Skunk and psychosis in South East London

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Di Forti ◽  
C. Morgan ◽  
V. Mondelli ◽  
L. Gittens ◽  
R. Handley ◽  
...  

Background:Epidemiological studies have reported that the increased risk of developing psychosis in cannabis users is dose related. In addition, experimental research has shown that the active constituent of cannabis responsible for its psychotogenic effect is Delta-9-Tetrahydrocannabinol (THC) (Murray et al, 2007). Recent evidence has suggested an increased in potency (% TCH) in the cannabis seized in the UK (Potter et al, 2007).Hypothesis:We predicted that first episode psychosis patients are more likely to use higher potency cannabis and more frequently than controls.Methods:We collected information concerning socio-demographic, clinical characteristics and cannabis use (age at first use, frequency, length of use, type of cannabis used) from a sample of 191 first-episode psychosis patients and 120 matched healthy volunteers. All were recruited as part of the Genetic and Psychosis (GAP) study which studied all patients who presented to the South London and Maudsley Trust.Results:There was no significant difference in the life-time prevalence of cannabis use or age at first use between cases and controls. However, cases were more likely to be regular users (p=0.05), to be current users (p=0.04) and to have smoked cannabis for longer (p=0.01). Among cannabis users, 86.8% of 1st Episode Psychosis Patients preferentially used Skunk/Sinsemilla compared to 27.7% of Controls. Only 13.2 % of 1st Episode psychosis Patients chose to use Resin/Hash compared to 76.3% of controls. The concentration of TCH in these in South East London, ranges between 8.5 and 14 % (Potter et al, 2007). Controls (47%) were more likely to use Hash (Resin) whose average TCH concentration is 3.4% (Potter et al, 2007).Conclusions:Patients with first episode psychosis have smoked higher potency cannabis, for longer and with greater frequency, than healthy controls.

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
M. Di Forti

Epidemiological studies have reported that the increased risk of developing psychosis in cannabis users is dose related. In addition, experimental research has shown that the active constituent of cannabis responsible for its psychotogenic effect is Delta-9-Tetrahydrocannabinol (THC) (Murray et al, 2007). Recent evidence has suggested an increased in potency (% TCH) in the cannabis seized in the UK (Potter et al, 2007). We predicted that first episode psychosis patients are more likely to use higher potency cannabis and more frequently than controls.We collected information concerning socio-demographic, clinical characteristics and cannabis use (age at first use, frequency, length of use, type of cannabis used) from a sample of 191 first-episode psychosis patients and 120 matched healthy volunteers. Cases were more likely to be regular users (p=0.05), to be current users (p=0.04) and to have smoked cannabis for longer (p=0.01). Among cannabis users, 86.8% of 1st Episode Psychosis Patients preferentially used Skunk/Sinsemilla compared to 27.7% of Controls. Only 13.2 % of 1st Episode psychosis Patients chose to use Resin/Hash compared to 76.3% of controls (OR*= 7.4 95% CI 3.4- 17.2, Adjusted for age, gender, ethnicity, level of Education and employment status).The concentration of TCH in these in South East London, ranges between 8.5 and 14 % (Potter et al, 2007). Controls (47%) were more likely to use Hash (Resin) whose average TCH concentration is 3.4% (Potter et al, 2007).Patients with first episode psychosis have smoked higher potency cannabis, for longer and with greater frequency, than healthy controls.


2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S240-44
Author(s):  
Mohsin Aliemuddin ◽  
Muhammad Kamran ◽  
Zarrar Akbar CH ◽  
Ahmed Shoaib Tabassum ◽  
Farrukh Salim

Objective: To determine the frequency and correlates of cannabis use among the psychiatric inpatients presenting with first episode of psychosis at Combined Military Hospital (CMH), Lahore. Study Design: Correlational study. Place and Duration of Study: Combined Military Hospital Lahore, from Nov 2016 to Apr 2017. Methodology: A total of 88 patients between 18-40 years of age, both male and female, meeting the inclusion and exclusion criteria, presenting to Psychiatry department, CMH Lahore; were enrolled in the study after obtaining their informed consent. Patients were interviewed through Present state examination and the diagnosis was made on the basis of International Classification of Diseases version 10. The data was recorded on the study proforma. Outcome variable was frequency of cannabis abuse among these patients of first episode psychosis. It was compared among various age and gender groups and across educational, marital and residential status of the patient. Results: The mean age of the patients was 26.59 ± 5.79 years. There were 57 (64.8%) male and 31 (35.2%) female patients in the study group, with a ratio of 1.8 males to 1 female (1.8:1). Cannabis use was found in 25 (28.4%) patients. Statistical analysis revealed non-significant difference in the frequency of cannabis use in age (p=0.15), gender (p=0.69), educational (p=0.91), marital (p=0.180) and residential status (p=0.30). Conclusion: Cannabis use is highly correlated and prevalent among the patients presenting with first episode of psychosis.


2016 ◽  
Vol 13 (03) ◽  
pp. 152-157
Author(s):  
A. O. Berg ◽  
K. Leopold ◽  
S. Zarafonitis-Müller ◽  
M. Nerhus ◽  
L. H. Stouten ◽  
...  

Summary Background: Immigrants have increased risk of a poor recovery from first episode psychosis (FEP). Early treatment can improve prognosis, but having an immigrant background may influence pathways to care. Method: We present research of service use and factors influencing treatment outcome in immigrants with FEP. Service use was assessed in in-patients at an early intervention center in Berlin, Germany. Duration of untreated psychosis and beliefs about illness was assessed in a FEP study in Oslo, Norway and cognitive functioning in patients with FEP schizophrenia from the regular mental health services in The Hague, the Netherlands. The proportion of immigrants in Berlin and Oslo was at level with the local populations, while the proportion in The Hague appeared to be higher. Result: There were clear indications that mental health literacy, probably based in different cultural expectations, were lower in first generation immigrants (FGI). Findings regarding clinical insight were ambiguous. There were also indications that FGI had more cognitive problems, based in higher stress levels or in cognitive styles. Early psychosis services must take issues of immigration and ethnicity into consideration.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Natalie Martos ◽  
William Hall ◽  
Alicia Marhefka ◽  
Thomas W. Sedlak ◽  
Frederick C. Nucifora

Abstract Background Neutropenia, a decrease in total number of neutrophils below 1500/mm3 and particularly severe neutropenia, defined as neutrophils less than 500/mm3, is a potential adverse effect of antipsychotic medications that can lead to increased risk of infections and death. However, much of the attention on the potential adverse effect is centered exclusively on clozapine, which remains the only antipsychotic medication in the United States requiring standardized monitoring of blood work. We demonstrate here that paliperidone can also cause neutropenia and therefore clinicians should be aware of this possibility especially during initiation of treatment. Case presentation The following report presents the case of a 23-year-old African American male with first episode psychosis who developed neutropenia after initiation of paliperidone. Neutropenia resolved after discontinuation of paliperidone and initiation of an alternative antipsychotic, haloperidol. Conclusions This case report demonstrates an example of paliperidone induced neutropenia which resolved with a switch to haloperidol. We conclude that when initiating paliperidone, clinicians should be more aware of the risk of neutropenia. Moreover, neutropenia may be a more common and overlooked issue in patients on antipsychotic medications other than clozapine and increased awareness of comparative risk across antipsychotics could help direct treatment.


2001 ◽  
Vol 178 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Attila Sipos ◽  
Glynn Harrison ◽  
David Gunnell ◽  
Shazad Amin ◽  
Swaran P. Singh

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.


2001 ◽  
Vol 178 (5) ◽  
pp. 433-440 ◽  
Author(s):  
John Milton ◽  
Shazad Amin ◽  
Swaran P. Singh ◽  
Glynn Harrison ◽  
Peter Jones ◽  
...  

BackgroundRecent research has reported increased risk of aggressive incidents by individuals with psychotic illness.AimsTo examine acts of aggression in first-episode psychosis.MethodSubjects with a first-episode psychosis were ascertained from a defined catchment area (Nottingham, UK) and reassessed at 3 years (n=166) using clinical interview, informants, health care and forensic records.ResultsOf the subjects, 9.6% demonstrated at least one act of serious aggression (defined as weapon use, sexual assault or victim injury) during at least one psychotic episode and 23.5% demonstrated lesser acts of aggression (defined as all other acts of aggression). For all aggressive subjects (33.1%), unemployment (OR=3.6, 95%CI 1.6–8.0), comorbid substance misuse (OR=3.1, CI 1.1–8.8) and symptoms of overactivity at service contact (OR=6.9, CI 2.7–17.8) had independent effects on risk of aggression.ConclusionsWe confirmed some previously reported demographic and clinical associations with aggression in first-episode psychosis but no relationship with specific psychotic symptoms or diagnostic groups was observed.


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