Social network confidants, duration of untreated psychosis and cannabis use in people with first episode psychosis: An exploratory study

Carrà, Giuseppe; Battaglia, Cristina; Hinton, Mark; Rains, Luke Sheridan; Crocamo, Cristina

doi:10.1111/eip.12476

Cited by 3 publications

(3 citation statements)

References 37 publications

(46 reference statements)

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“…However, a more substantial change in approach is also worth considering. Several studies 72,73 have noted that young people who have psychosis and problematic cannabis use are often multiply disadvantaged, and often have restricted social networks in which their main sources of social contact are other cannabis users. This may make cannabis use hard to modify without a broader approach to the social context, for example to support isolated young people with comorbid cannabis use to find new forms of social contact and activity, perhaps alongside psychological approaches to reducing substance misuse.…”

Section: Discussionmentioning

confidence: 99%

A contingency management intervention to reduce cannabis use and time to relapse in early psychosis: the CIRCLE RCT

Rains

Marwaha

Strang

et al. 2019

Health Technol Assess

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Background Cannabis is the most prevalent illicit substance among people with psychosis, and its use is associated with poorer clinical and social outcomes. However, so far, there has been limited evidence that any treatment is effective for reducing use. Contingency management (CM) is an incentive-based intervention for substance misuse that has a substantial evidence base across a range of substances and cohorts. However, to date there have been no randomised controlled trials (RCTs) of CM as a treatment for cannabis use specifically in psychosis. Objective To conduct a RCT investigating the clinical effectiveness and cost-effectiveness of CM in reducing cannabis use among Early Intervention in Psychosis (EIP) service users. Design The CIRCLE (Contingency Intervention for Reduction of Cannabis in Early Psychosis) trial was a rater-blinded, multicentre RCT with two arms. Participants were randomised 1 : 1 to either an CM arm, in which participants received CM for cannabis use alongside an optimised treatment-as-usual programme including structured psychoeducation, or a control arm in which participants received the treatment as usual only. Setting EIP services across the Midlands and the south-east of England. Participants The main eligibility criteria were EIP service users with a history of psychosis, aged 18–36 years, and having used cannabis at least once per week during 12 of the previous 24 weeks. Intervention The CM intervention offered financial incentives (i.e. shopping vouchers) for cannabis abstinence over 12 once-weekly sessions, confirmed using urinalysis. The maximum value in vouchers that participants could receive was £240. Main outcome measures The main outcome was time to relapse, operationalised as admission to an acute mental health service or hospital. The primary outcome was assessed at 18 months post inclusion using electronic patient records. Secondary outcomes assessed the clinical effectiveness and cost-effectiveness of the intervention, for which data were collected at 3 and 18 months. Results A total of 278 participants were randomised to the CM arm and 273 were randomised to the control arm. In total, 530 (96%) participants were followed up for the primary outcome. There was no significant difference in time to admission between trial arms by 18 months following consent (hazard ratio 1.03, 95% confidence interval 0.76 to 1.40). There were no statistically significant differences in most secondary outcomes, including cannabis use, at either follow-up assessment. There were 58 serious adverse events, comprising 52 inpatient episodes, five deaths and one arrest. Limitations Participant retention was low at 18 months, limiting the assessment of secondary outcomes. A different CM intervention design or reward level may have been effective. Conclusions The CM intervention did not appear to be effective in reducing cannabis use and acute relapse among people with early psychosis and problematic cannabis use. Future work Cannabis use is still a significant clinical concern in this population. A pressing need remains to identify suitable treatments. A wider perspective on the social circumstances of young people with psychosis may be needed for a successful intervention to be found. Trial registration Current Controlled Trials ISRCTN33576045. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 45. See the NIHR Journals Library website for further project information.

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Section: Discussionmentioning

confidence: 99%

A contingency management intervention to reduce cannabis use and time to relapse in early psychosis: the CIRCLE RCT

Rains

Marwaha

Strang

et al. 2019

Health Technol Assess

Self Cite

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“…One was composed solely of cannabis-using patients, 41 and another did not provide data on the general symptomatology subscale. 42 These studies could not be included in the analyses. Two others included very few cannabis-users as compared to non-users so the mean difference between both groups could not be adjusted for covariates.…”

Section: Resultsmentioning

confidence: 99%

Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals

Argote,

Sescousse,

Brunelin

et al. 2023

eClinicalMedicine

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“…Many observational studies have established that social networks are related to healthy behaviors. Social network interventions have been used to reduce weight, improve schizophrenics' health, and treat HIV infection [10,11] . Social networks also play an important role in smoking behavior [12][15] [16] .…”

Section: Introductionmentioning

confidence: 99%

Social Network Characteristics and Smoking Index Among Smoking Cessation Outpatients in Kunming’s Grade-A Tertiary Hospitals in China: A Cross-Sectional Observational Study

Zeng

Yuan

et al. 2021

Preprint

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IntroductionThe success rate of smoking cessation outpatients remains modest. Previous studies have highlighted the importance of social networks for quitting smoking, yet there is a substantial lack of studies examining participants in outpatient smoking cessation programs, especially regarding their smoking index.AimWe aimed to identify the associations between the social network characteristics of smoking cessation outpatients and their smoking indexes. The association was analyzed with participants in Grade-A Tertiary Hospitals in Kunming, the capital of Yunnan province in China.MethodsA multicenter cross-sectional survey was conducted in Kunming in six randomly sampled Grade-A tertiary hospitals. Participants included 351 smoking cessation outpatients who provided data on cigarette smoking and social networks. Multivariate logistic regression was used to examine the association between social network characteristics and smoking index across outpatients. Strong associations were identified using adjusted odds ratios and a 95% confidence interval.ResultsLarge network size (AOR=1.79, 95%CI=0.99, 3.86), having children (AOR = 6.35, 95%CI = 2.26, 19.86), and at least one highly influential person in the network (AOR = 2.74, 95% CI =1.13, 7.01)were all associated with the risk of a high smoking index. However, having drinking friends (AOR = 0.28, 95% CI = 0.14, 0.56), non-smoking and non-drinking friends in the network (AOR = 0.44, 95% CI = 0.21, 0.88), and a network member who provided health advice (AOR = 0.41, 95% CI = 0.11, 1.35) were associated with a lower risk of a high smoking index.The results were sustained even after adjusting for demographic details.ConclusionsThe study findings suggest the importance of social network characteristics for smoking cessation physicians when formulating a personalized smoking cessation plan for outpatients.

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Social network confidants, duration of untreated psychosis and cannabis use in people with first episode psychosis: An exploratory study

Cited by 3 publications

References 37 publications

A contingency management intervention to reduce cannabis use and time to relapse in early psychosis: the CIRCLE RCT

A contingency management intervention to reduce cannabis use and time to relapse in early psychosis: the CIRCLE RCT

Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals

Social Network Characteristics and Smoking Index Among Smoking Cessation Outpatients in Kunming’s Grade-A Tertiary Hospitals in China: A Cross-Sectional Observational Study

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