Premorbid social adjustment is better in cannabis-using than non-using psychotic patients across Europe

IntroductionA number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage in illegal drug consumption, than non-using patients.ObjectivesGiven that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to study first-episode psychosis (FEP) cannabis-using and non-using patients coming from different European countries as part of the EUGEI-STUDY.AimsWe tested the hypothesis of better premorbid social adjustment in cannabis-using FEP patients, by comparing them to FEP non cannabis users and to their respective healthy controls.MethodsA total of 1745 people (746 cases; 999 controls) completed the assessment for premorbid adjustment [Premorbid Adjustment Scale (PAS)] and cannabis use (CEQ-Revised). We first extracted the Premorbid Social Adjustment Factor (PSA) from PAS and then performedlinear mixed models with PSA as dependent variable and cannabis lifetime (Yes/No) and subject status (Cases/Controls) as independent variables. We then considered “Country” as random intercept.ResultsAcross all countries, PSA scores were better in patients who had smoked cannabis in their lifetime than patients who had not (P = 0.009). The difference in PSA score between cannabis users and non-users was significantly greater in cases than controls (P = 0.038). The relationship between PSA, cannabis lifetime (Yes/No) and subject status among nations (random intercept) is shown on Fig. 1.ConclusionsCannabis-using psychotic patients show better premorbid social adjustment than non-using patients, across 5 European countries.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Exploring the relationship between recency and frequency of cannabis use and diminished expression and apathy as two dimensions of negative symptoms in first episode psychosis. A one-year follow-up study

Schizophrenia Research ◽

10.1016/j.schres.2021.08.004 ◽

2021 ◽

Vol 236 ◽

pp. 89-96

Author(s):

Henrik Myhre Ihler ◽

Trine Vik Lagerberg ◽

Siv Hege Lyngstad ◽

Ingrid Melle ◽

Kristin Lie Romm

Keyword(s):

Negative Symptoms ◽

First Episode Psychosis ◽

Two Dimensions ◽

Cannabis Use ◽

First Episode ◽

Follow Up Study ◽

Episode Psychosis ◽

One Year ◽

The Relationship

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T84. PREMORBID ADJUSTMENT AND IQ IN PATIENTS WITH FIRST-EPISODE PSYCHOSIS: A MULTISITE CASE-CONTROL STUDY OF THEIR RELATIONSHIP WITH CANNABIS USE

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa029.644 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S263-S263

Keyword(s):

Case Control Study ◽

First Episode Psychosis ◽

Case Control ◽

Cannabis Use ◽

First Episode ◽

Premorbid Adjustment ◽

Episode Psychosis ◽

Control Study

Abstract Abstract not included.

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The relationship between cannabis use and cognition in people diagnosed with first-episode psychosis

Psychiatry Research ◽

10.1016/j.psychres.2020.113424 ◽

2020 ◽

Vol 293 ◽

pp. 113424

Author(s):

Chloé de Vos ◽

Karolina Leopold ◽

Elisabeth S. Blanke ◽

Stefan Siebert ◽

Johanna Baumgardt ◽

...

Keyword(s):

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Episode Psychosis ◽

The Relationship

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Premorbid Adjustment and IQ in Patients With First-Episode Psychosis: A Multisite Case-Control Study of Their Relationship With Cannabis Use

Schizophrenia Bulletin ◽

10.1093/schbul/sbz077 ◽

2019 ◽

Vol 46 (3) ◽

pp. 517-529 ◽

Cited By ~ 2

Author(s):

Laura Ferraro ◽

Caterina La Cascia ◽

Diego Quattrone ◽

Lucia Sideli ◽

Domenica Matranga ◽

...

Keyword(s):

Social Adjustment ◽

Psychotic Disorders ◽

Social Factor ◽

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Episode Psychosis ◽

History Of ◽

History Of Use ◽

And Control

Abstract Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = −0.3, 95% CI = [−0.5; −0.2]) and never-users (Mdiff = −0.4, 95% CI = [−0.6; −0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders.

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Brain glutamate levels and antipsychotic response in schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.820 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S19-S19 ◽

Cited By ~ 1

Author(s):

A. Egerton

Keyword(s):

Antipsychotic Drugs ◽

Imaging Techniques ◽

Treatment Strategies ◽

First Episode Psychosis ◽

First Episode ◽

Treatment Resistant ◽

Ongoing Research ◽

Episode Psychosis ◽

Competing Interest ◽

The Relationship

There is considerable interest in identifying biomarkers of antipsychotic response in schizophrenia. Glutamate is one key candidate. The development of brain imaging techniques for measuring brain glutamate levels has allowed this hypothesis to be tested directly in patients. This talk will present our ongoing research examining the relationship between brain glutamate levels and antipsychotic response in first-episode psychosis and in treatment-resistant schizophrenia. I will summarise our results from both our completed and ongoing studies, to consider whether glutamate imaging might be useful in the future to identify patients who would benefit from non-dopaminergic antipsychotic drugs and inform novel, glutamate-based, treatment strategies.Disclosure of interestThe author has not supplied his declaration of competing interest.

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The relationship of symptom dimensions with premorbid adjustment and cognitive characteristics at first episode psychosis: Findings from the EU-GEI study

Schizophrenia Research ◽

10.1016/j.schres.2021.08.008 ◽

2021 ◽

Vol 236 ◽

pp. 69-79

Author(s):

Laura Ferraro ◽

Caterina La Cascia ◽

Daniele La Barbera ◽

Teresa Sanchez-Gutierrez ◽

Giada Tripoli ◽

...

Keyword(s):

First Episode Psychosis ◽

First Episode ◽

Symptom Dimensions ◽

Cognitive Characteristics ◽

Premorbid Adjustment ◽

Episode Psychosis ◽

Relationship Of ◽

The Relationship ◽

The Eu

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Pathways to functional outcomes following a first episode of psychosis: The roles of premorbid adjustment, verbal memory and symptom remission

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867417747401 ◽

2017 ◽

Vol 52 (8) ◽

pp. 793-803 ◽

Cited By ~ 11

Author(s):

Gerald Jordan ◽

Franz Veru ◽

Martin Lepage ◽

Ridha Joober ◽

Ashok Malla ◽

...

Keyword(s):

Confidence Interval ◽

Negative Symptom ◽

Verbal Memory ◽

Functional Outcomes ◽

First Episode Psychosis ◽

First Episode ◽

Premorbid Adjustment ◽

Episode Psychosis ◽

Symptom Remission ◽

The Relationship

Objective: Most studies have investigated either the singular or relative contributions of premorbid adjustment, verbal memory and symptom remission to functional outcomes in first-episode psychosis. Fewer studies have examined the pathways of these factors in impacting functioning. Our study addresses this gap. The objective was to determine whether the relationship between premorbid adjustment and functional outcomes was mediated by verbal memory and symptom remission. Method: A total of 334 first-episode psychosis participants (aged 14–35 years) were assessed on premorbid adjustment, verbal memory upon entry, and positive and negative symptom remission and functioning at multiple time points over a 2-year follow-up. Results: Mediation analyses showed that over the first year, the relationship between premorbid adjustment and functioning was mediated by verbal memory and positive symptom remission (β = –0.18; 95% confidence interval = [–0.51, –0.04]), as well as by verbal memory and negative symptom remission (β = –0.41; 95% confidence interval = [–1.11, –1.03]). Over 2 years, the relationship between premorbid adjustment and functioning was mediated by verbal memory and only negative symptom remission (β = –0.38; 95% confidence interval = [–1.46, –0.02]). Conclusion: Comparatively less malleable factors (premorbid adjustment and verbal memory) may contribute to functional outcomes through more malleable factors (symptoms). Promoting remission may be an important parsimonious means to achieving better functional outcomes.

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