The relationship between cannabis use and cortisol levels in youth at ultra high-risk for psychosis

BackgroundPrevious research has established the relationship between cannabis use and psychotic disorders. Whether cannabis use is related to transition to psychosis in patients at ultra-high risk (UHR) for psychosis remains unclear. The present study aimed to review the existing evidence on the association between cannabis use and transition to psychosis in UHR samples.MethodA search of PsychInfo, Embase and Medline was conducted from 1996 to August 2015. The search yielded 5559 potentially relevant articles that were selected on title and abstract. Subsequently 36 articles were screened on full text for eligibility. Two random-effects meta-analyses were performed. First, we compared transition rates to psychosis of UHR individuals with lifetime cannabis use with non-cannabis-using UHR individuals. Second, we compared transition rates of UHR individuals with a current DSM-IV cannabis abuse or dependence diagnosis with lifetime users and non-using UHR individuals.ResultsWe found seven prospective studies reporting on lifetime cannabis use in UHR subjects (n = 1171). Of these studies, five also examined current cannabis abuse or dependence. Lifetime cannabis use was not significantly associated with transition to psychosis [odds ratio (OR) 1.14, 95% confidence interval (CI) 0.856–1.524, p = 0.37]. A second meta-analysis yielded an OR of 1.75 (95% CI 1.135–2.710, p = 0.01), indicating a significant association between current cannabis abuse or dependence and transition to psychosis.ConclusionsOur results show that cannabis use was only predictive of transition to psychosis in those who met criteria for cannabis abuse or dependence, tentatively suggesting a dose–response relationship between current cannabis use and transition to psychosis.

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Effects of cannabis use on event related potentials in subjects at ultra high risk for psychosis and healthy controls

International Journal of Psychophysiology ◽

10.1016/j.ijpsycho.2013.03.012 ◽

2013 ◽

Vol 88 (2) ◽

pp. 149-156 ◽

Cited By ~ 10

Author(s):

Mirjam J. van Tricht ◽

Emma C. Harmsen ◽

Johannes H.T.M. Koelman ◽

Lo J. Bour ◽

Thérèse A. van Amelsvoort ◽

...

Keyword(s):

High Risk ◽

Event Related Potentials ◽

Cannabis Use ◽

Healthy Controls ◽

Ultra High Risk ◽

Related Potentials

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Effects of Cannabis Use in Those at Ultra-High Risk for Psychosis

The Complex Connection Between Cannabis and Schizophrenia ◽

10.1016/b978-0-12-804791-0.00007-0 ◽

2018 ◽

pp. 167-181 ◽

Cited By ~ 3

Author(s):

Brian O'Donoghue ◽

Meredith McHugh ◽

Barnaby Nelson ◽

Patrick McGorry

Keyword(s):

High Risk ◽

Cannabis Use ◽

Ultra High Risk

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Perceived stress mediates the relationship between social adaptation and quality of life in individuals at ultra high risk of psychosis

Early Intervention in Psychiatry ◽

10.1111/eip.12791 ◽

2019 ◽

Vol 13 (6) ◽

pp. 1447-1454 ◽

Cited By ~ 1

Author(s):

Laura Ortega ◽

Itziar Montalvo ◽

Rosa Monseny ◽

Elisabet Vilella ◽

Javier Labad

Keyword(s):

Quality Of Life ◽

High Risk ◽

Perceived Stress ◽

Social Adaptation ◽

Ultra High Risk ◽

The Relationship

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The relationship between childhood trauma and clinical characteristics in ultra-high risk for psychosis youth

Psychosis ◽

10.1080/17522439.2019.1582686 ◽

2019 ◽

Vol 11 (1) ◽

pp. 28-41 ◽

Cited By ~ 3

Author(s):

Chloé de Vos ◽

Andrew Thompson ◽

Paul Amminger ◽

Sarah Bendall ◽

Lieuwe de Haan ◽

...

Keyword(s):

High Risk ◽

Childhood Trauma ◽

Clinical Characteristics ◽

Ultra High Risk ◽

The Relationship

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Concomitant Cannabis Misuse and Associations with Depression, Pain and Substance Misuse among Patients Prescribed Opioids

Pharmacy ◽

10.3390/pharmacy9030134 ◽

2021 ◽

Vol 9 (3) ◽

pp. 134

Author(s):

M. Aryana Bryan ◽

Elizabeth Charron ◽

Omolola Adeoye-Olatunde ◽

Jennifer Brown ◽

Udi Ghitza ◽

...

Keyword(s):

Depressive Symptoms ◽

High Risk ◽

Substance Misuse ◽

Monitoring Program ◽

Secondary Data ◽

Cannabis Use ◽

Community Pharmacies ◽

Medical Cannabis ◽

Abuse Treatment ◽

The Relationship

Background: Cannabis use is common among individuals with pain who are prescribed opioids, occurring in approximately 10% of this population. This study aims to explore the relationship between non-medical cannabis use and other health risks among individuals filling opioids at community pharmacies. Methods: This study was an exploratory secondary data analysis of a National Drug Abuse Treatment Clinical Trials Network (CTN)-sponsored study, Validation of a Community Pharmacy-Based Prescription Drug Monitoring Program Risk Screening, examining the relationship between risky cannabis use and depressive symptoms, pain, overdose, and other substance misuse among individuals filling opioid prescriptions in community pharmacies (N = 1440). Results: Participants reporting moderate- to high-risk compared to low-risk cannabis use were more likely to report depressive symptoms (adjusted OR = 1.67, 95% CI = 1.11–2.56), history of overdose (adjusted OR = 2.15, 95% CI = 1.34–3.44), and moderate- to high-risk use of alcohol (adjusted OR = 2.10, 95% CI = 1.28–3.45), opioids (adjusted OR = 2.50, 95% CI = 1.67–3.76), sedatives (adjusted OR = 2.58, 95% CI = 1.72–3.86), stimulants (adjusted OR = 4.79, 95% CI = 2.83–8.01), and tobacco (adjusted OR = 3.60, 95% CI = 2.47–5.24). Conclusions: Community pharmacies may be valuable sites for identifying, studying, and intervening with substance use problems.

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Cannabis Use is Not Associated With the Development of Psychosis in an ‘Ultra’ High-Risk Group

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2002.01089.x ◽

2002 ◽

Vol 36 (6) ◽

pp. 800-806 ◽

Cited By ~ 83

Author(s):

Lisa J Phillips ◽

Christina Curry ◽

Alison R Yung ◽

Hok Pan Yuen ◽

Steven Adlard ◽

...

Keyword(s):

Risk Factor ◽

High Risk ◽

Psychotic Disorder ◽

Risk Group ◽

High Risk Group ◽

Cannabis Use ◽

Psychotic Symptoms ◽

First Episode ◽

Psychotic Episode ◽

Ultra High Risk

Background: The association between cannabis use and the development of a first psychotic episode was studied in a group of 100 young people identified as being at very high risk for the onset of psychosis. Method: The ‘ultra’ high risk cohort was identified by the presence of subthreshold psychotic symptoms, or a combination of first-degree relative with a psychotic disorder and recent functional decline. Thirty-two per cent of the cohort developed an acute psychotic episode over the 12-month period after recruitment. As a component of a larger research study, the level of cannabis use by participants in the year prior to enrolment in the study was assessed at intake. Results: Cannabis use or dependence in the year prior to recruitment to this study was not associated with a heightened risk of developing psychosis over the following 12-month period and therefore did not appear to contribute to the onset of a psychotic disorder. Conclusion: The results of this study suggest that cannabis use may not play an integral role in the development of psychosis in a high-risk group. While this study does not support a role for cannabis in the development of first-episode psychosis, we cannot conclude that cannabis use should be completely ignored as a candidate risk factor for onset of psychosis. A number of weaknesses of the study (the low level of cannabis use in the current sample, the lack of monitoring of cannabis use after intake) suggest that it may be premature to dismiss cannabis use as a risk factor for the development of psychosis and further research is urged in this area.

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THE RELATIONSHIP BETWEEN TRANSITION TO PSYCHOSIS, AND FUNCTIONAL OUTCOME IN A GROUP AT ULTRA HIGH RISK FOR PSYCHOTIC DISORDER

Schizophrenia Research ◽

10.1016/s0920-9964(12)70146-9 ◽

2012 ◽

Vol 136 ◽

pp. S40-S41

Author(s):

Barnaby Nelson ◽

A.R. Yung ◽

A. Lin ◽

S.J. Wood ◽

A. Thompson

Keyword(s):

High Risk ◽

Functional Outcome ◽

Psychotic Disorder ◽

Ultra High Risk ◽

The Relationship

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Defense Mechanisms in Adolescents at High Risk of Developing Psychosis: An Empirical Investigation

Research in Psychotherapy Psychopathology Process and Outcome ◽

10.4081/ripppo.2020.456 ◽

2020 ◽

Vol 23 (1) ◽

Cited By ~ 2

Author(s):

Tommaso Boldrini ◽

Gabriele Lo Buglio ◽

Guido Giovanardi ◽

Vittorio Lingiardi ◽

Silvia Salcuni

Keyword(s):

At Risk ◽

High Risk ◽

Defense Mechanisms ◽

Rating Scales ◽

Defense Mechanism ◽

Psychotic Symptoms ◽

Ultra High Risk ◽

Risk Patients ◽

Not At Risk ◽

The Relationship

Research within psychotherapy and psychopathology frameworks has been inspired by the central concept of defense mechanisms, which play a pivotal role in psychoanalysis. Defense specificities have only recently been studied systematically in the context of several clinical diagnoses. The present study aimed to explore the specificities of defense mechanisms in adolescents at ultra-high risk of developing psychosis and test the relationship between defensive functioning and attenuated psychotic symptoms. Twenty-six adolescent inpatients at ultra-high risk of developing psychosis and a matched clinical control group of inpatients not at risk of psychosis were interviewed. Two observer-rater methods, the Defense Mechanism Rating Scales and the Psychotic-Defense Mechanism Rating Scales were applied to interview transcripts to assess the individual use of defenses. Ultra-high-risk patients demonstrated lower defense mechanisms (i.e., total instances of defense mechanisms observed) and lower overall adaptiveness of the defenses presented. When specific differences between groups were observed, psychotic defenses were the sole defenses that could partially discriminate between ultra-high-risk and not at-risk patients. Regarding the relationship between defense mechanisms and subthreshold psychotic symptoms, psychotic defenses were associated with negative and disorganization symptoms, rather than with positive symptoms. The psychological vulnerability of ultra-high-risk patients is discussed and treatment implications for psychotherapy with such challenging patients are addressed.

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