Social Functioning Trajectories of Young First-Episode Psychosis Patients with and without Cannabis Misuse: A 30-Month Follow-Up Study

González‐Blanch, César; Gleeson, John; Koval, Peter; Cotton, Sue; McGorry, Patrick D.; Álvarez‐Jiménez, Mario

doi:10.1371/journal.pone.0122404

Cited by 24 publications

(12 citation statements)

References 43 publications

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“…A recent study comparing first-episode patients with and without cannabis misuse at baseline found that baseline cannabis misuse was predictive of poorer social functioning over a 30-month follow-up period. 31 First-episode patients with comorbid SUD have unique needs that may be different from SUD patients without psychosis, and even from SUD patients with chronic psychosis. To address these unique needs, we are working with SUD experts at McLean Hospital to develop a program geared specifically for SUD in first-episode patients, particularly targeting cannabis use disorder.…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, although the affective psychosis group has higher pre‐morbid functional status, all categories of psychosis (affective, primary psychotic disorder or psychotic disorder NOS) have similar baseline indices of illness severity, including high rates of prior hospitalizations and SUD, particularly cannabis use disorders. A recent study comparing first‐episode patients with and without cannabis misuse at baseline found that baseline cannabis misuse was predictive of poorer social functioning over a 30‐month follow‐up period . First‐episode patients with comorbid SUD have unique needs that may be different from SUD patients without psychosis, and even from SUD patients with chronic psychosis.…”

Section: Discussionmentioning

confidence: 99%

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McLean OnTrack: a transdiagnostic program for early intervention in first‐episode psychosis

Shinn

Bolton

Karmacharya

et al. 2015

Early Intervention Psych

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Aims Most programs specializing in the treatment of first-episode psychosis in the United States focus on schizophrenia. However, many early psychosis patients do not fit into this diagnostic category. Here we describe McLean OnTrack, an intensive outpatient treatment program that accepts all-comers with first-episode psychosis. Methods We assessed baseline characteristics of patients in the 2.5 years since program initiation. We examined how initial referral diagnoses compare to current diagnoses, calculating the proportion of diagnostic changes. Results At 2.5 years, patients in McLean OnTrack consist of 30 (33.0%) individuals with primary psychotic disorder, 40 (44.0%) with affective psychosis, 19 (20.9%) with psychotic disorder NOS who do not meet full criteria for either category, and two (2.2%) individuals with no psychosis. While patients with affective psychosis had higher pre-morbid functioning, all three categories of psychosis had similar rates of prior hospitalizations and substance use. The retention rate in the psychotic disorder NOS group was lower than that in affective and primary psychotic disorders. Finally, diagnoses changed over the course of treatment in 50.5% of patients. Conclusions Diagnostic heterogeneity appears to be the norm among patients with first-episode psychosis, and diagnoses commonly evolve over the illness course. Baseline indices of illness severity were similar across categories and suggest the need for early intervention, irrespective of specific diagnosis. We discuss the benefits and challenges of a trans-diagnostic approach to early intervention in first episode psychosis, treating patients who share many but not all characteristics.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

McLean OnTrack: a transdiagnostic program for early intervention in first‐episode psychosis

Shinn

Bolton

Karmacharya

et al. 2015

Early Intervention Psych

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“…The majority of studies that explored premorbid functioning in psychotic patients selected current or recent daily-users and compared them with non-users, revealing worse academic functioning in the former 23,24,53 , conceptually in line with our results on lifetime daily-users. Other studies found no association between premorbid function and drug or cannabis abuse [80][81][82] , probably because they used total PAS mean scores; therefore, inverse results in social and academic factors, related to cannabisuse, could have nullified each-other. Some authors used a different methodology, focusing on recent cannabis-use, and did not find any relationships with premorbid sociability 83,84 , but better current social cognition in recent cannabis-abusers 83 .…”

Section: Comparison With Previous Literaturementioning

confidence: 91%

Premorbid Adjustment and IQ in Patients With First-Episode Psychosis: A Multisite Case-Control Study of Their Relationship With Cannabis Use

Ferraro

Cascia

Quattrone

et al. 2019

Schizophrenia Bulletin

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Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = −0.3, 95% CI = [−0.5; −0.2]) and never-users (Mdiff = −0.4, 95% CI = [−0.6; −0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders.

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“…Reliable change was judged to be clinically significant when moved from the clinical range to the non‐clinical range. The clinical range was operationalized as two standard deviations below the mean for a clinical population (These descriptive statistics were derived from past research; González‐Blanch et al ., ; Moncrieff et al ., ; Williams et al ., ). This criterion is quite conservative, because of the wide variance in these clinical ranges, but was taken because of a lack of data regarding a comparable non‐clinical range.…”

Section: Methodsmentioning

confidence: 97%

Cognitive Analytic Therapy for psychosis: A case series

Taylor

Perry²,

Hutton

et al. 2018

Psychol Psychother

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Objectives Cognitive Analytic Therapy (CAT) is an effective psychological intervention for several different mental health conditions. However, whether it is acceptable, safe, and beneficial for people with psychosis remains unclear, as is the feasibility of providing and evaluating it within a research context. The aim of this study was to begin to address these questions and to obtain for the first time a rich and detailed understanding of the experience of receiving CAT for psychosis. Design A mixed‐methods case series design. Method Seven individuals who experienced non‐affective psychosis received CAT. They completed assessments at the start of CAT, 16 weeks, and 28 weeks post‐baseline. Qualitative interviews were completed with four individuals following completion of or withdrawal from therapy. Results Six participants attended at least four sessions of therapy and four went on to complete therapy. There were no serious adverse events, and self‐reported adverse experiences were minimal. Qualitative interviews suggested CAT is acceptable and provided a way to understand and work therapeutically with psychosis. There was limited evidence of change in psychotic symptoms, but improvement in perceived recovery and personality integration was observed. Conclusions The results suggest that CAT is a safe and acceptable intervention for psychosis. Personality integration, perceived recovery, and functioning are relevant outcomes for future evaluations of CAT for psychosis. Practitioner points It is feasible to conduct research evaluating CAT for people with psychosis. Within this case series, CAT appears acceptable and safe to individuals with psychosis. Within this case series, clients reported that CAT was a positive and helpful experience. There is a mixed picture with regard to secondary outcomes, but the design and aims of this case series limit conclusion that can be drawn from this data.

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Social Functioning Trajectories of Young First-Episode Psychosis Patients with and without Cannabis Misuse: A 30-Month Follow-Up Study

Cited by 24 publications

References 43 publications

McLean OnTrack: a transdiagnostic program for early intervention in first‐episode psychosis

McLean OnTrack: a transdiagnostic program for early intervention in first‐episode psychosis

Premorbid Adjustment and IQ in Patients With First-Episode Psychosis: A Multisite Case-Control Study of Their Relationship With Cannabis Use

Cognitive Analytic Therapy for psychosis: A case series

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