A Retrospective Study of the Clinical Characteristics Associated with Alcohol and Cannabis use in Early Phase Psychosis

Cookey, Jacob; McGavin, Jacob; Crocker, Candice E.; Matheson, Kara; Stewart, Sherry H.; Tibbo, Philip G.

doi:10.1177/0706743720905201

Cited by 13 publications

(13 citation statements)

References 55 publications

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“…The eligibility criteria are as follows: (1) meet the criteria for a first episode of psychosis defined as the first illness episode involving psychosis symptoms; (2) meet DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) criteria for a psychotic disorder and a lifetime or current cannabis use disorder (up to 45% of people with a first episode of psychosis will meet the criteria for cannabis use disorder [ 16 , 47 , 48 ]; patients diagnosed with cannabis-induced psychosis by definition meet the criteria for both conditions [ 49 ] and will be eligible); (3) be between the ages of 16 and 30 years; (4) self-identify as a Black African or Black Caribbean first- or second-generation immigrant (English speaking), or belong to any ethnic group; (5) be a client of an early psychosis intervention with up to 12 months of service; and (6) be fluent in English.…”

Section: Methodsmentioning

confidence: 99%

Insights About Cannabis and Psychosis Using Video Games for Young People With a First Episode of Psychosis, Particularly Those From Black Racialized Communities: Protocol for a Mixed Methods Study

Archie¹,

Palaniyappan

Olagunju

et al. 2022

JMIR Res Protoc

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Background Cannabis use disorder among young people with a first episode of psychosis contributes to relapse, hospitalization, and impaired functioning. However, few studies have examined what young people with early phase psychosis, particularly those from Black racialized communities, understand or appreciate about this relationship, even though they may be at risk. There are no formally tested knowledge translation strategies that disseminate these research findings for young people with emerging psychosis from Black racialized communities. Objective This study aims to conceptualize what young people with early phase psychosis/cannabis use disorder understand about the relationship between cannabis and psychosis, focusing on people from racialized backgrounds. This study also aims to assess whether the knowledge translation product, the “Back to Reality Series,” increases awareness of the impact of cannabis use on psychosis from the perspectives of young people with emerging psychosis and cannabis use disorder from Black African and Caribbean communities. Methods Qualitative analysis will reveal themes from qualitative interviews about cannabis and psychosis from the perspectives of young people with emerging psychosis and cannabis use disorder from Black African and Caribbean communities. Perceptions before and after exposure to the Back to Reality Series will be qualitatively analyzed. A control game will be used for comparison, and scores on a quiz after playing the Back to Reality Series will be quantitatively analyzed to establish whether the Back to Reality Series raises awareness of the effects of cannabis on psychosis. An advisory council involving young people from Black communities, family members, and clinicians will bring community perspectives to this research. Results We began recruiting participants for this study in September 2021. We will complete data collection on demographic and clinical factors, qualitative interviews, and quantitative assessments of the Back to Reality Series. Conclusions The voices of young people from racialized backgrounds will generate preliminary data to inform early psychosis programs, addressing cannabis use in this population. The findings may advance the use of a new knowledge translation product that deals with gaps in knowledge about cannabis use for people experiencing early phase psychosis, particularly those from racialized communities. International Registered Report Identifier (IRRID) DERR1-10.2196/36758

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Section: Methodsmentioning

confidence: 99%

Insights About Cannabis and Psychosis Using Video Games for Young People With a First Episode of Psychosis, Particularly Those From Black Racialized Communities: Protocol for a Mixed Methods Study

Archie¹,

Palaniyappan

Olagunju

et al. 2022

JMIR Res Protoc

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“…A meta-analysis showed that in samples of patients treated in FEP clinics, between 29 and 38% used cannabis ( 40 ). Prior to legalization of cannabis in Canada, a study of a sample of patients with recent diagnoses of psychosis reported that 13% were misusing alcohol-only, 21% cannabis-only, and 50% both alcohol and cannabis ( 41 ). Cannabis may be specifically linked to AB among persons with severe mental illness.…”

Section: Additional Factors Promoting Abmentioning

confidence: 99%

Could Expanding and Investing in First-Episode Psychosis Services Prevent Aggressive Behaviour and Violent Crime?

Hodgins

2022

Front. Psychiatry

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ObjectiveSome persons developing, or presenting, schizophrenia engage in aggressive behaviour (AB) and/or criminal offending. Most of these individuals display AB prior to a first episode of psychosis (FEP). In fact, approximately one-third of FEP patients have a history of AB, some additionally display other antisocial behaviours (A+AB). The large majority of these individuals have presented conduct problems since childhood, benefit from clozapine, have extensive treatment needs, and are unlikely to comply with treatment. A smaller sub-group begin to engage in AB as illness onsets. A+AB persists, often for many years in spite of treatment-as-usual, until a victim is seriously harmed. This article proposes providing multi-component treatment programs at FEP in order to prevent aggressive and antisocial behaviours of persons with schizophrenia.MethodNon-systematic reviews of epidemiological studies of AB among persons with schizophrenia, of the defining characteristics of sub-types of persons with schizophrenia who engage in AB and their responses to treatment, and of FEP service outcomes.ResultsStudies have shown that mental health services that simultaneously target schizophrenia and aggressive behaviour are most effective both in reducing psychotic symptoms and aggressive behaviour. Evidence, although not abundant, suggests that a multi-component treatment program that would include the components recommended to treat schizophrenia and cognitive-behavioural interventions to reduce A+AB, and the other factors promoting A+AB such as substance misuse, victimisation, and poor recognition of emotions in the faces of others has the potential to effectively treat schizophrenia and reduce A+AB. Patients with a recent onset of AB would require few components of treatment, while those with prior conduct disorder would require all. Such a program of treatment would be long and intense.ConclusionsTrials are needed to test the effectiveness of multi-component treatment programs targeting schizophrenia and A+AB at FEP. Studies are also necessary to determine whether providing such programs in hospitals and/or prisons, with long-term community after-care, and in some cases with court orders to participate in treatment, would enhance effectiveness. Whether investing at FEP would be cost-effective requires investigation.

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“…Cannabis users with psychosis have an earlier onset of illness, increased symptom severity, poorer adherence to psychiatric medication, poorer functional outcomes, higher relapse rates and longer hospital stays compared with non-users. 5,6,7,8,9,10,11 In addition, people with schizophrenia spectrum and other psychotic disorders and comorbid cannabis use tend to have poorer psychosocial functioning, homelessness, violence, incarceration and increased burden of care for families. 4,12,13,14 having been reported.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa

Mona

Ntlantsana²,

Tomita³

et al. 2022

South African Journal of Psychiatry

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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.

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A Retrospective Study of the Clinical Characteristics Associated with Alcohol and Cannabis use in Early Phase Psychosis

Cited by 13 publications

References 55 publications

Insights About Cannabis and Psychosis Using Video Games for Young People With a First Episode of Psychosis, Particularly Those From Black Racialized Communities: Protocol for a Mixed Methods Study

Insights About Cannabis and Psychosis Using Video Games for Young People With a First Episode of Psychosis, Particularly Those From Black Racialized Communities: Protocol for a Mixed Methods Study

Could Expanding and Investing in First-Episode Psychosis Services Prevent Aggressive Behaviour and Violent Crime?

Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa

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