Pre-illness cannabis use and the early course of nonaffective psychotic disorders: associations with premorbid functioning, the prodrome, and mode of onset of psychosis
- PMID: 21036542
- PMCID: PMC3052993
- DOI: 10.1016/j.schres.2010.10.005
Pre-illness cannabis use and the early course of nonaffective psychotic disorders: associations with premorbid functioning, the prodrome, and mode of onset of psychosis
Abstract
Introduction: Limited research indicates that pre-illness cannabis use may result in an earlier age at onset of psychosis, though little is known about the influence of prior cannabis use on the premorbid and prodromal phases. This study examined the effects of prior or concurrent cannabis (as well as nicotine and alcohol) use on: (1) early adolescent (12-15 years) premorbid functioning, (2) late adolescent (16-18 years) premorbid functioning, (3) two features of the prodrome, and (4) mode of onset of psychosis.
Methods: Participants included 109 well-characterized first-episode patients hospitalized in public-sector settings. Assessments included ages at initiation of first, weekly, and daily use of substances, the Premorbid Adjustment Scale, the Symptom Onset in Schizophrenia inventory, and a consensus-based best estimate of mode of onset.
Results: Participants having used cannabis at ≤15 years had better early adolescence social functioning than those who had not used cannabis (p=0.02). Conversely, those who had used cannabis at ≤18 years had poorer late adolescence academic functioning (p<0.001). Participants having used cannabis before onset of psychotic symptoms did not differ from those who had not in terms of having had an identifiable prodrome or the number of prodromal symptoms experienced. Whereas 42% of those having used cannabis daily had an acute mode of onset of psychosis, only 20% of those without prior daily cannabis use had an acute onset (p=0.04).
Conclusions: Findings suggest that cannabis use is associated with premorbid social and academic functioning and mode of onset. Further research is warranted to elucidate the complex associations between cannabis use and diverse early-course features.
Copyright © 2010 Elsevier B.V. All rights reserved.
Conflict of interest statement
The authors know of no conflicts of interest pertaining to this research or this article.
References
-
- Alvarez E, Garcia-Ribera C, Torrens M, Udina C, Guillamat R, Casas M. Premorbid Adjustment Scale as a prognostic predictor for schizophrenia. Br J Psychiatry. 1987;150(3):411. - PubMed
-
- Barnes T, Mutsatsa S, Hutton S, Watt H, Joyce E. Comorbid substance use and age at onset of schizophrenia. Br J Psychiatry. 2006;188(3):237–242. - PubMed
-
- Barnett J, Werners U, Secher S, Hill K, Brazil R, Masson K, Pernet D, Kirkbride J, Murray G, Bullmore E, Jones P. Substance use in a population-based clinic sample of people with first-episode psychosis. Br J Psychiatry. 2007;190(6):515–520. - PubMed
-
- Cannon-Spoor HE, Potkin SG, Wyatt RJ. Measurement of premorbid adjustment in chronic schizophrenia. Schizophr Bull. 1982;8(3):470–484. - PubMed
-
- Cantwell R, Brewin J, Glazebrook C, Dalkin T, Fox R, Medley I, Harrison G. Prevalence of substance misuse in first-episode psychosis. Br J Psychiatry. 1999;174(2):150–153. - PubMed
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