P01-345-Prevalence and impact of cannabis use disorders in adolescents with early onset first episode psychosis

ObjectivePrevious studies on the impact of cannabis use disorders (CU) on outcome in psychosis were mostly based on non-representative samples, have often not controlled for confounders and rarely focused on adolescents. Thus, the aims of the present study were to assess;(i) prevalence of CU;(ii) pre-treatment and baseline differences between CU and those without CU (NCU); and(iii) the impact of baseline and course of CU on 18-month outcomes in a representative cohort of adolescents with early onset first episode psychosis (EOP).MethodThe sample comprised 99 adolescents (age 14 to 18) with EOP (onset age 14 to 17), admitted to the Early Psychosis Prevention and Intervention Centre in Australia. Data were collected from medical files using a standardized questionnaire.ResultsPrevalence of lifetime CU was 65.7%, baseline CU 53.5%, and persistent CU 26.3%. Baseline CU compared to NCU was associated with higher illness-severity, lower functioning, less insight, lower premorbid functioning and longer duration of untreated psychosis. Compared to both NCU and those who decreased or stopped CU during treatment, only persistent CU was linked to worse outcomes and more service disengagement. Effect sizes were medium controlling for relevant confounders. Medication non-adherence did not explain the link between persistent CU and worse outcome.ConclusionsThe prevalence of CU in adolescents with EOP is high, while only persistent CU use was associated with worse outcome with medium effect sizes. Specific needs of adolescent patients with respect to cannabis interventions within integrated care settings should be addressed in future studies.

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Prevalence and impact of cannabis use disorders in adolescents with early onset first episode psychosis

European Psychiatry ◽

10.1016/j.eurpsy.2011.03.001 ◽

2012 ◽

Vol 27 (6) ◽

pp. 463-469 ◽

Cited By ~ 40

Author(s):

B.G. Schimmelmann ◽

P. Conus ◽

S. Cotton ◽

S. Kupferschmid ◽

P.D. McGorry ◽

...

Keyword(s):

Early Onset ◽

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Episode Psychosis ◽

Cannabis Use Disorders

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Cannabis use and nonuse in patients with first-episode psychosis: A systematic review and meta-analysis of studies comparing neurocognitive functioning

European Psychiatry ◽

10.1192/j.eurpsy.2019.9 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

Teresa Sánchez-Gutiérrez ◽

Belén Fernandez-Castilla ◽

Sara Barbeito ◽

Ana González-Pinto ◽

Juan Antonio Becerra-García ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

First Episode Psychosis ◽

Cannabis Use ◽

Effect Sizes ◽

Neurocognitive Functioning ◽

Psychotic Symptoms ◽

First Episode ◽

Moderator Variables ◽

Episode Psychosis

Abstract Background. The implications of cannabis use in the onset of early psychosis and the severity of psychotic symptoms have resulted in a proliferation of studies on this issue. However, few have examined the effects of cannabis use on the cognitive symptoms of psychosis (i.e., neurocognitive functioning) in patients with first-episode psychosis (FEP). This systematic review and meta-analysis aim to assess the neurocognitive functioning of cannabis users (CU) and nonusers (NU) with FEP. Methods. Of the 110 studies identified through the systematic review of 6 databases, 7 met the inclusion criteria, resulting in 14 independent samples and 78 effect sizes. The total sample included 304 CU with FEP and 369 NU with FEP. The moderator variables were age at first use, duration of use, percentage of males, and age. Results. Effect sizes were not significantly different from zero in any neurocognitive domain when users and NU were compared. Part of the variability in effect sizes was explained by the inclusion of the following moderator variables: (1) frequency of cannabis use (β = 0.013, F = 7.56, p = 0.017); (2) first-generation antipsychotics (β = 0.019, F = 34.46, p ≤ 0.001); and (3) country where the study was carried out (β = 0.266, t = 2.06, p = 0.043). Conclusions. This meta-analysis indicates that cannabis use is not generally associated with neurocognitive functioning in patients with FEP. However, it highlights the deleterious effect of low doses of cannabis in some patients. It also stresses the importance of the type of antipsychotic prescription and cannabis dose as moderator variables in the neurocognitive functioning of CU with FEP.

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1.3 The Impact of Tobacco, Alcohol, and Cannabis Use on Treatment Outcomes Among Patients Experiencing First-Episode Psychosis: Data From the National RA1SE Early Treatment Program (ETP) Study

Journal of the American Academy of Child & Adolescent Psychiatry ◽

10.1016/j.jaac.2018.07.619 ◽

2018 ◽

Vol 57 (10) ◽

pp. S270

Author(s):

Michael McDonell

Keyword(s):

Treatment Outcomes ◽

Treatment Program ◽

Early Treatment ◽

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Episode Psychosis ◽

The Impact

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Poster #M266 CLINICAL CHARACTERISTICS IN EARLY ONSET FIRST-EPISODE PSYCHOSIS WITH CANNABIS USE

Schizophrenia Research ◽

10.1016/s0920-9964(14)70816-3 ◽

2014 ◽

Vol 153 ◽

pp. S287-S288

Author(s):

Radhika Patel ◽

Maria-de-Gracia Dominguez ◽

Helen Fisher ◽

Sonia Johnson ◽

Matthew Hodes

Keyword(s):

Early Onset ◽

Clinical Characteristics ◽

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Episode Psychosis

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Cannabis Use in a First Onset Psychosis Sample: Prevalence and Clinical Differences in Relation to Age of Onset

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.110 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S275-S275

Author(s):

M. Pardo ◽

J. Matalí ◽

A. Butjosa ◽

V. Regina ◽

M. Dolz ◽

...

Keyword(s):

Early Onset ◽

Age Of Onset ◽

Pearson Correlation ◽

Child And Adolescent ◽

First Episode Psychosis ◽

Cannabis Use ◽

Psychotic Symptoms ◽

First Episode ◽

Episode Psychosis ◽

Wide Range

IntroductionThere is a wide range of studies focusing on the use of cannabis in first episode psychosis (PEP). Literature using child and adolescent samples is scarce.Objectives and aimsTo determine the prevalence and clinical differences between cannabis users and non-cannabis users of early onset first episode psychosis (EOP), and adult onset first episode psychosis (AOP).MethodOne hundred and forty patients were recruited in adult (AOP subsample, n = 69) and child and adolescent (EOP subsample, n = 71) mental health services. The Positive and Negative Syndrome Scale was used for psychotic symptoms and the Calgary Scale for affective symptoms. The Chi2 test analysed clinical differences between users and nonusers within subsamples, and in the total sample a Pearson correlation was used for the relationship between age at cannabis use and PEP.ResultsThe prevalence of lifetime use of cannabis and the average age at first use were 48% and 13.82 years (± 1.15) in the EOP subsample, and 58% and 17.78 years (± 3.93) in the AOP subsample. Within EOP, cannabis users were older (P = .001), had fewer negative symptoms (P = .045) and less depressive symptoms (P = .005). Within AOP, cannabis users were younger (P = .018) and had greater severity of positive symptoms (P = .021). Age at first cannabis use and age at PEP were positively correlated.ConclusionsCannabis use is prevalent in adult and early onset psychosis. Cannabis users differ clinically from non-users, and the earlier the use of cannabis, the earlier the onset of psychosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Cannabis use disorders and age at onset of psychosis in 606 patients with first episode psychosis

European Psychiatry ◽

10.1016/s0924-9338(11)73204-7 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1500-1500

Author(s):

B. Schimmelmann ◽

S. Kupferschmid ◽

P. Conus ◽

S. Cotton ◽

P. McGorry ◽

...

Keyword(s):

Late Onset ◽

Age At Onset ◽

First Episode Psychosis ◽

Cannabis Use ◽

Psychotic Symptoms ◽

First Episode ◽

Episode Psychosis ◽

Small Effect Size ◽

Early Onset Psychosis ◽

Cannabis Use Disorders

BackgroundAge at onset of psychosis (AAO) may be younger in patients with cannabis use disorders (CUD) compared to those without CUD (NCUD). Most previous studies did not control for potential confounders, did not report effect sizes and included mostly adult patients from non-representative samples.MethodsControlling for relevant confounders, differences in AAO between patients with and without lifetime CUD were analysed in a large epidemiologically based cohort of 606 first-episode psychosis (FEP) patients (age 14 to 29 years) admitted within three years to the Melbourne Early Psychosis Prevention and Intervention Centre. Data were collected from medical files using a standardized scale.ResultsOverall, AAO was not significantly different in CUD (n = 449; 74.1%) compared to NCUD, neither univariate nor when controlling for gender and premorbid functioning. However, AAO was younger in those with early CUD (starting before age 14) compared to NCUD (F(1) = 11.3; p = 0.001; partial η2 = 0.042). When considering the subgroups of early versus late onset psychosis, AAO was even later in early onset psychosis patients with CUD compared to those with NCUD (F(1) = 8.4; p = 0.004; partial η2 = 0.072). These findings were consistent for patients with non-affective psychoses, in those with CUD without other substance use disorders and in those with CUD explicitly starting in the pre-psychotic phase. Notably, 89.1% started cannabis before the onset of psychotic symptoms.ConclusionsCUD starting before age 14 was associated with an earlier AAO at a small effect size, but only in adult onset FEP patients.

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