A prospective study of cannabis use as a risk factor for non-adherence and treatment dropout in first-episode schizophrenia

Miller, Rachel; Ream, Geoffrey L.; McCormack, Joanne; Gunduz‐Bruce, Handan; Sevy, Serge; Robinson, Delbert G.

doi:10.1016/j.schres.2009.04.018

Cited by 89 publications

(87 citation statements)

References 38 publications

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“…However, the studies have reported conflicting results. Miller and coworkers reported that cannabis use was a risk factor for nonadherence to medication and dropout from treatment [66]. Cantwell reported that substance-abusing psychotic patients were younger, more likely to be men and had an earlier age at psychosis onset [67].…”

Section: Reviewmentioning

confidence: 99%

Suicide in schizophrenia

Carlborg

Winnerbäck

Jönsson

et al. 2010

Expert Review of Neurotherapeutics

116

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SchizophreniaSchizophrenia is a devastating psychiatric disorder affecting approximately 1% of the population worldwide during a lifetime. The onset of the illness occurs relatively early in life, usually in the late teens or early adulthood, and most patients have long-lasting adverse effects. Schizophrenia is a clinical syndrome diagnosed on the basis of symptom profiles, and is characterized by a constellation of symptoms of psychosis, such as abnormalities in the perception or expression of reality, as well as negative symptoms, such as affective flattening and avolition. Cognitive deficits are also usually present, and the symptoms must have persisted continuously for a least 6 months: however, schizophrenia cannot be diagnosed if symptoms of mood disorder are present or the symptoms are the direct result of a medical condition or substance abuse (Box 1) [201].The specific causes of schizophrenia are not known and combinations of several factors are likely to be involved. Genetic factors play a major role in the development of the disease [1], and environmental factors are also of importance. These latter factors include a history of obstetric complications, such as asphyxia [2] and prematurity [3]. Advanced paternal age is also considered to be a risk factor [4], and birth during the spring and late winter also increases the risk [5]. Prenatal viral infections [6], serious viral infections of the CNS during childhood [7], migrant status and urban rearing [8], and a lifetime history of cannabis use [9] are other well-known risk factors.Contrary to previous interpretations, the incidence and prevalence of schizophrenia show marked variation between sites. For example, migrants have an increased incidence and prevalence of schizophrenia, and exposures related to urbanicity, economic status and latitude are also associated with various frequency measures [10]. Men have a higher risk than women [11], and a recent review concluded that men have a 40% higher incidence of schizophrenia than women [12]. SuicideSuicide is defined as a self-inflicted death with evidence that the person intended to die (Box 2) [13]. Suicide is among the leading causes of premature death in the world and it is estimated that approximately 1 million people die by suicide every year [202]. Suicide rates vary according to region, gender, age, time and ethnic origin, and also according to death registration practices. The annual suicide rate in the world is 14.5 out of 10,0000 (in 2000), which is equal to one suicide every 40 s. Suicide is approximately three-to four-times more common in men than in women [202]. Suicide rates vary between different regions, and underestimation of suicide rates is common due to under-reporting, lack of epidemiological data and misclassification [14]. It has been estimated from psychological autopsies that more than 90% of those dying by suicide have a diagnosable psychiatric disorder at the time of death, and approximately 60% of the Schizophrenia is a disorder with an estimated suicide risk of 4-5%. Many f...

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Section: Reviewmentioning

confidence: 99%

Suicide in schizophrenia

Carlborg

Winnerbäck

Jönsson

et al. 2010

Expert Review of Neurotherapeutics

116

View full text Add to dashboard Cite

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“…Use of substances, including cannabis and alcohol, has been found in several studies to be associated with poor medication adherence (Faridi et al, 2012;Hill et al, 2010;Lambert et al, 2010;Miller et al, 2009), as have a number of other demographic and clinical factors (Hill et al, 2010;Lambert et al, 2010). Furthermore, comorbid substance use has emerged as one of the greatest obstacles to the effective treatment of persons with psychosis; substance use is a risk factor for both poor medication adherence and dropout from treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, some studies suggest a dose-response relationship between severity of substance use and medication adherence rates (Dixon, 1999;Miller et al, 2009;Wade et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Substance use, medication adherence and outcome one year following a first episode of psychosis

Colizzi

Carra

Fraietta

et al. 2016

Schizophrenia Research

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Substance use, medication adherence and outcome one year following a first episode of psychosis ABSTRACT Both substance use and poor medication adherence are associated with poor outcome in psychosis. To clarify the contributions of substance use and poor medication adherence to poor outcome in the year following a first episode of psychosis, 205 patients were evaluated for use of tobacco, alcohol, cannabis and stimulants at their psychosis onset, and in a 1-year follow-up. Data on medication adherence and symptom remission were also collected. Patients had high rates of overall substance use before (37-65%) and after psychosis onset (45-66%). 44% showed poor medication adherence and 55% did not reach remission from psychosis. Nicotine dependence and cannabis use after psychosis onset significantly predicted both poor medication adherence and nonremission, and poor medication adherence mediated the effects of these substances on nonremission. In conclusion, medication adherence lies on the causal pathway between nicotine dependence and cannabis on the one hand and non-remission on the other.

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“…The indicators included and extracted are as manifold as in multiple episode patients: lower occupational status, substance abuse, psychopathology (more pronounced delusional symptoms and suspiciousness; Verdoux et al 2000), negative attitudes toward drug treatment and lack of insight (Kampmann et al 2002, Mutsatsa et al 2003, poor premorbid (cognitive) and post-acute (executive) functioning, more pronounced (extrapyramidal) side effects (Robinson et al 2002, Perkins et al 2008, lower expectations regarding the need for or effectiveness of general or drug-specific treatment, treatment with first (vs. second) generation antipsychotics (FGAs / SGAs; Perkins et al 2006), hostility and uncooperativeness, involuntary admission (De Haan et al 2007), poor treatment response, low adherence to preceding treatment, poor cognitive functioning, persisting negative or depressive symptoms, ethnicity (Perkins et al 2008), less social support, living alone, refusing drugs at treatment initiation (Rabinovitch et al 2009), and substance abuse (Perkins et al 2008, Miller et al 2009). …”

Section: Introductionmentioning

confidence: 99%