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Age at onset of non-affective psychosis in relation to cannabis use, other drug use and gender

Published online by Cambridge University Press:  27 March 2012

N. Dekker ,
J. Meijer ,
M. Koeter ,
W. van den Brink ,
N. van Beveren ,
R. S. Kahn ,
D. H. Linszen ,
J. van Os ,
D. Wiersma  and
R. Bruggeman
...Show all authors
N. Dekker
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
J. Meijer
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
M. Koeter
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
W. van den Brink
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
N. van Beveren
Affiliation:
Department of Psychiatry, Erasmus University Medical Centre Rotterdam, The Netherlands
R. S. Kahn
Affiliation:
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, The Netherlands
D. H. Linszen
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
J. van Os
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
D. Wiersma
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands
R. Bruggeman
Affiliation:
Department of Psychiatry, University Medical Centre Groningen, University of Groningen, The Netherlands
W. Cahn
Affiliation:
Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, The Netherlands
L. de Haan*
Affiliation:
Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
L. Krabbendam
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
I. Myin-Germeys
Affiliation:
Maastricht University Medical Centre, South Limburg Mental Health Research and Teaching Network, Maastricht, The Netherlands
*
*Address for correspondence: Dr L. de Haan, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands. (Email: l.dehaan@amc.uva.nl)
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Abstract

Background

Cannabis use is associated with an earlier age at onset of psychotic illness. The aim of the present study was to examine whether this association is confounded by gender or other substance use in a large cohort of patients with a non-affective psychotic disorder.

Method

In 785 patients with a non-affective psychotic disorder, regression analysis was used to investigate the independent effects of gender, cannabis use and other drug use on age at onset of first psychosis.

Results

Age at onset was 1.8 years earlier in cannabis users compared to non-users, controlling for gender and other possible confounders. Use of other drugs did not have an additional effect on age at onset when cannabis use was taken into account. In 63.5% of cannabis-using patients, age at most intense cannabis use preceded the age at onset of first psychosis. In males, the mean age at onset was 1.3 years lower than in females, controlling for cannabis use and other confounders.

Conclusions

Cannabis use and gender are independently associated with an earlier onset of psychotic illness. Our findings also suggest that cannabis use may precipitate psychosis. More research is needed to clarify the neurobiological factors that make people vulnerable to this precipitating effect of cannabis.

Keywords

Cannabisgenderillness-onsetpsychosisschizophreniasubstance use
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 9 , September 2012 , pp. 1903 - 1911
Copyright
Copyright © Cambridge University Press 2012

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