Delayed preattentional functioning in early psychosis patients with cannabis use

Pesa, Nicole; Hermens, Daniel F.; Battisti, Robert A.; Kaur, Manreena; Hickie, Ian B.; Solowij, Nadia

doi:10.1007/s00213-012-2676-2

Cited by 21 publications

(20 citation statements)

References 77 publications

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“…It is thought to represent basic auditory information processing, and sensory memory generated primarily in the superior temporal and prefrontal cortex (PFC), while being relatively independent of attention (161, 162). Deficits in MMN have been shown in patients with schizophrenia, early psychosis, and high-risk subjects (163, 164). While oral THC did not produce any acute changes in MMN amplitude (93), studies in chronic cannabis users have demonstrated decreased MMN amplitudes in the frequency deviance condition (154, 165–167).…”

Section: Immediate Effects Of Cannabinoids: Experimental Evidencementioning

confidence: 99%

Gone to Pot â€“ A Review of the Association between Cannabis and Psychosis

2014

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Cannabis is the most commonly used illicit drug worldwide, with ~5 million daily users worldwide. Emerging evidence supports a number of associations between cannabis and psychosis/psychotic disorders, including schizophrenia. These associations-based on case-studies, surveys, epidemiological studies, and experimental studies indicate that cannabinoids can produce acute, transient effects; acute, persistent effects; and delayed, persistent effects that recapitulate the psychopathology and psychophysiology seen in schizophrenia. Acute exposure to both cannabis and synthetic cannabinoids (Spice/K2) can produce a full range of transient psychotomimetic symptoms, cognitive deficits, and psychophysiological abnormalities that bear a striking resemblance to symptoms of schizophrenia. In individuals with an established psychotic disorder, cannabinoids can exacerbate symptoms, trigger relapse, and have negative consequences on the course of the illness. Several factors appear to moderate these associations, including family history, genetic factors, history of childhood abuse, and the age at onset of cannabis use. Exposure to cannabinoids in adolescence confers a higher risk for psychosis outcomes in later life and the risk is dose-related. Individuals with polymorphisms of COMT and AKT1 genes may be at increased risk for psychotic disorders in association with cannabinoids, as are individuals with a family history of psychotic disorders or a history of childhood trauma. The relationship between cannabis and schizophrenia fulfills many but not all of the standard criteria for causality, including temporality, biological gradient, biological plausibility, experimental evidence, consistency, and coherence. At the present time, the evidence indicates that cannabis may be a component cause in the emergence of psychosis, and this warrants serious consideration from the point of view of public health policy.

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Section: Immediate Effects Of Cannabinoids: Experimental Evidencementioning

confidence: 99%

Gone to Pot â€“ A Review of the Association between Cannabis and Psychosis

2014

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“…However, this pattern differs from the alterations observed in patients with schizophrenia who do not use cannabis [75]. Finally, results of Pesa et al [76] also suggest altered effects of cannabis in schizophrenia. While amplitudes of mismatch-related potentials were more pronounced in schizophrenic patients without cannabis use history as compared to patients with cannabis use, schizophrenic cannabis users showed longer latencies in some of these potentials.…”

Section: Discussionmentioning

confidence: 86%

Attentional dysfunction in abstinent long-term cannabis users with and without schizophrenia

Rentzsch

Stadtmann

Montag

et al. 2015

Eur Arch Psychiatry Clin Neurosci

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Long-term cannabis use may confer cognitive deficits and increased risk of psychosis. However, the relationship between cannabis use and schizophrenia is complex. In particular, little is known about the effects of chronic cannabis use on the attention-related electric brain response in schizophrenia. We investigated auditory novelty and oddball P300 evoked potentials in a mixed sample of first-episode and chronic schizophrenic patients and healthy controls with (SZCA, n = 20; COCA, n = 20, abstinence ≥28 days) or without (SZ, n = 20; CO, n = 20) chronic cannabis use. Duration of regular cannabis use was 8.3 ± 5.6 (SZCA) and 9.1 ± 7.1 (COCA) years. In general, schizophrenic patients showed reduced P300 amplitudes. Cannabis use was associated with both a reduced early and late left-hemispheric novelty P300. There was a significant 'diagnosis × cannabis' interaction for the left-hemispheric late novelty P300 in that cannabis use was associated with a reduced amplitude in the otherwise healthy but not in the schizophrenic group compared with their relative control groups (corrected p < 0.02; p > 0.9, respectively). The left-hemispheric late novelty P300 in the otherwise healthy cannabis group correlated inversely with amount and duration of cannabis use (r = -0.50, p = 0.024; r = -0.57, p = 0.009, respectively). Our study confirms attentional deficits with chronic cannabis use. However, cannabis use may lead to different cognitive sequelae in patients with schizophrenia and in healthy controls, possibly reflecting preexisting alterations in the endocannabinoid system in schizophrenia.

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“…This dimensional approach shifts the emphasis from making a specific diagnosis to determining the current level of cognitive or behavioral change in individual patients. Clinical and related neurobiological research then examines the extent to which common risk variables (for example, developmental delay, trait neurocognitive impairments, alcohol or other substance misuse) increase risk to measured behavioral or cognitive change, increase risk to markers of brain impairment (for example, poor neuropsychological function, excessive cortical thinning, disturbed neurophysiological markers) or increase risk to poor outcomes - independently of any specific relationship with classical ‘diagnostic’ entities [108,147,148]. …”

Section: Discussionmentioning

confidence: 99%

Clinical classification in mental health at the cross-roads: which direction next?

Hickie

Scott

Hermens

et al. 2013

BMC Med

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BackgroundAfter 30 years of consensus-derived diagnostic categories in mental health, it is time to head in new directions. Those categories placed great emphasis on enhanced reliability and the capacity to identify them via standardized checklists. Although this enhanced epidemiology and health services planning, it failed to link broad diagnostic groupings to underlying pathophysiology or specific treatment response.DiscussionIt is time to adopt new goals that prioritize the validation of clinical entities and foster alternative strategies to support those goals. The value of new dimensions (notably clinical staging), that are both clinically relevant and directly related to emerging developmental and neurobiological research, is proposed. A strong emphasis on ‘reverse translation’ (that is, working back from the clinic to the laboratory) underpins these novel approaches. However, it relies on using diagnostic groupings that already have strong evidence of links to specific risk factors or patterns of treatment response.SummaryThe strategies described abandon the historical divides between clinical neurology, psychiatry and psychology and adopt the promotion of pathways to illness models.

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Delayed preattentional functioning in early psychosis patients with cannabis use

Abstract: This study provides further evidence that MMN/P3a deficits are present during early psychosis and suggests that this biomarker may have utility in differentiating substance- from non-substance-related psychoses.

Cited by 21 publications

References 77 publications

Gone to Pot â€“ A Review of the Association between Cannabis and Psychosis

Gone to Pot â€“ A Review of the Association between Cannabis and Psychosis

Attentional dysfunction in abstinent long-term cannabis users with and without schizophrenia

Clinical classification in mental health at the cross-roads: which direction next?

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