Pre-illness cannabis use and the early course of nonaffective psychotic disorders: Associations with premorbid functioning, the prodrome, and mode of onset of psychosis

Abstract

Introduction-Limited research indicates that pre-illness cannabis use may result in an earlier age at onset of psychosis, though little is known about the influence of prior cannabis use on the premorbid and prodromal phases. This study examined effects of prior or concurrent cannabis (as well as nicotine and alcohol) use on: (1) early adolescent (12-15 years) premorbid functioning, (2) late adolescent (16-18 years) premorbid functioning, (3) two features of the prodrome, and (4) mode of onset of psychosis.Methods-Participants included 109 well-characterized first-episode patients hospitalized in public-sector settings. Assessments included ages at initiation of first, weekly, and daily use of substances, the Premorbid Adjustment Scale, the Symptom Onset in Schizophrenia inventory, and a consensus-based best estimate of mode of onset.Results-Participants having used cannabis at ≤15 years had better early adolescence social functioning than those who had not used cannabis (p=0.02). Conversely, those who had used cannabis at ≤18 years had poorer late adolescence academic functioning (p<0.001). Participants having used cannabis before onset of psychotic symptoms did not differ from those who had not in terms of having had an identifiable prodrome or the number of prodromal symptoms experienced. Whereas 42% of those having used cannabis daily had an acute mode of onset of psychosis, only 20% of those without prior daily cannabis use had an acute onset (p=0.04).Conclusions-Findings suggest that cannabis use is associated with premorbid social and academic functioning and mode of onset. Further research is warranted to elucidate the complex associations between cannabis use and diverse early-course features.

Does substance use disorder affect clinical expression in first-hospitalization patients with schizophrenia? Analysis of a prospective cohort

“…The substance most commonly used is cannabis, followed by cocaine, amphetamine, hallucinogen and other drugs (Allebeck et al, 1993;Hambrecht and Häfner, 2000;Compton et al, 2009Compton et al, , 2011. Moreover high frequency of polysubstance abuse and misuse are reported Barnett et al, 2007).…”

“…(Cantwell et al, 1999;Veen et al, 2004;Henquet et al, 2005;Mauri et al, 2006;Koskinen et al, 2010;Mazzoncini et al, 2010;Barrigón et al, 2010). Several studies on schizophrenia have reported that patients with SUD have worse premorbid social functioning (Sevy et al, 2010;Mazzoncini et al, 2010;Compton et al, 2011;Schimmelmann et al, 2011), more severe symptoms at onset (Gearon and Bellack, 2000;Dawe et al, 2011), lower compliance and worse treatment response, thus more inappropriate use of mental health services, (Lambert et al, 2005;de Haan et al, 2007;Schimmelmann et al, 2011) with higher mental health costs (Bartels et al, 1993).…”

Clinical profile of cannabis-induced psychosis in comparison to schizophrenia

“…The majority of first-episode schizophrenia studies also suggest that the profile of cognitive functioning is similar to that of patients with chronic schizophrenia, with generalized impairment across the majority of cognitive domains overlaid with more selective impairments in memory and learning, executive functioning, attention, and speed of information processing [16].…”

Marijuana and Psychosis: The Effects of Adolescent Abuse of Marijuana and other Drugs in a Group of Forensic Psychiatric Patients

“…Many of the drug-induced psychoses in the present study were of this sort: most mimicked classic schizophrenia; a few resembled delusional disorder or bipolar disorder. In some instances, however, the marijuana (with or without concomitant use of other drugs) may have unleashed a true schizophrenia earlier than it would have manifested itself, had not the adolescent abused the drugs [28,29]. Since drug abuse usually begins around the time of puberty, it is not easy to determine whether a particular adolescent drug-abuser who appears schizophrenic at say, sixteen, was destined to have shown signs of the classic psychosis at twenty, but for the early drug abuse.…”