Association of cannabis use with hospital admission and antipsychotic treatment failure in first episode psychosis: an observational study

AbstractBackgroundPoor response to dopaminergic antipsychotics constitutes a major challenge in the treatment of psychotic disorders and markers for non-response during first-episode are warranted. Previous studies have found increased levels of glutamate and γ-aminobutyric acid (GABA) in non-responding first-episode patients compared to responders, but it is unknown if non-responders can be identified using reference levels from healthy controls (HCs).MethodsThirty-nine antipsychotic-naïve patients with first-episode psychosis and 36 matched HCs underwent repeated assessments with the Positive and Negative Syndrome Scale and 3T magnetic resonance spectroscopy. Glutamate scaled to total creatine (/Cr) was measured in the anterior cingulate cortex (ACC) and left thalamus, and levels of GABA/Cr were measured in ACC. After 6 weeks, we re-examined 32 patients on aripiprazole monotherapy and 35 HCs, and after 26 weeks we re-examined 30 patients on naturalistic antipsychotic treatment and 32 HCs. The Andreasen criteria defined non-response.ResultsBefore treatment, thalamic glutamate/Cr was higher in the whole group of patients but levels normalized after treatment. ACC levels of glutamate/Cr and GABA/Cr were lower at all assessments and unaffected by treatment. When compared with HCs, non-responders at week 6 (19 patients) and week 26 (16 patients) had higher baseline glutamate/Cr in the thalamus. Moreover, non-responders at 26 weeks had lower baseline GABA/Cr in ACC. Baseline levels in responders and HCs did not differ.ConclusionGlutamatergic and GABAergic abnormalities in antipsychotic-naïve patients appear driven by non-responders to antipsychotic treatment. If replicated, normative reference levels for glutamate and GABA may aid estimation of clinical prognosis in first-episode psychosis patients.

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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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Childhood symptoms of inattention–hyperactivity predict cannabis use in first episode psychosis

Schizophrenia Research ◽

10.1016/j.schres.2011.06.027 ◽

2011 ◽

Vol 132 (2-3) ◽

pp. 171-176 ◽

Cited By ~ 8

Author(s):

Clifford M. Cassidy ◽

Ridha Joober ◽

Suzanne King ◽

Ashok K. Malla

Keyword(s):

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Episode Psychosis

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S101. CLINICAL FACTORS ASSOCIATED WITH CANNABIS USE IN A CHILEAN SAMPLE OF FIRST EPISODE PSYCHOSIS PATIENTS

Schizophrenia Bulletin ◽

10.1093/schbul/sby018.888 ◽

2018 ◽

Vol 44 (suppl_1) ◽

pp. S364-S364

Author(s):

Barbara Iruretagoyena ◽

Nicolas Crossley ◽

Alfonso Gonzalez-Valderrama ◽

Cristian Mena ◽

Carmen Castañeda ◽

...

Keyword(s):

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Clinical Factors ◽

Factors Associated ◽

Episode Psychosis

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Does food responsiveness change in people with first episode psychosis (FEP) over a period of 6 months after commencing antipsychotics? Preliminary results

BJPsych Open ◽

10.1192/bjo.2021.682 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S255-S255

Author(s):

Adrian Heald ◽

Mark Shakespeare ◽

Kevin Williamson ◽

Adrianne Close ◽

Adrian Phillipson ◽

...

Keyword(s):

Rating Scales ◽

Eating Behaviour ◽

First Episode Psychosis ◽

Intuitive Eating ◽

First Episode ◽

Antipsychotic Treatment ◽

Loss Of Control ◽

Convenience Sample ◽

Preliminary Results ◽

Episode Psychosis

AimsWe here present preliminary results from our study to understand better the changes in people’ s experience of food in the months after diagnosis with first episode psychosis (FEP). Weight gain often occurs in the weeks/months after diagnosis and is related to an increase in appetite and food intake. Many drugs that are effective in treating psychosis are associated with changes in the way that people experience reward when they eat.The aim of this project is to increase our understanding of exactly why this happens in terms of an individual's experience of food reward and reduced satiety – and therefore how we can help people with FEP to keep their weight down. At this stage we are looking at the feasibility of applying currently available evaluation tools to people in this situation.MethodA convenience sample was used to recruit 10 service users from RDaSH NHS FT Early Intervention Services. This is a feasibility study which will provide data to underpin a fully powered, larger trial.Rating scales applied were:Power of food questionnaire: measures responsiveness to the food environment.Intuitive Eating Scale: measures an individual's tendency to follow their physical hunger and satiety cues.The loss of control over eating scale (LOCES): measures a global sense of whether individuals experience LOC over eating.Dutch Eating Behaviour Questionnaire (DEBQ): measures restrained eating, emotional eating and external eating.ResultThe ages of the participants ranged from 17-26 years. All were started on Olanzapine at the dose of 5 or 10 mg daily.Baseline total scores for the Power of Food (2.47-3.80)/5 (higher score = more responsiveness) and Intuitive Eating scales (2.10-2.62)/5 (higher score = greater tendency to follow hunger and satiety cues) were in the mid-range, while the LOCES scores varied widely from 1.50-2.38/5.The DEBQ restrained subscale score range was 2.40-2.80/5 (higher indicates greater restraint with food) while the DEBQ external subscale ranged from 2.70—3.00/5 (higher = greater tendency to overeat) and the DEBQ emotional subtotal score was 1.92-1.94/5, in keeping with a relatively low emotional drive to eat.ConclusionOur preliminary results reveal at the beginning of antipsychotic treatment a moderate responsiveness to food and tendency to follow hunger/ satiety cues, with scores for Loss of Control of eating in the low to moderate range and a low emotional drive to eat. The difference between these and the follow-up eating behaviour scores will provide important clues as to the precise changes in eating behaviour with anti-psychotic treatment in FEP.

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Cannabis use and family history in adolescent first episode psychosis in Durban, South Africa

Journal of Child and Adolescent Mental Health ◽

10.2989/17280583.2013.767264 ◽

2013 ◽

Vol 25 (1) ◽

pp. 61-68 ◽

Cited By ~ 9

Author(s):

Saeeda Paruk ◽

Jonathan K Burns ◽

Rochelle Caplan

Keyword(s):

South Africa ◽

Family History ◽

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Episode Psychosis

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Trajectories after first-episode psychosis: Complement to ambiguous outcomes of long-term antipsychotic treatment by exploring a few hidden cases

Early Intervention in Psychiatry ◽

10.1111/eip.12696 ◽

2018 ◽

Vol 13 (4) ◽

pp. 895-901 ◽

Cited By ~ 1

Author(s):

Chen-Chung Liu ◽

Yi-Ting Lin ◽

Chih-Min Liu ◽

Ming H. Hsieh ◽

Yi-Ling Chien ◽

...

Keyword(s):

First Episode Psychosis ◽

First Episode ◽

Antipsychotic Treatment ◽

Episode Psychosis

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Continued Cannabis Use and Outcome in First-Episode Psychosis

The Journal of Clinical Psychiatry ◽

10.4088/jcp.11m07069 ◽

2012 ◽

Vol 73 (05) ◽

pp. 632-638 ◽

Cited By ~ 23

Author(s):

Gunnar Faber ◽

Henderikus G. O. M. Smid ◽

Arthur R. Van Gool ◽

Lex Wunderink ◽

Robert J. van den Bosch ◽

...

Keyword(s):

First Episode Psychosis ◽

Cannabis Use ◽

First Episode ◽

Episode Psychosis

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Innate Immune Cells and C-Reactive Protein in Acute First-Episode Psychosis and Schizophrenia: Relationship to Psychopathology and Treatment

Schizophrenia Bulletin ◽

10.1093/schbul/sbz068 ◽

2019 ◽

Cited By ~ 2

Author(s):

Johann Steiner ◽

Thomas Frodl ◽

Kolja Schiltz ◽

Henrik Dobrowolny ◽

Roland Jacobs ◽

...

Keyword(s):

Innate Immunity ◽

First Episode Psychosis ◽

Innate Immune ◽

First Episode ◽

Antipsychotic Treatment ◽

C Reactive Protein ◽

Activation Markers ◽

Reactive Protein ◽

Immune System Activation ◽

Episode Psychosis

Abstract Innate immunity has been linked to initiation of Alzheimer’s disease and multiple sclerosis. Moreover, risk of first-episode psychosis (FEP) and schizophrenia (Sz) is increased after various infections in predisposed individuals. Thus, we hypothesized an analogous role of innate immunity with increased C-reactive protein (CRP) in non-affective psychosis. Differential blood count, CRP, neutrophil and monocyte–macrophage activation markers, cortisol and psychotic symptoms (Positive and Negative Syndrome Scale [PANSS]) were assessed in controls (n = 294) and acutely ill unmedicated FEP (n = 129) and Sz (n = 124) patients at baseline and after 6 weeks treatment. Neutrophils, monocytes, and CRP were increased in patients vs controls at baseline (P < .001), and neutrophil and monocyte counts correlated positively with activation markers. Eosinophils were lower at baseline in FEP (P < .001) and Sz (P = .021) vs controls. Differences in neutrophils (P = .023), eosinophils (P < .001), and CRP (P < .001) were also present when controlling for smoking and cortisol, and partially remitted after antipsychotic treatment. FEP patients with high neutrophils (P = .048) or monocytes (P = .021) had higher PANSS-P scores at baseline but similar disease course. CRP correlated with PANSS-P at baseline (ρ = 0.204, P = .012). Improvement of positive symptoms after treatment correlated with declining neutrophils (ρ = 0.186, P = .015) or CRP (ρ = 0.237, P = .002) and rising eosinophils (ρ = −0.161, P = .036). In FEP, normalization of neutrophils (ρ = −0.231, P = .029) and eosinophils (ρ = 0.209, P = .048) correlated with drug dosage. In conclusion, innate immune system activation correlated with PANSS-P, supporting the immune hypothesis of psychosis. Neutrophil and monocyte counts and CRP levels may be useful markers of disease acuity, severity, and treatment response.

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