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

Published online by Cambridge University Press:  06 February 2014

L. R. Valmaggia ,
F. L. Day ,
C. Jones ,
S. Bissoli ,
C. Pugh ,
D. Hall ,
S. Bhattacharyya ,
O. Howes ,
J. Stone  and
P. Fusar-Poli
...Show all authors
L. R. Valmaggia*
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
F. L. Day
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
C. Jones
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
S. Bissoli
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
C. Pugh
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
D. Hall
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
S. Bhattacharyya
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
O. Howes
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
J. Stone
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
P. Fusar-Poli
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
M. Byrne
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
P. K. McGuire
Affiliation:
Institute of Psychiatry, King's College London, London, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, London, UK
*
*Address for correspondence: L. R. Valmaggia, Ph.D., Institute of Psychiatry, King's College London, Box P077, De Crespigny Park, London SE5 8AF, UK. (Email: Lucia.Valmaggia@kcl.ac.uk)
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Abstract

Background

Cannabis use is associated with an increased risk of developing a psychotic disorder but the temporal relationship between cannabis use and onset of illness is unclear. The objective of this study was to assess prospectively the influence of cannabis use on transition to psychosis in people at ultra-high risk (UHR) for the disorder.

Method

Lifetime and continued cannabis use was assessed in a consecutively ascertained sample of 182 people (104 male, 78 female) at UHR for psychosis. Individuals were then followed clinically for 2 years to determine their clinical outcomes.

Results

Lifetime cannabis use was reported by 134 individuals (73.6%). However, most of these individuals had stopped using cannabis before clinical presentation (n = 98, 73.1%), usually because of adverse effects. Among lifetime users, frequent use, early-onset use and continued use after presentation were all associated with an increase in transition to psychosis. Transition to psychosis was highest among those who started using cannabis before the age of 15 years and went on to use frequently (frequent early-onset use: 25%; infrequent or late-onset use: 5%; χ21 = 10.971, p = 0.001). However, within the whole sample, cannabis users were no more likely to develop psychosis than those who had never used cannabis (cannabis use: 12.7%; no use: 18.8%; χ21 = 1.061, p = 0.303).

Conclusions

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.

Keywords

Cannabispsychosissubstance useultra-high risk
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 12 , September 2014 , pp. 2503 - 2512
Copyright
Copyright © Cambridge University Press 2014 

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