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Prevalence and impact of cannabis use disorders in adolescents with early onset first episode psychosis

Published online by Cambridge University Press:  15 April 2020

B.G. Schimmelmann ,
P. Conus ,
S. Cotton ,
S. Kupferschmid ,
P.D. McGorry  and
M. Lambert
B.G. Schimmelmann*
Affiliation:
University Hospital of Child and Adolescent Psychiatry, Bolligenstr. 111, 3000Bern 60, Switzerland
P. Conus
Affiliation:
Treatment and early Intervention in Psychosis Program (TIPP), Department of Psychiatry, CHUV, Lausanne, Switzerland Orygen Youth Health and Research Centre, Centre for Youth Mental Health, Melbourne, Australia
S. Cotton
Affiliation:
Orygen Youth Health and Research Centre, Centre for Youth Mental Health, Melbourne, Australia
S. Kupferschmid
Affiliation:
University Hospital of Child and Adolescent Psychiatry, Bolligenstr. 111, 3000Bern 60, Switzerland
P.D. McGorry
Affiliation:
Orygen Youth Health and Research Centre, Centre for Youth Mental Health, Melbourne, Australia
M. Lambert
Affiliation:
Orygen Youth Health and Research Centre, Centre for Youth Mental Health, Melbourne, Australia Psychosis Early Detection and Intervention Centre (PEDIC), Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
*
*Corresponding author. Tel.: +41 31 932 8564; fax: +41 31 932 8569. E-mail address: bschimme@aol.com
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Abstract

Background

Previous studies on the impact of cannabis use disorders (CU) on outcome in psychosis were predominantly based on non representative samples, often have not controlled for confounders and rarely focused on adolescent patients. Thus, the aims of the present study were to assess: (i) prevalence of CU; (ii) baseline and pretreatment differences between CU and those without CU (NCU); (iii) the impact of baseline and course of CU on 18-month outcomes in a representative cohort of adolescents with early onset first episode psychosis (EOP).

Methods

The sample comprised 99 adolescents (age 14 to 18) with EOP (onset age 14 to 17), admitted to the Early Psychosis Prevention and Intervention Centre in Australia. Data were collected from medical files using a standardized questionnaire.

Results

Prevalence of lifetime CU was 65.7%, of current CU at baseline 53.5%, and of persistent CU throughout treatment 26.3%. Baseline CU compared to NCU had significantly higher illness-severity, lower psychosocial functioning, less insight, lower premorbid functioning and longer duration of untreated psychosis. Compared to all other groups, only persistent CU was linked to worse outcomes and more service disengagement. Effect sizes were medium controlling for relevant confounders. Medication non-adherence did not explain the association between persistent CU and worse outcome.

Conclusions

Baseline CU was associated with worse baseline characteristics, but only persistent CU was linked with worse outcome. About half of those with baseline CU reduced cannabis during treatment. For these, effectively treating the psychotic disorder may already be beneficial. However, future research is necessary on the reasons for persistent CU in EOP and its treatment.

Keywords

First-episode psychosisEarly onset psychosisSchizophreniaSubstance useSymptomatic remissionAdolescence
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 6 , August 2012 , pp. 463 - 469
Copyright
Copyright © Elsevier Masson SAS 2012

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