Collapse
|
23
|
Hansen H, Stige SH, Moltu C, Johannessen JO, Joa I, Dybvig S, Veseth M. "We all have a responsibility": a narrative discourse analysis of an information campaign targeting help-seeking in first episode psychosis. Int J Ment Health Syst 2019; 13:32. [PMID: 31086563 PMCID: PMC6507175 DOI: 10.1186/s13033-019-0289-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/30/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Intervening at an early stage of psychosis improves the chances of recovery from first-episode psychosis. However, people who are experiencing distress and early psychotic symptoms generally seem to delay seeking help. Therefore, multifaced information campaigns targeting help-seeking behavior of potential patients and their network are considered important tools within early detection and intervention strategies. In this study, we aimed to explore which discursive meaning content, including roles and actors, such information campaigns build on and construct. Our intention was not to provide objective answers, but to contribute to a discursive debate about potential conflicts in messages conveyed in such campaigns. METHODS A broad sample of information material utilized by TIPS Stavanger University Hospital (Norway) was examined. The material consisted of posters, booklets and brochures, newspaper ads, Facebook ads, and TIPS Info's website, representing various campaigns from 1996 to April 2018. A narrative discursive approach was applied at an epistemological level. At a practical level, a team-based thematic analysis was utilized to identify patterns across data. RESULTS Diversity and several changes in strategy were recognized throughout the information material. Furthermore, three main themes and four subthemes were found to constitute the meaning content built in the information campaigns: knowledge is key; (almost) an illness among illnesses; and we all have a responsibility (comprising of the subthemes; to respond quickly; to step in; to provide an answer; and to tag along). CONCLUSION Our findings pointed to common dilemmas in mental health services: How to combine professional expert knowledge with collaborative practices that emphasize shared decision-making and active roles on behalf of patients? How to combine a focus on symptoms and illness and simultaneously express the importance of addressing patients' recourses? And how can we ask for societal responsibility in help-seeking when professionals are placed in expert positions which may not be optimal for dialogue with potential patients or their network? We discuss whether highlighting practices with more weight on resources and active roles for patients and their surroundings in information campaigns could promote earlier help-seeking.
Collapse
Affiliation(s)
- Hege Hansen
- Department of Welfare and Participation, Western Norway University of Applied Sciences, Postbox 7030, 5020 Bergen, Norway
| | | | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
| | - Jan Olav Johannessen
- TIPS-Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Network for Medical Sciences, Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Inge Joa
- TIPS-Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
- Network for Medical Sciences, Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Sveinung Dybvig
- TIPS-Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | - Marius Veseth
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| |
Collapse
|
24
|
Vázquez-Bourgon J, Setién-Suero E, Pilar-Cuéllar F, Romero-Jiménez R, Ortiz-García de la Foz V, Castro E, Crespo-Facorro B. Effect of cannabis on weight and metabolism in first-episode non-affective psychosis: Results from a three-year longitudinal study. J Psychopharmacol 2019; 33:284-294. [PMID: 30702972 DOI: 10.1177/0269881118822173] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cannabis smoking is highly prevalent among patients with psychotic disorders. Its use has been found to be related to clinical characteristics and the prognosis of the disorder. Recent evidence indicates a protective effect of cannabis on weight gain and related metabolic alterations. However, there are no previous studies on the long-term longitudinal effects of cannabis on first-episode drug-naïve patients, which would thereby avoid the confounding effects of chronicity and previous treatment exposure. We aimed to explore the effect of cannabis smoking on weight and lipid/glycaemic metabolic measures in a sample of first-episode non-affective psychosis patients. METHOD Anthropometric measurements and glycaemic and lipid parameters were obtained at baseline and three years after initiation of treatment. Patients self-reported their cannabis use at both time points. To explore the longitudinal effect of cannabis, patients were divided into three groups: continuers, discontinuers and non-users. RESULTS Cannabis users at baseline presented a lower weight ( F=14.85, p<0.001), body mass index ( F=13.14, p<0.001), total cholesterol ( F=4.85, p=0.028) and low-density lipoprotein-cholesterol ( F=6.26, p=0.013) compared to non-users. These differences were also observed after three years: weight ( F=8.07, p=0.005), body mass index ( F=4.66, p=0.032) and low-density lipoprotein-cholesterol ( F=3.91, p=0.049). Moreover, those patients discontinuing cannabis use presented a higher increase in weight ( F=2.98, p=0.052), body mass index ( F=2.73, p=0.067) and triglyceride-high-density lipoprotein ratio ( F=2.72, p=0.067) than the 'non-users' and 'continuers'. CONCLUSIONS The study suggests that cannabis use may produce a protective effect against weight gain and related metabolic alterations in psychosis. However, these results need to be replicated in a larger sample size.
Collapse
Affiliation(s)
- Javier Vázquez-Bourgon
- 1 Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain.,3 Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain
| | - Esther Setién-Suero
- 1 Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain.,3 Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain
| | - Fuencisla Pilar-Cuéllar
- 2 Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Santander, Spain.,4 Department of Physiology and Pharmacology, University of Cantabria, Santander, Spain.,5 Instituto de Biomedicina y Biotecnología de Cantabria, University of Cantabria-Consejo Superior de Investigaciones Científicas (CSIC)-Sociedad para el Desarrollo de Cantabria (SODERCAN), Santander, Spain
| | - Rodrigo Romero-Jiménez
- 1 Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Víctor Ortiz-García de la Foz
- 1 Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain.,2 Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Santander, Spain
| | - Elena Castro
- 2 Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Santander, Spain.,4 Department of Physiology and Pharmacology, University of Cantabria, Santander, Spain.,5 Instituto de Biomedicina y Biotecnología de Cantabria, University of Cantabria-Consejo Superior de Investigaciones Científicas (CSIC)-Sociedad para el Desarrollo de Cantabria (SODERCAN), Santander, Spain
| | - Benedicto Crespo-Facorro
- 1 Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain.,3 Department of Medicine and Psychiatry, University of Cantabria, Santander, Spain
| |
Collapse
|
25
|
Khachikian T, Cameron LD. Perceptions and Beliefs Motivating Parental Discussions of Marijuana Use With Children. Ann Behav Med 2019; 53:169-179. [PMID: 29750410 DOI: 10.1093/abm/kay027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Parents can influence their children's use of marijuana and other substances through targeted parent-child discussions. Little is known about what factors motivate parents' decisions to discuss marijuana use with their children. Purpose Guided by an elaborated prototype-willingness model, we tested hypotheses that: (a) parental perceived risk of harms and negative prototypes of youth who use marijuana positively predict worry about their child using marijuana; (b) higher perceived risk and worry predict higher intentions to discuss marijuana use with one's child; (c) negative prototypes and worry positively predict willingness to have discussions; and (d) higher intentions and willingness predicts having discussions. Method We administered a longitudinal survey to 499 American parents of youth ages 10 to 17 assessing risk perceptions, prototypes, worry, discussion intentions, and willingness. One month later, 409 participants completed another survey assessing whether they had discussed marijuana use with their child. Results At follow-up, 40% of participants reported having marijuana use discussions in the previous month. Structural-equation modeling revealed that perceived risks and negative prototypes positively predicted worry about their child using marijuana. Worry positively predicted intentions and willingness to discuss marijuana use with children. Worry mediated the relationship between perceived risks and intentions, but not the relationship between prototypes and willingness. Intentions positively predicted likelihood of marijuana use discussions, whereas willingness did not. Conclusions These findings support most predictions of the adapted model and identify cognitive and affective factors that could be targeted in health communications promoting parental discussions of marijuana use with children.
Collapse
Affiliation(s)
- Tenie Khachikian
- Psychological Sciences, University of California, Merced, Merced, CA, USA
| | - Linda D Cameron
- Psychological Sciences, University of California, Merced, Merced, CA, USA
| |
Collapse
|
26
|
Williams SR, Agapoff JR, Lu BY, Hishinuma ES, Lee M. The frequency of hospitalizations and length of stay differences between schizophrenic and schizoaffective disorder inpatients who use cannabis. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2018.1489013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Steven R. Williams
- Department of Psychiatry, University of Hawai‘i at Mānoa, Honolulu, HI, USA
| | - James R. Agapoff
- Department of Psychiatry, University of Hawai‘i at Mānoa, Honolulu, HI, USA
| | - Brett Y. Lu
- Department of Psychiatry, University of Hawai‘i at Mānoa, Honolulu, HI, USA
| | - Earl S. Hishinuma
- Department of Psychiatry, University of Hawai‘i at Mānoa, Honolulu, HI, USA
| | - Mark Lee
- Weill Cornell Medicine, New York, NY, USA
| |
Collapse
|
27
|
Waterreus A, Di Prinzio P, Martin-Iverson MT, Morgan VA. Sex differences in the cardiometabolic health of cannabis users with a psychotic illness. Drug Alcohol Depend 2019; 194:447-452. [PMID: 30502546 DOI: 10.1016/j.drugalcdep.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/22/2018] [Accepted: 11/04/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Growing evidence shows cannabis use is associated with lower rates of metabolic dysregulation. Despite cannabis impacting each sex differently, few studies have examined the metabolic profile of male and female cannabis users separately. Our aim was to investigate sex differences in the impact of cannabis use on metabolic syndrome in adults with psychotic illness. METHOD Data from 1078 men and 735 women interviewed in the second Australian national survey of psychosis were analyzed using multiple logistic regression to model separately, for each sex, the influence of no, occasional and frequent past-year cannabis use on metabolic syndrome, adjusting for potential covariates including antipsychotic medication, smoking, and physical activity. RESULTS The proportion of women and men with metabolic syndrome was 58.1% and 57.6% respectively. Unadjusted analyses showed frequent cannabis use was associated with significantly lower odds of metabolic syndrome for both sexes. In adjusted analyses, the association between metabolic syndrome and frequent cannabis use remained significant for men (AOR = 0.49, 95% CI = 0.31-0.78), but not for women (AOR = 0.68, 95% CI = 0.37-1.24). Frequent cannabis use was associated with lower odds of abdominal obesity, hypertension and elevated triglyceride levels in men only. CONCLUSIONS The differences we found suggest cannabinoid regulation of energy balance may be sex-dependent and highlight the importance of examining cannabis use in men and women separately. At the same time, the negative association between cannabis and psychosis onset and relapse should not be dismissed.
Collapse
Affiliation(s)
- Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia.
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| | - Mathew T Martin-Iverson
- Pharmacology, School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia; Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia
| |
Collapse
|
28
|
Campbell-Williams KA, Oshi DC, Whitehorne-Smith P, Abel WD. Sociodemographic and clinical factors associated with comorbid hazardous cannabis use among psychiatric patients at a tertiary hospital in Jamaica. JOURNAL OF SUBSTANCE USE 2018. [DOI: 10.1080/14659891.2018.1552729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Kayan A. Campbell-Williams
- Department of Community Health and Psychiatry, Faculty of Medical Sciences, Mona Campus, Kingston, Jamaica
| | - Daniel C. Oshi
- Department of Community Health and Psychiatry, Faculty of Medical Sciences, Mona Campus, Kingston, Jamaica
| | - Patrice Whitehorne-Smith
- Department of Community Health and Psychiatry, Faculty of Medical Sciences, Mona Campus, Kingston, Jamaica
| | - Wendel D. Abel
- Department of Community Health and Psychiatry, Faculty of Medical Sciences, Mona Campus, Kingston, Jamaica
| |
Collapse
|
29
|
Moulin V, Alameda L, Baumann PS, Gholamrezaee MM, Palix J, Gasser J, Conus P. [Three clinical risk profiles of violent behavior in a cohort of early psychosis patients]. L'ENCEPHALE 2018; 45:214-220. [PMID: 30446287 DOI: 10.1016/j.encep.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 08/21/2018] [Accepted: 08/26/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study aims to determine whether it is possible to identify clinical profiles at risk of violent behaviors (VB) in the early phase of psychotic disorders, on the basis of the main dynamic psychopathological risk factors and describe characteristics of the groups with highest levels of violent behaviors. METHOD A total of 265 patients, aged 18 to 35, treated at the Treatment and early Intervention in Psychosis Program (TIPP-Lausanne), a specialized early psychosis program, were included in this study. We conducted a latent-class analysis and a discriminative analysis on the basis of the main dynamic VB risk factors: substance use disorder, impulsivity, positive symptoms, insight, aggression, hostility, anger, emotional instability and adherence to treatment. These factors were evaluated by specialized scales and on the basis of the Positive and Negative Syndrome Scale (PANSS). VB were restricted to physical aggression against people, defined as "serious violence". They were assessed on the basis of a questionnaire listing violent offenses (Swiss Criminal Code) and VB such as assault and battery, information through the forensic psychiatric services and on the basis of the Staff Observation Aggression Scale (SOAS-R scale) during inpatient treatment phase. RESULTS Four heterogeneous subgroups were identified with respect to the studied clinical characteristics, including two groups with high rates of VB. The first group, comprising 46% of patients with VB, is distinguished by the prevalence of a range of dimensions related to hostility, impulsivity and emotional instability, associated with high levels of substance abuse and positive symptoms. These clinical dimensions are very significant at the statistical level, since they explain 70% of the construction of subgroups (discriminant analysis). The second group with 37% of patients with VB, is characterized by a lack of insight, lack of adherence to treatment and substance use. These two clinical profiles could increase the impairment of cognitive, functional and relational abilities and contribute to the development of VB in this early phase of psychosis. The third subgroup, with a violent behaviors rate of 28.6%, is distinguished by its high proportion of diagnoses of substance abuse (100%) and women (54%). A last subgroup of patients, the largest quantitatively, has a low proportion of VB (15%) and the lowest levels on the studied factors, suggesting that the majority of patients with this profile commit few VB. CONCLUSION Our results show that it is possible to identify groups at risk of violent behaviors during the early phase of psychosis on the basis of clinical characteristics that may evolve and therefore be the focus of preventive care. These results highlight the need to target substance use, impulsivity and lack of insight at follow-up in order to prevent VB.
Collapse
Affiliation(s)
- V Moulin
- Unité de recherche en psychiatrie et psychologie légales, institut de psychiatrie légale, département de psychiatrie du centre hospitalier universitaire Vaudois (CHUV), site de Cery, bâtiment Les Cèdres, 1008 Prilly-Lausanne, Suisse.
| | - L Alameda
- Service de psychiatrie générale, centre de neuroscience psychiatrique, département de psychiatrie du centre hospitalier universitaire Vaudois (CHUV), Lausanne, Suisse; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - P S Baumann
- Service de psychiatrie générale, département de psychiatrie du centre hospitalier universitaire Vaudois (CHUV), Lausanne, Suisse
| | - M M Gholamrezaee
- Centre d'épidémiologie psychiatrique et psychopathologie, département de psychiatrie du centre hospitalier universitaire Vaudois (CHUV), Lausanne, Suisse
| | - J Palix
- Unité de recherche en psychiatrie et psychologie légales, institut de psychiatrie légale, département de psychiatrie du centre hospitalier universitaire Vaudois (CHUV), site de Cery, bâtiment Les Cèdres, 1008 Prilly-Lausanne, Suisse
| | - J Gasser
- Institut de psychiatrie légale, département de psychiatrie du centre hospitalier universitaire Vaudois (CHUV), Lausanne, Suisse
| | - P Conus
- Service de psychiatrie générale, département de psychiatrie du centre hospitalier universitaire Vaudois (CHUV), Lausanne, Suisse
| |
Collapse
|
30
|
van Amsterdam J, Vervloet J, de Weert G, Buwalda VJA, Goudriaan AE, van den Brink W. Acceptance of pharmaceutical cannabis substitution by cannabis using patients with schizophrenia. Harm Reduct J 2018; 15:47. [PMID: 30236118 PMCID: PMC6149068 DOI: 10.1186/s12954-018-0253-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/04/2018] [Indexed: 11/13/2022] Open
Abstract
Background Cannabis-smoking patients with a psychotic disorder have poorer disease outcomes than non-cannabis-smoking patients with poorest outcomes in patients smoking high-potency cannabis (HPC) containing high Δ9-tetrahydrocannabinol (THC) and low cannabidiol (CBD). Quitting cannabis smoking or substitution of HPC by cannabis variants containing less THC and/or more CBD may benefit these patients. The present study explores whether daily HPC-smoking patients with schizophrenia accept smoking such variants. Methods Twelve male patients were asked to smoke on six different occasions one joint: on two occasions, the cannabis they routinely smoke (HPC; not blind), and blind in random order; on two occasions, cannabis containing low THC and no CBD; and on two occasions, cannabis containing low THC and high CBD. Results Both substitute variants were appreciated, but patients preferred the HPC they usually smoked. The effect of the low THC/high CBD variant was reported by 32% to be too short and by 36% to be not strong enough, whereas this was reported by 5% and 64%, respectively, for the low THC cannabis variant. Conclusions Based on these findings, a larger and longer study on the efficacy of cannabis substitution treatment in HPC-smoking patients with schizophrenia seems feasible and should be considered. Trial registration 2014-005540-17NL. Registered 22 October 2014, 2014-005540-17NL 20141215 CTA.xml
Collapse
Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | | | - Gerdien de Weert
- Jellinek-Arkin, P.O. Box 75848, 1070 AV, Amsterdam, The Netherlands
| | | | - Anna E Goudriaan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.,Jellinek-Arkin, P.O. Box 75848, 1070 AV, Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| |
Collapse
|
31
|
Scheffler F, Kilian S, Chiliza B, Asmal L, Phahladira L, du Plessis S, Kidd M, Murray RM, Di Forti M, Seedat S, Emsley R. Effects of cannabis use on body mass, fasting glucose and lipids during the first 12 months of treatment in schizophrenia spectrum disorders. Schizophr Res 2018. [PMID: 29519756 DOI: 10.1016/j.schres.2018.02.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
While acute cannabis use stimulates appetite, general population studies suggest that chronic use is associated with reduced risk of obesity and other cardiometabolic risk factors. In this study we investigated changes in body mass index (BMI), fasting blood glucose and lipids, and rates of metabolic syndrome risk factors in cannabis users vs. non-users in 109 minimally treated patients with first-episode schizophrenia, schizophreniform or schizo-affective disorder who were treated according to a standardized treatment regime with depot antipsychotic medication over 12 months. Participants underwent repeated urine toxicology tests for cannabis and those testing positive at any time during the study (n = 40), were compared with those who tested negative at all time points (n = 69). There was a significant group*time interaction effect (p = 0.002) with the cannabis negative group showing a greater increase in BMI than the cannabis positive group, after adjusting for age, sex, methamphetamine use and modal dose of antipsychotic. There were no group*time interaction effects for fasting blood glucose or lipids. Post hoc tests indicated significant increases in fasting blood glucose and triglycerides and a decrease in high-density lipoprotein cholesterol for the cannabis negative group, with no significant changes in the cannabis positive group. Rates of metabolic syndrome did not differ significantly between groups, although more cannabis negative patients had elevated waist-circumference at endpoint (p = 0.003). It may be that chronic cannabis use directly suppresses appetite, thereby preventing weight gain in users. However, other indirect effects such as dietary neglect and smoking may be contributory and could explain our findings.
Collapse
Affiliation(s)
- F Scheffler
- Department of Psychiatry, Stellenbosch University, South Africa.
| | - S Kilian
- Department of Psychiatry, Stellenbosch University, South Africa
| | - B Chiliza
- Centre for Statistical Consultation, Stellenbosch University, South Africa
| | - L Asmal
- Department of Psychiatry, Stellenbosch University, South Africa
| | - L Phahladira
- Department of Psychiatry, Stellenbosch University, South Africa
| | - S du Plessis
- Department of Psychiatry, Stellenbosch University, South Africa
| | - M Kidd
- Centre for Statistical Consultation, Stellenbosch University, South Africa
| | - R M Murray
- Department of Psychiatry, King's College, London, United Kingdom
| | - M Di Forti
- Department of Psychiatry, King's College, London, United Kingdom
| | - S Seedat
- Department of Psychiatry, Stellenbosch University, South Africa
| | - R Emsley
- Department of Psychiatry, Stellenbosch University, South Africa
| |
Collapse
|
32
|
Secci ME, Mascia P, Sagheddu C, Beggiato S, Melis M, Borelli AC, Tomasini MC, Panlilio LV, Schindler CW, Tanda G, Ferré S, Bradberry CW, Ferraro L, Pistis M, Goldberg SR, Schwarcz R, Justinova Z. Astrocytic Mechanisms Involving Kynurenic Acid Control Δ 9-Tetrahydrocannabinol-Induced Increases in Glutamate Release in Brain Reward-Processing Areas. Mol Neurobiol 2018; 56:3563-3575. [PMID: 30151725 DOI: 10.1007/s12035-018-1319-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/14/2018] [Indexed: 12/27/2022]
Abstract
The reinforcing effects of Δ9-tetrahydrocannabinol (THC) in rats and monkeys, and the reinforcement-related dopamine-releasing effects of THC in rats, can be attenuated by increasing endogenous levels of kynurenic acid (KYNA) through systemic administration of the kynurenine 3-monooxygenase inhibitor, Ro 61-8048. KYNA is a negative allosteric modulator of α7 nicotinic acetylcholine receptors (α7nAChRs) and is synthesized and released by astroglia, which express functional α7nAChRs and cannabinoid CB1 receptors (CB1Rs). Here, we tested whether these presumed KYNA autoreceptors (α7nAChRs) and CB1Rs regulate glutamate release. We used in vivo microdialysis and electrophysiology in rats, RNAscope in situ hybridization in brain slices, and primary culture of rat cortical astrocytes. Acute systemic administration of THC increased extracellular levels of glutamate in the nucleus accumbens shell (NAcS), ventral tegmental area (VTA), and medial prefrontal cortex (mPFC). THC also reduced extracellular levels of KYNA in the NAcS. These THC effects were prevented by administration of Ro 61-8048 or the CB1R antagonist, rimonabant. THC increased the firing activity of glutamatergic pyramidal neurons projecting from the mPFC to the NAcS or to the VTA in vivo. These effects were averted by pretreatment with Ro 61-8048. In vitro, THC elicited glutamate release from cortical astrocytes (on which we demonstrated co-localization of the CB1Rs and α7nAChR mRNAs), and this effect was prevented by KYNA and rimonabant. These results suggest a key role of astrocytes in interactions between the endocannabinoid system, kynurenine pathway, and glutamatergic neurotransmission, with ramifications for the pathophysiology and treatment of psychiatric and neurodegenerative diseases.
Collapse
Affiliation(s)
- Maria E Secci
- Behavioral Neuroscience Research Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Baltimore, MD, 21224, USA
| | - Paola Mascia
- Behavioral Neuroscience Research Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Baltimore, MD, 21224, USA
| | - Claudia Sagheddu
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Sarah Beggiato
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Miriam Melis
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Andrea C Borelli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Maria C Tomasini
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Leigh V Panlilio
- Behavioral Neuroscience Research Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Baltimore, MD, 21224, USA
| | - Charles W Schindler
- Behavioral Neuroscience Research Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Baltimore, MD, 21224, USA
| | - Gianluigi Tanda
- Molecular Targets and Medications Discovery Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Sergi Ferré
- Molecular Targets and Medications Discovery Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Charles W Bradberry
- Behavioral Neuroscience Research Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Baltimore, MD, 21224, USA
| | - Luca Ferraro
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Marco Pistis
- Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
- National Research Council of Italy (CNR), Section of Cagliari, Neuroscience Institute, Monserrato, Italy
| | - Steven R Goldberg
- Behavioral Neuroscience Research Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Baltimore, MD, 21224, USA
| | - Robert Schwarcz
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Zuzana Justinova
- Behavioral Neuroscience Research Branch, Intramural Research Program, Department of Health and Human Services, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd., Baltimore, MD, 21224, USA.
| |
Collapse
|
33
|
Riess P, Sher L. First break psychosis in a young military veteran with cannabis use disorder: an educational case report. Int J Adolesc Med Health 2018; 32:ijamh-2017-0140. [PMID: 30118435 DOI: 10.1515/ijamh-2017-0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 02/19/2018] [Indexed: 06/08/2023]
Abstract
Psychotropic management of a first psychotic break is challenging for many psychiatrists. The literature shows that the use of cannabis is widespread in psychotic individuals. The literature also points to young males being most at risk for substance abuse. Studies also show that obstructive sleep apnea and the stress of the military lifestyle contribute to the development of psychosis. Here, we present a case study of a young non-combat veteran with a medical history of obstructive sleep apnea who presented to the Emergency Department of a Veteran's Affairs hospital with symptoms consistent with a first psychotic break. On routine admission laboratory work, his urine toxicology screen was positive for cannabis. Given the widespread use of cannabis in individuals with psychosis, we suggest that it plays an important role in the regulation of psychosis and behavior.
Collapse
Affiliation(s)
- Paulina Riess
- Department of Psychiatry, Bronx Lebanon Hospital Center, 1276 Fulton Ave, Bronx, NY 10456, USA, Phone: +1-917-698-0653
| | - Leo Sher
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
34
|
Abstract
The evolving legal cannabis landscape in the US continues to present novel regulatory challenges that necessitate the development of a Cannabis Regulatory Science. Two specific issues of concern within Cannabis Regulatory Science are (1) the impact that cannabis use has on the incidence, prevalence, and severity of mental disorders, and (2) how cannabis laws and regulations modify this impact. This paper first provides several conceptual points that are useful for evaluating the relationship between cannabis use and mental disorders. Second, it selectively reviews and comments on data relevant to the relationship between cannabis use and depression, several forms of anxiety, post-traumatic stress disorder, schizophrenia, and bipolar disorder. Next, regulatory and public health parallels between the nascent cannabis industry and the pharmaceutical, tobacco, and alcohol industries are discussed. The focus is on specific types of industry practices that may harm those with or at risk for mental disorders. Recommendations are then offered for legal cannabis regulations that could mitigate this harm. Last, future research goals are discussed for building the field of Cannabis Regulatory Science and addressing the potential negative impact of cannabis on those with mental disorders.
Collapse
Affiliation(s)
- Jacob T. Borodovsky
- Dartmouth Geisel School of Medicine, Center for Technology and Behavioral Health, 46 Centerra Parkway, Lebanon, NH 03766, United States,The Dartmouth Institute for Health Policy and Clinical Practice, 74 College St. Hanover, NH 03755, United States
| | - Alan J. Budney
- Dartmouth Geisel School of Medicine, Center for Technology and Behavioral Health, 46 Centerra Parkway, Lebanon, NH 03766, United States
| |
Collapse
|
35
|
Antoniades M, Schoeler T, Radua J, Valli I, Allen P, Kempton MJ, McGuire P. Verbal learning and hippocampal dysfunction in schizophrenia: A meta-analysis. Neurosci Biobehav Rev 2018; 86:166-175. [PMID: 29223768 PMCID: PMC5818020 DOI: 10.1016/j.neubiorev.2017.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 10/24/2017] [Accepted: 12/01/2017] [Indexed: 12/19/2022]
Abstract
This meta-analysis summarizes research examining whether deficits in verbal learning are related to bilateral hippocampal volume reductions in patients with or at risk for schizophrenia and in healthy controls. 17 studies with 755 patients with schizophrenia (SCZ), 232 Genetic High Risk (GHR) subjects and 914 healthy controls (HC) were included. Pooled correlation coefficients were calculated between hemisphere (left, right or total) and type of recall (immediate or delayed) for each diagnostic group individually (SCZ, GHR and HC). In SCZ, left and right hippocampal volume positively correlated with immediate (r=0.256, 0.230) and delayed (r=0.132, 0.231) verbal recall. There was also a correlation between total hippocampal volume and delayed recall (r=0.233). None of these correlations were significant in healthy controls. There was however, a positive correlation between left hippocampal volume and immediate recall in the GHR group (r=0.356). The results suggest that hippocampal volume affects immediate and delayed verbal learning capacity in schizophrenia and provides further evidence of hippocampal dysfunction in the pathophysiology of schizophrenia.
Collapse
Affiliation(s)
- Mathilde Antoniades
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
| | - Tabea Schoeler
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Joaquim Radua
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; FIDMAG Germanes Hospitalàries - CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain; Centre for Psychiatric Research and Education, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Isabel Valli
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Paul Allen
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; Department of Psychology, University of Roehampton, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| |
Collapse
|
36
|
Vaessen TSJ, de Jong L, Schäfer AT, Damen T, Uittenboogaard A, Krolinski P, Nwosu CV, Pinckaers FME, Rotee ILM, Smeets APW, Ermiş A, Kennedy JL, Nieman DH, Tiwari A, van Os J, Drukker M. The interaction between cannabis use and the Val158Met polymorphism of the COMT gene in psychosis: A transdiagnostic meta - analysis. PLoS One 2018; 13:e0192658. [PMID: 29444152 PMCID: PMC5812637 DOI: 10.1371/journal.pone.0192658] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 01/26/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Neither environmental nor genetic factors are sufficient to predict the transdiagnostic expression of psychosis. Therefore, analysis of gene-environment interactions may be productive. OBJECTIVE A meta-analysis was performed using papers investigating the interaction between cannabis use and catechol-O-methyl transferase (COMT) polymorphism Val158Met (COMTVal158Met). DATA SOURCES PubMed, Embase, PsychInfo. STUDY ELIGIBILITY CRITERIA All observational studies assessing the interaction between COMTVal158Met and cannabis with any psychosis or psychotic symptoms measure as an outcome. STUDY APPRAISAL AND SYNTHESIS METHODS A meta-analysis was performed using the Meta-analysis of Observational Studies in Epidemiology guidelines and forest plots were generated. Thirteen articles met the selection criteria: 7 clinical studies using a case-only design, 3 clinical studies with a dichotomous outcome, and 3 studies analysing a continuous outcome of psychotic symptoms below the threshold of psychotic disorder. The three study types were analysed separately. Validity of the included studies was assessed using "A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions". RESULTS For case-only studies, a significant interaction was found between cannabis use and COMTVal158Met, with an OR of 1.45 (95% Confidence Interval = 1.05-2.00; Met/Met as the risk genotype). However, there was no evidence for interaction in either the studies including dichotomous outcomes (B = -0.51, 95% Confidence Interval -1.72, 0.70) or the studies including continuous outcomes (B = -0.04 95% Confidence Interval -0.16-0.08). LIMITATION A substantial part of the included studies used the case-only design, which has lower validity and tends to overestimate true effects. CONCLUSION The interaction term between cannabis use and COMTVal158Met was only statistically significant in the case-only studies, but not in studies using other clinical or non-clinical psychosis outcomes. Future additional high quality studies might change current perspectives, yet currently evidence for the interaction remains unconvincing.
Collapse
Affiliation(s)
| | - Lea de Jong
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Annika Theresia Schäfer
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Thomas Damen
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Aniek Uittenboogaard
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Pauline Krolinski
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Chinyere Vicky Nwosu
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Iris Leah Marije Rotee
- Student Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | | | - Ayşegül Ermiş
- Department of Psychiatry, Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Istanbul, Turkey
| | - James L. Kennedy
- Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Dorien H. Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, the Netherlands
| | - Arun Tiwari
- Neurogenetics Section, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Jim van Os
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
- King's College London, King's Health Partners Department of Psychosis Studies; Institute of Psychiatry, London, United Kingdom
| | - Marjan Drukker
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- * E-mail:
| |
Collapse
|
37
|
Lally J, Higaya EE, Nisar Z, Bainbridge E, Hallahan B. Prevalence study of head shop drug usage in mental health services. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/pb.bp.111.038315] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and methodTo examine the prevalence of head shop drug usage in individuals attending a range of adult mental health services. We examined the effect of head shop drug usage on the mental state of individuals with a range of mental health disorders. Clinical data were obtained from 608 consecutively reviewed individuals attending adult mental health services in relation to their use of head shop and psychoactive drugs and the putative effects of head shop drugs on their mental state.ResultsThe prevalence of head shop drug use was 13% (n= 78), with a higher prevalence of usage noted in individuals younger than 35 years of age (25%). A large proportion of individuals (n= 41, 54%) reported adverse effects of these agents on their mental state, with psychotic symptoms being the most prevalent.Clinical implicationsHead shop drug usage was associated with a reported deleterious effect on mental state, which was particularly evident for individuals with a history of psychosis.
Collapse
|
38
|
Abstract
Cannabis use is more common among people with severe mental illness than in the general population. It has detrimental effects on the course of the illness, physical health and social life of users, as well as being a financial burden on health services. It is important to understand why some people with severe mental illness continue to use cannabis, despite experiencing its effects on their condition. This article reviews research on the scale of cannabis use by such patients, the effects on the course of their illness, possible reasons to explain why they use it, and how they can be assessed in clinical settings, as well as providing some assessment tools to measure various characteristics related to cannabis use.
Collapse
|
39
|
Moulin V, Baumann P, Gholamrezaee M, Alameda L, Palix J, Gasser J, Conus P. Cannabis, a Significant Risk Factor for Violent Behavior in the Early Phase Psychosis. Two Patterns of Interaction of Factors Increase the Risk of Violent Behavior: Cannabis Use Disorder and Impulsivity; Cannabis Use Disorder, Lack of Insight and Treatment Adherence. Front Psychiatry 2018; 9:294. [PMID: 30022956 PMCID: PMC6039574 DOI: 10.3389/fpsyt.2018.00294] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/14/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Previous literature suggests that prevalence of cannabis use in the early phase of psychosis is high, and that early psychosis patients are at high-risk for violent behavior. However, the link between cannabis use and violent behavior in early psychosis patients is unclear. We carried out a study on a sample of early psychosis patients, in order to explore the impact of cannabis use on the risk of violent behavior (VB), while taking into account (1) potential confounding factors and, (2) interactions with other dynamic risk factors of VB. Method: In a sample of 265 early psychosis patients, treated at the Treatment and Early Intervention in Psychosis Program (TIPP) in Lausanne, we used logistic regression models to explore the link between various dynamic risk factors of VB [positive symptoms, substance use disorder (drugs including cannabis, alcohol and others drugs), insight, impulsivity, affective instability, and treatment adherence], and VB occurring during treatment. In order to understand hierarchical effects attributable to the combinations of risk factors on VB we conducted a Classification and Regression Tree (CART). Results: Our results show that cannabis use disorder is a risk factor for VB. The associations among risk factors suggest the presence of two patient profiles with an increased rate of VB: the first is composed of patients with cannabis use disorder and impulsivity, and the second of patients combining cannabis use disorder, absence of insight and non-adherence to treatment. The results also show the moderating role of insight and adherence to treatment on the rate of VB in patients with cannabis use disorder. Conclusion: This study suggests that cannabis use disorder is a significant risk factor for VB amongst early psychosis patients, particularly when combined with either impulsivity, lack of insight and non-adherence to treatment. These results suggest that preventive strategies could be developed on the basis of such patient profiles.
Collapse
Affiliation(s)
- Valerie Moulin
- Unit for Research in Legal Psychiatry and Psychology, Department of Psychiatry, Institute of Forensic Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Lausanne, Switzerland
| | - Philipp Baumann
- Service of General Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Mehdi Gholamrezaee
- Department of Psychiatry, Center for Psychiatric Epidemiology and Psychopathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Unit for Research in Schizophrenia, Departement of Psychiatry, Center for Psychiatric Neuroscience and Service of General Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Lausanne, Switzerland
| | - Julie Palix
- Unit for Research in Legal Psychiatry and Psychology, Department of Psychiatry, Institute of Forensic Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Lausanne, Switzerland
| | - Jacques Gasser
- Unit for Research in Legal Psychiatry and Psychology, Department of Psychiatry, Institute of Forensic Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne University Hospital, Lausanne, Switzerland
| | - Philippe Conus
- Service of General Psychiatry, Department of Psychiatry, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| |
Collapse
|
40
|
Abstract
A major factor associated with poor prognostic outcome after a first psychotic break is cannabis misuse, which is prevalent in schizophrenia and particularly common in individuals with recent-onset psychosis. Behavioral interventions aimed at reducing cannabis use have been unsuccessful in this population. Cannabidiol (CBD) is a phytocannabinoid found in cannabis, although at low concentrations in modern-day strains. CBD has a broad pharmacological profile, but contrary to ∆9-tetrahydrocannabinol (THC), CBD does not activate CB1 or CB2 receptors and has at most subtle subjective effects. Growing evidence indicates that CBD acts as an antipsychotic and anxiolytic, and several reports suggest neuroprotective effects. Moreover, CBD attenuates THC's detrimental effects, both acutely and chronically, including psychotogenic, anxiogenic, and deleterious cognitive effects. This suggests that CBD may improve the disease trajectory of individuals with early psychosis and comorbid cannabis misuse in particular-a population with currently poor prognostic outcome and no specialized effective intervention.
Collapse
Affiliation(s)
- Britta Hahn
- Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD,To whom correspondence should be addressed; tel: 001-410-402-6112, fax: 001-410-402-7198, e-mail:
| |
Collapse
|
41
|
Waterreus A, Badcock JC, Di Prinzio P, Martin-Iverson M, Morgan VA. The impact of current cannabis use on general cognitive function in people with psychotic illness. Schizophr Res 2017; 190:164-171. [PMID: 28381332 DOI: 10.1016/j.schres.2017.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Despite growing research, it remains unclear if cannabis use is associated with additive cognitive impairment in people with psychotic illness and whether exposure in early adolescence is associated with poorer cognitive performance in adulthood. METHODS This cross-sectional study of a nationally representative sample of 1199 adults with psychotic illness compared current cognition (digit symbol coding) of 297 current users of cannabis (used in the past year), 460 past users (used previously but not in the past year) and 442 non-users (never used). Multiple logistic regression was used to examine whether cognitive performance of cannabis-user groups varied by exposure age and diagnosis (non-affective/affective psychoses). RESULTS Unadjusted analysis showed current cannabis users had significantly higher odds of impaired cognitive function compared to non-users (odds ratio=1.52, 95%CI=1.04-2.22). After adjusting for potential confounders, differences between the three groups were not significant. Exposure age was not significant in adjusted analysis. In participants with nonaffective psychoses, cognitive ability of current cannabis users did not differ from non-users. However, in participants with affective psychoses, using cannabis in the last year was a significant predictor of impaired cognitive function (odds ratio=2.25, 95%CI=1.05-4.84). CONCLUSION Among people with psychotic illness, there was no significant difference in cognitive function between current, past and non-users of cannabis. However, when we compared cognitive performance of the three cannabis groups by diagnostic grouping, current cannabis use had a significant negative relationship with cognitive function in people with affective psychoses, but not in those with non-affective psychoses. This finding requires replication and further investigation.
Collapse
Affiliation(s)
- Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia.
| | - Johanna C Badcock
- Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| | - Patsy Di Prinzio
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| | - Mathew Martin-Iverson
- Pharmacology, M510, School of Biomedical Sciences, University of Western Australia, Stirling Highway, Crawley, 6009, Australia
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia; Centre for Clinical Research in Neuropsychiatry, Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Medical Research Foundation Building, Rear 50 Murray Street, Perth 6000, Australia
| |
Collapse
|
42
|
Skalisky J, Leickly E, Oluwoye O, McPherson SM, Srebnik D, Roll JM, Ries RK, McDonell MG. Prevalence and Correlates of Cannabis Use in Outpatients with Serious Mental Illness Receiving Treatment for Alcohol Use Disorders. Cannabis Cannabinoid Res 2017; 2:133-138. [PMID: 28861513 PMCID: PMC5569619 DOI: 10.1089/can.2017.0006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Introduction: People with serious mental illness (SMI) use cannabis more than any other illicit drug. Cannabis use is associated with increased psychotic symptoms and is highly comorbid with alcohol use disorders (AUDs). Despite the national trend toward decriminalization, little is known about the prevalence, correlates, and impact of cannabis use on those with SMI receiving treatment for substance use disorders, a group at high risk for the negative effects of cannabis use. Methods: In this secondary data analysis, cannabis use prevalence, correlates, and impact on treatment outcomes were examined in 121 adults with cooccurring SMI and AUDs receiving outpatient addiction treatment in a randomized trial of contingency management (CM) for alcohol. Prevalence and frequency of cannabis use were calculated across the 7-month study period using self-report and urine tests. Cannabis users were compared with nonusers by SMI diagnosis, psychiatric symptoms, medical problems, legal problems, and HIV-risk behavior. The relationship between cannabis use and longest duration of alcohol abstinence in participants randomized to CM (n=40) was assessed. Results: Fifty-seven (47%) of participants submitted at least one cannabis-positive urine sample during the study. Out of the 2834 total samples submitted, 751 (27%) were positive for cannabis. Cannabis users were 2.2 times more likely to submit an alcohol-positive sample, and 2.5 times more likely to submit a cocaine-positive sample at baseline, relative to noncannabis users (p=0.01). Cannabis users were more likely to engage in risky sexual behavior (p=0.01) and to report being homeless (p=0.03) than nonusers. When controlling for pretreatment alcohol use, the relationship between comorbid cannabis use and alcohol abstinence during CM was not significant (p=0.77). Conclusion: Rates of comorbid cannabis use were high in this sample of adults with SMI and AUDs. Cannabis use was correlated with recent alcohol and cocaine use, risky sexual behavior, and homelessness, but not with alcohol abstinence during CM.
Collapse
Affiliation(s)
- Jordan Skalisky
- Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, Washington.,Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.,Program for Excellence in Addiction Research, Washington State University, Spokane, Washington
| | - Emily Leickly
- Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, Washington.,Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.,Program for Excellence in Addiction Research, Washington State University, Spokane, Washington
| | - Oladunni Oluwoye
- Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, Washington.,Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.,Program for Excellence in Addiction Research, Washington State University, Spokane, Washington
| | - Sterling M McPherson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.,Program for Excellence in Addiction Research, Washington State University, Spokane, Washington.,Providence Medical Research Center, Providence Health Care, Spokane, Washington
| | - Debra Srebnik
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - John M Roll
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.,Program for Excellence in Addiction Research, Washington State University, Spokane, Washington
| | - Richard K Ries
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Michael G McDonell
- Initiative for Research and Education to Advance Community Health, Washington State University, Spokane, Washington.,Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington.,Program for Excellence in Addiction Research, Washington State University, Spokane, Washington
| |
Collapse
|
43
|
Foglia E, Schoeler T, Klamerus E, Morgan K, Bhattacharyya S. Cannabis use and adherence to antipsychotic medication: a systematic review and meta-analysis. Psychol Med 2017; 47:1691-1705. [PMID: 28179039 DOI: 10.1017/s0033291717000046] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Substance use may increase the risk of non-adherence to antipsychotics, resulting in negative outcomes in patients with psychosis. METHOD We aimed to quantitatively summarize evidence regarding the effect of cannabis use, the most commonly used illicit drug amongst those with psychosis, on adherence to antipsychotic medication. Studies were identified through a systematic database search. Adopting random-effects models, pooled odds ratios (OR) for risk of non-adherence to antipsychotic medications were calculated comparing: cannabis-users at baseline v. non-users at baseline; non users v. continued cannabis users at follow-up; non-users v. former users at follow-up; former users v. current users. RESULTS Fifteen observational studies (n = 3678) were included. Increased risk of non-adherence was observed for cannabis users compared to non-users (OR 2.46, n = 3055). At follow-up, increased risk of non-adherence was observed for current users compared to non-users (OR 5.79, n = 175) and former users (OR 5.5, n = 192), while there was no difference between former users and non-users (OR 1.12, n = 187). CONCLUSIONS Cannabis use increases the risk of non-adherence and quitting cannabis use may help adherence to antipsychotics. Thus, cannabis use may represent a potential target for intervention to improve medication adherence in those with psychosis.
Collapse
Affiliation(s)
- E Foglia
- King's College London, Institute of Psychiatry, Psychology & Neuroscience,London,UK
| | - T Schoeler
- King's College London, Institute of Psychiatry, Psychology & Neuroscience,London,UK
| | - E Klamerus
- King's College London, Institute of Psychiatry, Psychology & Neuroscience,London,UK
| | - K Morgan
- University of Westminster,London,UK
| | - S Bhattacharyya
- King's College London, Institute of Psychiatry, Psychology & Neuroscience,London,UK
| |
Collapse
|
44
|
Kebbell MR, Westera N. The 'Worst of the Worst': Detectives' Beliefs about Dangerous Violent Offenders and How to Deal with Them. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2017; 24:843-852. [PMID: 31983994 PMCID: PMC6818224 DOI: 10.1080/13218719.2017.1315786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Police detectives come into contact with a community's most dangerous violent offenders, but there is little empirical research concerning detectives' beliefs about their characteristics. Twenty experienced detectives compared the characteristics and attributes of two offenders they believed to be the most dangerous repeat violent offenders in their community with two violent offenders who they believed to be less dangerous. Eighty offenders were identified in total. Thirteen bipolar dangerous-less dangerous constructs that differentiate the most dangerous violent offenders from other violent offenders were identified. The most frequently identified themes, mentioned by three quarters or more of the detectives, are being a heavy drug user (particularly amphetamines), being impulsive, and not thinking of the consequences of one's actions. The next three themes, mentioned by half of the detectives are extensive and regular offending, breadth of offending, and wishing to portray oneself as a 'tough guy'. One theme detectives did not mention frequently is mental illness as being associated with the most violent offenders, suggesting that detectives may miss mental illness in their interactions with offenders. Detectives suggested responding to the most dangerous violent offenders with longer sentences, extensive monitoring and better intelligence.
Collapse
Affiliation(s)
- Mark Rhys Kebbell
- School of Applied Psychology, Griffith University, Nathan, Queensland, Australia
| | - Nina Westera
- School of Criminology and Criminal Justice, Griffith University, Nathan, Queensland, Australia
| |
Collapse
|
45
|
Nesvåg R, Reichborn-Kjennerud T, Gillespie NA, Knudsen GP, Bramness JG, Kendler KS, Ystrom E. Genetic and Environmental Contributions to the Association Between Cannabis Use and Psychotic-Like Experiences in Young Adult Twins. Schizophr Bull 2017; 43:644-653. [PMID: 27431873 PMCID: PMC5464089 DOI: 10.1093/schbul/sbw101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
To investigate contributions of genetic and environmental risk factors and possible direction of causation for the relationship between symptoms of cannabis use disorders (CUD) and psychotic-like experiences (PLEs), a population-based sample of 2793 young adult twins (63.5% female, mean [range] age 28.2 [19-36] y) were assessed for symptoms of CUD and PLEs using the Composite International Diagnostic Interview. Latent risk of having symptoms of CUD or PLEs was modeled using Item Response Theory. Co-twin control analysis was performed to investigate effect of familiar confounding for the association between symptoms of CUD and PLEs. Biometric twin models were fitted to estimate the heritability, genetic and environmental correlations, and direction for the association. Lifetime use of cannabis was reported by 10.4 % of the twins, and prevalence of PLEs ranged from 0.1% to 2.2%. The incidence rate ratio of PLEs due to symptoms of CUD was 6.3 (95% CI, 3.9, 10.2) in the total sample and 3.5 (95% CI, 1.5, 8.2) within twin pairs. Heritability estimates for symptoms of CUD were 88% in men and women, and for PLEs 77% in men and 43% in women. The genetic and environmental correlations between symptoms of CUD and PLEs were 0.55 and 0.52, respectively. The model allowing symptoms of CUD to cause PLEs had a better fit than models specifying opposite or reciprocal directions of causation. The association between symptoms of CUD and PLEs is explained by shared genetic and environmental factors and direct effects from CUD to risk for PLEs.
Collapse
Affiliation(s)
- Ragnar Nesvåg
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway;,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway;,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nathan A. Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics and Departments of Psychiatry, Virginia Commonwealth University, Richmond, VA
| | - Gun Peggy Knudsen
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Jørgen G. Bramness
- The Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics and Departments of Psychiatry, Virginia Commonwealth University, Richmond, VA
| | - Eivind Ystrom
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway;,Department of Psychology, University of Oslo, Oslo, Norway;,School of Pharmacy, University of Oslo, Oslo, Norway
| |
Collapse
|
46
|
|
47
|
Dugré JR, Dellazizzo L, Giguère CÉ, Potvin S, Dumais A. Persistency of Cannabis Use Predicts Violence following Acute Psychiatric Discharge. Front Psychiatry 2017; 8:176. [PMID: 28983261 PMCID: PMC5613094 DOI: 10.3389/fpsyt.2017.00176] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/05/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Violence is a major concern and is prevalent across several mental disorders. The use of substances has been associated with an exacerbation of psychiatric symptoms as well as with violence. Compared to other substances such as alcohol and cocaine, existing literature on the cannabis-violence relationship has been more limited, with most studies being conducted in the general population, and has shown controversial results. Evidence has suggested a stronger relationship when examining the effects of the persistency of cannabis use on future violent behaviors. Though, while cannabis use is highly prevalent amid psychiatric patients, far less literature on the subject has been conducted in this population. Hence, the present prospective study aims to investigate the persistency of cannabis use in psychiatric patients. METHOD The sample comprised of 1,136 recently discharged psychiatric patients provided by the MacArthur Risk Assessment Study. A multi-wave (five-assessment) follow-up design was employed to allow temporal sequencing between substance use and violent behaviors. Generalized estimating equations (GEE) were used to examine the effect of persistency of cannabis use on violence, while controlling for potential confounding factors. Potential bidirectional association was also investigated using the same statistical approach. RESULTS Our results suggest a unidirectional association between cannabis use and violence. GEE model revealed that the continuity of cannabis use across more than one time wave was associated with increased risks of future violent behavior. Patients who reported having used cannabis at each follow-up periods were 2.44 times more likely to display violent behaviors (OR = 2.44, 95% CI: 1.06-5.63, p < 0.05). CONCLUSION These findings are particularly relevant as they suggest that the longer individuals report having used cannabis after a psychiatric discharge, the more likely they are of being violent in the following time waves. These results add to our understanding of the negative consequences of chronic cannabis use amid psychiatric patients.
Collapse
Affiliation(s)
- Jules R Dugré
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Laura Dellazizzo
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Charles-Édouard Giguère
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
| | - Stéphane Potvin
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Alexandre Dumais
- Centre de recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Institut Philippe-Pinel de Montréal, Montréal, QC, Canada
| |
Collapse
|
48
|
Welter S, Lücke C, Lam AP, Custal C, Moeller S, Sörös P, Thiel CM, Philipsen A, Müller HHO. Synthetic Cannabinoid Use in a Psychiatric Patient Population: A Pilot Study. Eur Addict Res 2017; 23:182-193. [PMID: 28848170 DOI: 10.1159/000479554] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/16/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Consumption of natural cannabis (NC) and synthetic cannabinoids (SCs) has been associated with psychotic disorders. We compared the prevalence of use, consumer profiles, and psychosis-inducing potential of NC and SCs in a specific high-risk population. METHODS This prospective pilot study included 332 patients (18-64 years, mean 36.83, SD 13.33). Patients' sociodemographics and medical histories as well as illicit substance use and psychiatric symptom histories were collected using a drug consumption survey that assessed the use of new psychoactive substances and the Psychotic Symptoms Interview. RESULTS In total, 7.2% of all patients, 10.6% of psychotic patients, and 4.5% of nonpsychotic patients reported SC consumption. Compared with SCs, NC was consumed much more frequently by its users (mean 222.73, SD 498.27). NC and SC use induced persistent psychosis. Psychotic symptoms were first experienced by patients with a history of NC or SC use during intoxication and persisted after cessation (>1 year) of drug use. Positive and negative symptoms tended to be more severe in SC and NC users, respectively. CONCLUSIONS NC and SCs may cause different symptom clusters. These relationships should be further evaluated.
Collapse
Affiliation(s)
- Stella Welter
- Department of Biological Psychology, Carl von Ossietzky University of Oldenburg, Faculty of Medicine and Health Sciences, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Cannabis and Amphetamine-type Stimulant-induced Psychoses: A Systematic Overview. ADDICTIVE DISORDERS & THEIR TREATMENT 2016. [DOI: 10.1097/adt.0000000000000086] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
50
|
Chase KA, Feiner B, Rosen C, Gavin DP, Sharma RP. Characterization of peripheral cannabinoid receptor expression and clinical correlates in schizophrenia. Psychiatry Res 2016; 245:346-353. [PMID: 27591408 DOI: 10.1016/j.psychres.2016.08.055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 08/16/2016] [Accepted: 08/19/2016] [Indexed: 01/13/2023]
Abstract
The relationship between cannabinoid receptor signaling and psychosis vulnerability requires further exploration. The endocannabinoid signaling system is extensive, with receptors exerting regulatory functions in both immune and central nervous systems. In the brain, cannabinoid receptors (CBR) directly modulate neurotransmitter systems. In the peripheral lymphocyte, CBRs mediate cytokine release, with dysregulated cytokine levels demonstrated in schizophrenia. mRNA levels of CBRs were measured in human peripheral blood mononuclear cells (PBMCs) obtained from 70 participants (35 non-clinical controls, 35 participants with schizophrenia), who were recruited for the absence of marijuana use/abuse by self-report. Changes in mRNA expression were measured using qRT-PCR. Clinical measurements collected included the MATRICS Cognitive Battery and the Positive and Negative Syndrome Scale. Levels of CB1R and CB2R mRNA in PBMCs were significantly higher in participants with schizophrenia compared to the non-clinical controls. Additionally, CB1R and CB2R mRNA levels correlated with impairments in cognitive processing and clinical symptom severity in multiple domains. These results continue to support dysregulation of particular aspects of the endocannabinoid signaling system in participants with schizophrenia selected for the self-reported absence of marijuana abuse/dependence.
Collapse
Affiliation(s)
- Kayla A Chase
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St, Chicago, IL 60612, USA; University of California, Department of Psychiatry, 9500 Gilman Drive, MC 8505, La Jolla, San Diego, CA 92037, USA
| | - Benjamin Feiner
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St, Chicago, IL 60612, USA
| | - Cherise Rosen
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St, Chicago, IL 60612, USA
| | - David P Gavin
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St, Chicago, IL 60612, USA; Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue (M/C 151), Chicago, IL 60612, USA
| | - Rajiv P Sharma
- The Psychiatric Institute, University of Illinois at Chicago, 1601 W. Taylor St, Chicago, IL 60612, USA; Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue (M/C 151), Chicago, IL 60612, USA.
| |
Collapse
|