Cannabis use and transition to psychosis in people at ultra-high risk

Valmaggia, Lucia; Day, Fern; Jones, Ceri; Bissoli, Sarah; Pugh, Charlotte; Hall, Deanna L.; Bhattacharyya, Sagnik; Howes, Oliver; Stone, James; Fusar‐Poli, Paolo; Byrne, Majella; McGuire, Philip

doi:10.1017/s0033291714000117

Cited by 88 publications

(113 citation statements)

References 43 publications

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“…According to neurobiological theories, early cannabis use could be partially explained by a two-factor model including sensation seeking and impulsivity or disinhibiton, both traits related to increased dopaminergic activity in the reward system [24,33,34]. Furthermore, results regarding psychoticism -also related with reward sensitivity and testosterone levels -also suggest that early cannabis use might be associated to antisocial characteristics, as well as to negative aspects of schizotypal spectrum disorders [25,23,7,32,3,6,31]. Although psychoticism is a broad normal personality dimension whose upper end predisposes individuals to psychotic like experiences in a varying degree [16], some studies suggest that it is not a heightened risk for psychosis [12,11] and it is rather associated to symptoms of antisocial, schizotypal and borderline personality disorders [3,10].…”

Section: Discussionmentioning

confidence: 99%

Age, sex and personality in early cannabis use

Muro

2015

Eur. psychiatr.

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Previous studies analysing personality and cannabis use in adult samples suggest that cannabis users show significant higher levels of impulsivity, sensation seeking and schizotypy. However, there are few studies exploring this relationship in adolescence using psychobiological models of personality. Given the relevance of identifying individual differences that lead adolescents to early cannabis use to prevent future health problems, the present study aimed to explore the relationship between age, sex, personality and early cannabis use using a psychobiological model of personality in a sample of 415 students (51.8% boys) from 12 to 18 years. Chi(2) tests showed significant higher prevalence of cannabis use in boys and in the group aged 15-18 years. Multiple analysis of variance showed significant higher scores in psychoticism, sensation seeking and in all its subscales in cannabis users group, while an interaction with age was found for extraversion and neuroticism: cannabis users scored higher than non-users in the youngest group (12-14 years) but lower in the oldest group in both dimensions. Finally, regression analysis showed that narrower traits of sensation seeking (experience seeking and disinhibition) were the most associated to early cannabis use. Results are discussed in terms of early cannabis users' personality profiles and in terms of the self-medication theory.

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Section: Discussionmentioning

confidence: 99%

Age, sex and personality in early cannabis use

Muro

2015

Eur. psychiatr.

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“…The psychometric properties of this instrument have been established 21 and the CEQ has been used extensively to assess substance use in people with schizotypy 21 ; at risk mental state for psychosis 19 , and psychosis 18,22,23 . figure 1 contains a definition of the substances assessed.…”

Section: Substance Usementioning

confidence: 99%

“…We were particularly interested not just in assessing the use of substances, but also the characteristics of substance use associated with poorer health outcomes in community samples, such as age of first use, recent use, and poly-drug use [16][17][18][19] . Our secondary aim was to investigate the association between these characteristics and screening positive on the Prodromal Questionnaire Brief version.…”

Section: Introductionmentioning

confidence: 99%

Substance use and at‐risk mental state for psychosis in 2102 prisoners: the case for early detection and early intervention in prison

Cooper

Jarrett

Forrester

et al. 2016

Early Intervention Psych

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AimPrisoners exhibit high rates of substance use and mental health problems. In the present study we sought to gain detailed understanding of substance use among young prisoners to inform early detection and early intervention strategies in a prison setting. MethodsThis is a cross-sectional study of 2,102 prisoners who were screened by the London Early detection And Prevention in prison team (LEAP). Data on the use of substances were collected including age of first use, recent use, duration of use and poly-drug use. The Prodromal Questionnaire Brief version was used to screen for the at risk mental state. ResultsWe found high rates of lifetime and recent use and low age of first use of a number of substances. We also found strong associations between substance use and screening positive for an at risk mental state. Logistic regression analysis confirmed that use of any drug in the last year, poly-drug and early use, as well as heavy alcohol use, were related to an increased risk of screening positive. ConclusionsSubstance use in the prison population is not only widespread and heavy but is also strongly linked with a higher risk of developing mental health problems. The need for early detection and early intervention in prison is discussed.

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“…121 Outcome and transition to psychosis may be more strongly associated with early-onset use, frequent use and continued use rather than overall lifetime use. 122 More data from targeted intervention trials and usage over the time to transition or remission will be valuable in determining whether cannabis use is a potentially modifiable risk factor. 123 …”

Section: Characteristics and Correlates Of Psychosis Riskmentioning

confidence: 99%

Progress and Future Directions in Research on the Psychosis Prodrome

Woodberry¹,

Shapiro²,

Bryant³

et al. 2016

Harvard Review of Psychiatry

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The psychosis prodrome, or period of clinical and functional decline leading up to acute psychosis, offers a unique opportunity for identifying mechanisms of psychosis onset and testing early intervention strategies. We summarize major findings and emerging directions in prodromal research and provide recommendations for clinicians working with individuals suspected to be at high risk for psychosis. The past two decades of research have led to three major advances. First, tools and criteria have been developed that can reliably identify imminent risk for a psychotic disorder. Second, longitudinal clinical and psychobiological data from large multisite studies are strengthening individual risk assessment and offering insights into potential mechanisms of illness onset. Third, psychosocial and pharmacological interventions are demonstrating promise for delaying or preventing the onset of psychosis in help-seeking, high-risk individuals. The dynamic psychobiological processes implicated in both risk and onset of psychosis, including altered gene expression, cognitive dysfunction, inflammation, gray and white matter brain changes, and vulnerability-stress interactions suggest a wide range of potential treatment targets and strategies. The expansion of resources devoted to early intervention and prodromal research worldwide raises hope for investigating them. Future directions include identifying psychosis-specific risk and resilience factors in children, adolescents, and non-help-seeking community samples, improving study designs to test hypothesized mechanisms of change, and intervening with strategies that better engage youth, their environmental contexts, and neurodevelopmental targets to improve functional outcomes. Prospective research on putatively prodromal samples has the potential to substantially reshape our understanding of mental illness and our efforts to combat it.

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Cannabis use and transition to psychosis in people at ultra-high risk

Abstract: In people at UHR for psychosis, lifetime cannabis use was common but not related to outcome. Among cannabis users, frequent use, early-onset use and continued use after clinical presentation were associated with transition to psychosis.

Cited by 88 publications

References 43 publications

Age, sex and personality in early cannabis use

Age, sex and personality in early cannabis use

Substance use and at‐risk mental state for psychosis in 2102 prisoners: the case for early detection and early intervention in prison

Progress and Future Directions in Research on the Psychosis Prodrome

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