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Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls

Published online by Cambridge University Press:  28 April 2020

Musa Sami*
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK Institute of Mental Health, Jubilee Campus, University of Nottingham, Nottingham, UK
Diego Quattrone
Affiliation:
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
Laura Ferraro
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 9012 9Palermo, Italy
Giada Tripoli
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
Erika La Cascia
Affiliation:
Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Via G. La Loggia 1, 9012 9Palermo, Italy
Charlotte Gayer-Anderson
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
Jean-Paul Selten
Affiliation:
Rivierduinen Institute for Mental Health Care, Sandifortdreef 19, 2333 ZZLeiden, The Netherlands Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
Celso Arango
Affiliation:
Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), C/Doctor Esquerdo 46, 28007Madrid, Spain
Miguel Bernardo
Affiliation:
Department of Medicine, Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
Ilaria Tarricone
Affiliation:
Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
Andrea Tortelli
Affiliation:
Etablissement Public de Santé Maison Blanche, Paris, 75020, France
Giusy Gatto
Affiliation:
Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
Simona del Peschio
Affiliation:
Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Viale Pepoli 5, 40126Bologna, Italy
Cristina Marta Del-Ben
Affiliation:
Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
Bart P. Rutten
Affiliation:
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands
Peter B. Jones
Affiliation:
Department of Psychiatry, University of Cambridge, Herchel Smith Building for Brain & Mind Sciences, Forvie Site, Robinson Way, Cambridge, CB2 0SZ, UK CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, CB21 5EF, UK
Jim van Os
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, P.O. Box 616, 6200 MDMaastricht, The Netherlands Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
Lieuwe de Haan
Affiliation:
Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Meibergdreef 5, 1105 AZAmsterdam, The Netherlands
Craig Morgan
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
Cathryn Lewis
Affiliation:
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
Sagnik Bhattacharyya
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
Tom P. Freeman
Affiliation:
Department of Psychology, Addiciton and Mental Health Group (AIM), University of Bath, BA2 7AY, UK National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, LondonSE5 8BB, UK
Michael Lynskey
Affiliation:
National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 4 Windsor Walk, LondonSE5 8BB, UK
Robin M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK
Marta Di Forti
Affiliation:
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK
*
Author for correspondence: Musa Sami, E-mail: musa.sami@nottingham.ac.uk

Abstract

Background

First episode psychosis (FEP) patients who use cannabis experience more frequent psychotic and euphoric intoxication experiences compared to controls. It is not clear whether this is consequent to patients being more vulnerable to the effects of cannabis use or to their heavier pattern of use. We aimed to determine whether extent of use predicted psychotic-like and euphoric intoxication experiences in patients and controls and whether this differs between groups.

Methods

We analysed data on patients who had ever used cannabis (n = 655) and controls who had ever used cannabis (n = 654) across 15 sites from six countries in the EU-GEI study (2010–2015). We used multiple regression to model predictors of cannabis-induced experiences and to determine if there was an interaction between caseness and extent of use.

Results

Caseness, frequency of cannabis use and money spent on cannabis predicted psychotic-like and euphoric experiences (p ⩽ 0.001). For psychotic-like experiences (PEs) there was a significant interaction for caseness × frequency of use (p < 0.001) and caseness × money spent on cannabis (p = 0.001) such that FEP patients had increased experiences at increased levels of use compared to controls. There was no significant interaction for euphoric experiences (p > 0.5).

Conclusions

FEP patients are particularly sensitive to increased psychotic-like, but not euphoric experiences, at higher levels of cannabis use compared to controls. This suggests a specific psychotomimetic response in FEP patients related to heavy cannabis use. Clinicians should enquire regarding cannabis related PEs and advise that lower levels of cannabis use are associated with less frequent PEs.

Type
Original Article
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Collaborators: Ulrich Reininghaus, Kathryn Hubbard, Stephanie Beards, Simona A. Stilo, Antonio Lasalvia, Caitlin Turner, Pierre-Michel Llorca, Julio Bobes, Miguel Bernardo, Julio Sanjuán, Jose Luis Santos, Manuel Arrojo, Mara Parellada, Pedro Cuadrado, José Juan Rodríguez Solano, Angel Carracedo, Enrique García Bernardo, Eva Velthorst, Laura Roldán, Gonzalo López, Bibiana Cabrera, Esther Lorente-Rovira, Paz Garcia-Portilla, Javier Costas, Estela Jiménez-López, Mario Matteis, Marta Rapado, Emiliano González, Covadonga Martínez, Emilio Sánchez, Ma Soledad Olmeda, Nathalie Franke, Fabian Termorshuizen, Daniella van Dam, Elsje van der Ven, Elles Messchaart, Marion Leboyer, Franck Schürhoff, Stéphane Jamain, Flora Frijda, Grégoire Baudin, Aziz Ferchiou, Baptiste Pignon, Jean-Romain Richard, Thomas Charpeaud, Anne-Marie Tronche, Giovanna Marrazzo, Lucia Sideli, Crocettarachele Sartorio, Fabio Seminerio, Camila Marcelino Loureiro, Rosana Shuhama, Mirella Ruggeri, Sarah Tosato, Chiara Bonetto, Doriana Cristofalo

References

Azur, M. J., Stuart, E. A., Frangakis, C., & Leaf, P. J. (2012). Multiple imputation by chained equations – what is it, and how does it work. International Journal of Methods in Psychiatric Research, 20(1), 4049. http://doi.org/10.1002/mpr.329.MultipleCrossRefGoogle Scholar
Barkus, E., & Lewis, S. (2008). Schizotypy and psychosis-like experiences from recreational cannabis in a non-clinical sample. Psychological Medicine, 38(9), 12671276. http://doi.org/10.1017/S0033291707002619CrossRefGoogle Scholar
Barkus, E. J., Stirling, J., Hopkins, R. S., & Lewis, S. (2006). Cannabis-induced psychosis-like experiences are associated with high schizotypy. Psychopathology, 39(4), 175178. http://doi.org/PSP2006039004175[pii]\r10.1159/000092678CrossRefGoogle ScholarPubMed
Bianconi, F., Bonomo, M., Marconi, A., Kolliakou, A., Stilo, S. A., Iyegbe, C., … Di Forti, M. (2016). Differences in cannabis-related experiences between patients with a first episode of psychosis and controls. Psychological Medicine, 46(5), 9951003. http://doi.org/10.1017/S0033291715002494.CrossRefGoogle ScholarPubMed
Casado-Espada, N. M., Martín, C., De La Iglesia-Larrad, J. I., Alarcón, R. D. E., Fombellida, C. I., Fernández-Martín, L. C., & Roncero, C. (2019). Psychotic symptoms following oxycodone withdrawal, case report and update. European Review for Medical and Pharmacological Sciences, 23(14), 63156320. http://doi.org/10.26355/eurrev_201907_18454Google ScholarPubMed
Colizzi, M., Iyegbe, C., Powell, J., Blasi, G., Bertolino, A., Murray, R. M., & Di Forti, M. (2015). Interaction between DRD2 and AKT1 genetic variations on risk of psychosis in cannabis users: A case–control study. Npj Schizophrenia, 1(1), 15025. http://doi.org/10.1038/npjschz.2015.25CrossRefGoogle ScholarPubMed
Curran, H. V., Hindocha, C., Morgan, C. J. A., Shaban, N., Das, R. K., & Freeman, T. P. (2019). Which biological and self-report measures of cannabis use predict cannabis dependency and acute psychotic-like effects? Psychological Medicine, 49(9), 15741580. http://doi.org/10.1017/S003329171800226X.CrossRefGoogle ScholarPubMed
Dekker, N., Linszen, D. H., & De Haan, L. (2009). Reasons for cannabis use and effects of cannabis use as reported by patients with psychotic disorders. Psychopathology, 42(6), 350360. http://doi.org/10.1159/000236906.CrossRefGoogle ScholarPubMed
Di Forti, M., Marconi, A., Carra, E., Fraietta, S., Trotta, A., Bonomo, M., … Murray, R. M. (2015). Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: A case-control study. The Lancet Psychiatry, 2(3), 233238. http://doi.org/10.1016/S2215-0366(14)00117-5CrossRefGoogle ScholarPubMed
Di Forti, M., Quattrone, D., Freeman, T. P., Tripoli, G., Gayer-Anderson, C., Quigley, H., … van der Ven, E. (2019). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): A multicentre case-control study. The Lancet Psychiatry, 6(5), 427436. http://doi.org/10.1016/S2215-0366(19)30048-3CrossRefGoogle ScholarPubMed
D'Souza, D. C., Abi-Saab, W. M., Madonick, S., Forselius-Bielen, K., Doersch, A., Braley, G., … Krystal, J. H. (2005). Delta-9-tetrahydrocannabinol effects in schizophrenia: Implications for cognition, psychosis, and addiction. Biological Psychiatry, 57, 594608. http://doi.org/10.1016/j.biopsych.2004.12.006CrossRefGoogle ScholarPubMed
European Monitoring Centre for Drugs and Drug Addiction. (2016). European drug report trends and developments 2016. Luxembourg: European Union Publications Office.Google Scholar
Freeman, T. P., Morgan, C. J. A., Hindocha, C., Schafer, G., Das, R. K., & Curran, H. V. (2014). Just say “know”: How do cannabinoid concentrations influence users’ estimates of cannabis potency and the amount they roll in joints? Addiction (Abingdon, England), 109(10), 16861694. http://doi.org/10.1111/add.12634CrossRefGoogle ScholarPubMed
Guloksuz, S., Pries, L. K., Delespaul, P., Kenis, G., Luykx, J. J., Lin, B. D., … van Os, J. (2019). Examining the independent and joint effects of molecular genetic liability and environmental exposures in schizophrenia: Results from the EUGEI study. World Psychiatry, 18(2), 173182. http://doi.org/10.1002/wps.20629CrossRefGoogle ScholarPubMed
Hasan, A., von Keller, R., Friemel, C. M., Hall, W., Schneider, M., Koethe, D., … Hoch, E. (2019). Cannabis use and psychosis: A review of reviews. European Archives of Psychiatry and Clinical Neuroscience. http://doi.org/10.1007/s00406-019-01068-zGoogle ScholarPubMed
Jongsma, H. E., Gayer-Anderson, C., Lasalvia, A., Quattrone, D., Mule, A., Szöke, A., … Menezes, P. R. (2018). Treated Incidence of Psychotic Disorders in the Multinational EU-GEI Study, 75(1), 3646. http://doi.org/10.1001/jamapsychiatry.2017.3554.Google ScholarPubMed
Jongsma, H. E., Turner, C., Kirkbride, J. B., & Jones, P. B. (2019). International incidence of psychotic disorders, 2002–17: A systematic review and meta-analysis. The Lancet Public Health, 4(5), e229e244. http://doi.org/10.1016/S2468-2667(19)30056-8CrossRefGoogle ScholarPubMed
Marconi, A., Di Forti, M., Lewis, C. M., Murray, R. M., & Vassos, E. (2016). Meta-analysis of the association between the level of cannabis use and risk of psychosis. Schizophrenia Bulletin, 42(5), 12621269. http://doi.org/10.1093/schbul/sbw003CrossRefGoogle ScholarPubMed
Moore, T. H. M., Zammit, S., Lingford-Hughes, A., Barnes, T. R. E., Jones, P. B., Burke, M., & Lewis, G. (2007). Cannabis use and risk of psychotic or affective mental health outcomes: A systematic review. Lancet, 370, 319328. http://doi.org/10.1016/S0140-6736(07)61162-3CrossRefGoogle Scholar
Morgan, C. J. A., Freeman, T. P., Powell, J., & Curran, H. V. (2016). AKT1 Genotype moderates the acute psychotomimetic effects of naturalistically smoked cannabis in young cannabis smokers. Translational Psychiatry, 6(2), 16. http://doi.org/10.1038/tp.2015.219CrossRefGoogle ScholarPubMed
Morrison, P. D., Zois, V., McKeown, D. A., Lee, T. D., Holt, D. W., Powell, J. F., … Murray, R. M. (2009). The acute effects of synthetic intravenous Delta9-tetrahydrocannabinol on psychosis, mood and cognitive functioning. Psychological Medicine, 39(10), 16071616. http://doi.org/10.1017/S0033291709005522CrossRefGoogle ScholarPubMed
Murray, R. M., & Di Forti, M. (2016). Cannabis and psychosis: What degree of proof do we require? Biological Psychiatry, 79(7), 514515. http://doi.org/10.1016/j.biopsych.2016.02.005CrossRefGoogle ScholarPubMed
Myles, H., Myles, N., & Large, M. (2015). Cannabis use in first episode psychosis: Meta-analysis of prevalence, and the time course of initiation and continued use. Australian and New Zealand Journal of Psychiatry, 50(3), 208219. http://doi.org/10.1177/0004867415599846CrossRefGoogle ScholarPubMed
Ortiz-Medina, M. B., Perea, M., Torales, J., Ventriglio, A., Vitrani, G., Aguilar, L., & Roncero, C. (2018). Cannabis consumption and psychosis or schizophrenia development. International Journal of Social Psychiatry, 64(7), 690704. http://doi.org/10.1177/0020764018801690.CrossRefGoogle ScholarPubMed
Peters, E., Joseph, S., Day, S., Garety, P. (2004). Measuring delusional ideation: The 21-item Peters et Al. Delusions Inventory (PDI). Schizophrenia Bulletin, 30(4), 10051022. http://doi.org/10.1093/oxfordjournals.schbul.a007116CrossRefGoogle Scholar
Peters, E. R., Joseph, S. A., Garety, P. A. (1999). Measurement of delusional ideation in the normal population: Introducing the PDI (Peters et al. Delusions Inventory). Schizophrenia Bulletin, 25(3), 553576. http://doi.org/10.1093/oxfordjournals.schbul.a033401CrossRefGoogle Scholar
Quinn, C. A., Wilson, H., Cockshaw, W., Barkus, E., & Hides, L. (2017). Development and validation of the cannabis experiences questionnaire – intoxication effects checklist (CEQ-I) short form. Schizophrenia Research, 189, 9196. http://doi.org/10.1016/j.schres.2017.01.048.CrossRefGoogle ScholarPubMed
Roncero, C., Daigre, C., Gonzalvo, B., Valero, S., Castells, X., Grau-López, L., … Casas, M. (2013 a). Risk factors for cocaine-induced psychosis in cocaine-dependent patients. European Psychiatry, 28(3), 141146. http://doi.org/10.1016/j.eurpsy.2011.06.012CrossRefGoogle ScholarPubMed
Roncero, C., Daigre, C., Grau-López, L., Rodríguez-Cintas, L., Barral, C., Pérez-Pazos, J., … Casas, M. (2013 b). Cocaine-induced psychosis and impulsivity in cocaine-dependent patients. Journal of Addictive Diseases, 32(3), 263273. http://doi.org/10.1080/10550887.2013.824330CrossRefGoogle ScholarPubMed
Sami, M., Notley, C., Kouimtsidis, C., Lynskey, M., & Bhattacharyya, S. (2018). Psychotic-like experiences with cannabis use predict cannabis cessation and desire to quit: A cannabis discontinuation hypothesis. Psychological Medicine, 49(1), 110. http://doi.org/10.1017/S0033291718000569.Google ScholarPubMed
Schoeler, T., Petros, N., Di Forti, M., Klamerus, E., Foglia, E., Ajnakina, O., … Bhattacharyya, S. (2016). Effects of continuation, frequency and type of cannabis use on relapse in the first two years following onset of psychosis – an observational study. The Lancet. Psychiatry, 366(16), 17. http://doi.org/10.1016/S2215-0366(16)30188-2Google Scholar
Stefanis, N. C., Hanssen, M., Smirnis, N. K., Avramopoulos, D. A., Evdokimidis, I. K., Stefanis, C. N., … Van Os, J. (2002). Evidence that three dimensions of psychosis have a distribution in the general population. Psychological Medicine, 32(2), 347358. http://doi.org/10.1017/S0033291701005141CrossRefGoogle ScholarPubMed
Stirling, J., Barkus, E. J., Nabosi, L., Irshad, S., Roemer, G., Schreudergoidheijt, B., & Lewis, S. (2008). Cannabis-induced psychotic-like experiences are predicted by high schizotypy: Confirmation of preliminary results in a large cohort. Psychopathology, 41(6), 371378. http://doi.org/10.1159/000155215CrossRefGoogle ScholarPubMed
Taylor, M., Sullivan, J., Ring, S. M., Macleod, J., & Hickman, M. (2017). Assessment of rates of recanting and hair testing as a biological measure of drug use in a general population sample of young people. Addiction, 112(3), 477485. http://doi.org/10.1111/add.13645CrossRefGoogle Scholar
Vadhan, N. P., Corcoran, C. M., Bedi, G., Keilp, J. G., & Haney, M. (2017). Acute effects of smoked marijuana in marijuana smokers at clinical high-risk for psychosis: A preliminary study. Psychiatry Research, 257, 372374. http://doi.org/10.1016/j.psychres.2017.07.070CrossRefGoogle ScholarPubMed
Valmaggia, L. R., Day, F. L., Jones, C., Bissoli, S., Pugh, C., Hall, D., … McGuire, P. K. (2014). Cannabis use and transition to psychosis in people at ultra-high risk. Psychological Medicine, 44(12), 25032512. http://doi.org/10.1017/S0033291714000117CrossRefGoogle ScholarPubMed
van Os, J., Linscott, R. J., Myin-Germeys, I., Delespaul, P., & Krabbendam, L. (2009). A systematic review and meta-analysis of the psychosis continuum: Evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine, 39(2), 179195. http://doi.org/10.1017/S0033291708003814CrossRefGoogle ScholarPubMed
Van Os, J., Rutten, B. P., Myin-Germeys, I., Delespaul, P., Viechtbauer, W., Van Zelst, C., … Mirjanic, T. (2014). Identifying gene-environment interactions in schizophrenia: Contemporary challenges for integrated, large-scale investigations. Schizophrenia Bulletin, 40(4), 729736. http://doi.org/10.1093/schbul/sbu069Google ScholarPubMed
Weibel, S., Mallaret, M., Bennouna-Greene, M., & Bertschy, G. (2012). Case report: A case of acute psychosis after buprenorphine withdrawal. The Journal of Clinical Psychiatry, 73(6), e756. http://doi.org/10.4088/jcp.11cr07608CrossRefGoogle ScholarPubMed
Werbeloff, N., Drukker, M., Dohrenwend, B. P., Levav, I., Yoffe, R., Van Os, J., … Weiser, M. (2012). Self-reported attenuated psychotic symptoms as forerunners of severe mental disorders later in life. Archives of General Psychiatry, 69(5), 467475. http://doi.org/10.1001/archgenpsychiatry.2011.1580CrossRefGoogle Scholar
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