Additive Effects of Former Methylenedioxymethamphetamine and Cannabis Use on Subclinical Psychotic Symptoms

Abstract Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.

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Aberrant Salience among Young Healthy Postgraduate University Students: The Role of Cannabis Use, Psychotic-Like Experiences, and Personality

Psychopathology ◽

10.1159/000520331 ◽

2022 ◽

pp. 1-7

Author(s):

Andrea Patti ◽

Gabriele Santarelli ◽

Giulio D’Anna ◽

Andrea Ballerini ◽

Valdo Ricca

Keyword(s):

University Students ◽

Personality Traits ◽

Cannabis Use ◽

Positive Symptom ◽

Psychotic Symptoms ◽

Symptom Frequency ◽

Character Inventory ◽

Aberrant Salience ◽

Self Transcendence

Aberrant salience (AS) is an anomalous world experience which plays a major role in psychotic proneness. In the general population, a deployment of this construct – encompassing personality traits, psychotic-like symptoms, and cannabis use – could prove useful to outline the relative importance of these factors. For this purpose, 106 postgraduate university students filled the AS Inventory (ASI), the Community Assessment of Psychic Experiences (CAPE), the Temperament and Character Inventory (TCI), and the Symptom Checklist 90-Revised (SCL-90-R). Lifetime cannabis users (<i>n</i> = 56) and individuals who did not use cannabis (<i>n</i> = 50) were compared. The role of cannabis use and psychometric indexes on ASI total scores was tested in different subgroups (overall sample, cannabis users, and nonusers). The present study confirmed that cannabis users presented higher ASI scores. The deployment of AS proved to involve positive symptom frequency (assessed through CAPE), character dimensions of self-directedness and self-transcendence (TCI subscales), and cannabis use. Among nonusers, the role of personality traits (assessed through the TCI) was preeminent, whereas positive psychotic-like experiences (measured by means of CAPE) had a major weight among cannabis users. The present study suggests that pre-reflexive anomalous world experiences such as AS are intertwined with reflexive self-consciousness, personality traits, current subclinical psychotic symptoms, and cannabis use. In the present study, subthreshold psychotic experiences proved to play a major role among cannabis users, whereas personality appeared to be more relevant among nonusers.

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Early Diagnosis and Counseling in Adolescents With Subclinical Psychotic Symptoms

The Global Psychotherapist ◽

10.52982/lkj160 ◽

2022 ◽

Vol 2 (1) ◽

pp. 62-68

Author(s):

Veronika Ivanova

Keyword(s):

Early Diagnosis ◽

Medical Model ◽

Psychotic Symptoms ◽

Clinical Psychologist ◽

Psychotic Episode ◽

Clinical Approach ◽

First Psychotic Episode ◽

Psychotherapeutic Techniques ◽

Sexual Identification ◽

Subclinical Psychotic Symptoms

Psychosis is a condition characterized on current diagnostic tests by impairment and may include severe disturbances of cognition, thinking, behaviour, and emotion. The need for early diagnosis and prevention of psychotic episodes in adolescents challenges traditional models of counselling, diagnosis, and treatment. The aim of the present study is to derive the main themes and psychological manifestations in the first psychotic episode in adolescents and to deepen knowledge and raise questions around the specific experiences of psychotic adolescents in order to help the clinical psychologist and psychotherapist in diagnostic and therapeutic counselling. This thus goes beyond the visible behaviour and the medical model that pays little attention to the causal relationships in psychosis and its unconscious components. Thirty-six adolescents (27 girls) with subclinical and clinical psychotic symptoms and 30 adolescents (16 girls) with neurotic symptoms were interviewed. A clinical approach was used – clinical psychological interview followed by psychotherapeutic work. Findings and statements can be found showing that early psychotic signs may change into a more severe adolescent crisis, as well as indications of the nature of anger towards parents, unstable mood and aggressivity. Leading themes in interviews and psychotherapeutic sessions may relate to feelings of insignificance in the world around them, unclear sexual identification, too close a relationship with their mothers, and anxiety about real or symbolic absence such as their mothers’ working away from home for long periods of time. In 79% of the interviews with adolescents with psychotic symptoms, we see a lack of real symbolic play in childhood. suitable for non-psychotic adolescents, in this case to change in the first psychotic episode.****What does this last sentence mean? The importance of early diagnosis is recognized and the known psychotherapeutic techniques must be used. Keywords: early psychosis, adolescent, positive psychotherapy, counselling

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Obsessive-compulsive symptoms in schizophrenia patients and their first-degree relatives and the association with subclinical psychotic symptoms

Nordic Journal of Psychiatry ◽

10.1080/08039488.2021.1966097 ◽

2021 ◽

pp. 1-9

Author(s):

Barış Sancak ◽

Güliz Özgen Hergül

Keyword(s):

Psychotic Symptoms ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

First Degree Relatives ◽

Subclinical Psychotic Symptoms

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Cannabis use predicts future psychotic symptoms, and vice versa

Addiction ◽

10.1111/j.1360-0443.2005.01070.x ◽

2005 ◽

Vol 100 (5) ◽

pp. 612-618 ◽

Cited By ~ 107

Author(s):

Robert F. Ferdinand ◽

Frouke Sondeijker ◽

Jan van der Ende ◽

Jean-Paul Selten ◽

Anja Huizink ◽

...

Keyword(s):

Cannabis Use ◽

Psychotic Symptoms

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Cannabis use and first-episode psychosis: relationship with manic and psychotic symptoms, and with age at presentation

Psychological Medicine ◽

10.1017/s0033291713000883 ◽

2013 ◽

Vol 44 (3) ◽

pp. 499-506 ◽

Cited By ~ 40

Author(s):

J. M. Stone ◽

H. L. Fisher ◽

B. Major ◽

B. Chisholm ◽

J. Woolley ◽

...

Keyword(s):

Longitudinal Design ◽

First Episode Psychosis ◽

Cannabis Use ◽

Daily Functioning ◽

Psychotic Symptoms ◽

First Episode ◽

Time Points ◽

Manic Symptoms ◽

Episode Psychosis ◽

Early Intervention In Psychosis

BackgroundCannabis use has been reported to be associated with an earlier onset of symptoms in patients with first-episode psychosis, and a worse outcome in those who continue to take cannabis. In general, studies have concentrated on symptoms of psychosis rather than mania. In this study, using a longitudinal design in a large naturalistic cohort of patients with first-episode psychosis, we investigated the relationship between cannabis use, age of presentation to services, daily functioning, and positive, negative and manic symptoms.MethodClinical data on 502 patients with first-episode psychosis were collected using the MiData audit database from seven London-based Early Intervention in psychosis teams. Individuals were assessed at two time points – at entry to the service and after 1 year. On each occasion, the Positive and Negative Syndrome Scale, Young Mania Rating Scale and Global Assessment of Functioning Scale disability subscale were rated. At both time points, the use of cannabis and other drugs of abuse in the 6 months preceding each assessment was recorded.ResultsLevel of cannabis use was associated with a younger age at presentation, and manic symptoms and conceptual disorganization, but not with delusions, hallucinations, negative symptoms or daily functioning. Cannabis users who reduced or stopped their use following contact with services had the greatest improvement in symptoms at 1 year compared with continued users and non-users. Continued users remained more symptomatic than non-users at follow-up.ConclusionsEffective interventions for reducing cannabis use may yield significant health benefits for patients with first-episode psychosis.

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Cannabis and psychosis: revisiting a nineteenth century study of ‘Indian Hemp and Insanity’ in Colonial British India

Psychological Medicine ◽

10.1017/s0033291719001077 ◽

2019 ◽

Vol 50 (7) ◽

pp. 1164-1172 ◽

Cited By ~ 2

Author(s):

Oyedeji A. Ayonrinde

Keyword(s):

Nineteenth Century ◽

Mental Illness ◽

Current Knowledge ◽

Cannabis Use ◽

Mental Illnesses ◽

Current Evidence ◽

Psychotic Symptoms ◽

British India ◽

Indian Hemp ◽

Commission Report

AbstractBackgroundIn nineteenth-century British India, concern regarding large numbers of asylum patients with ‘Indian Hemp Insanity’ led to establishment of the Indian Hemp Drugs Commission. The exotic cannabis plant was widely used in pharmacopeia and a source of government revenue. The Commission was tasked with determining the public health risks of cannabis use, particularly mental illness. This analysis of the Commission report seeks to highlight the status of 1892 cannabis research and compare it with current evidence for medical and recreational cannabis use.MethodsDetailed historiographic review of the Indian Hemp Drugs Commission Report (1892).ResultsIn 1892, heavy cannabis use was considered to have been associated with severe mental illness (7.3% of asylum patients; 12.6% of patients with diagnoses). About two-thirds were children and young adults with higher relapse rates. Risk increased with early cannabis use and a family history of mental illness. Cannabis psychosis was found to have a shorter trajectory and better prognosis than other mental illnesses in the asylums. Different cannabis potency and modes of consumption had different effects. Occasional cannabis use was felt to have medicinal benefits for some. Appendices provided symptoms and demographic characteristics of cannabis-induced mental illness.ConclusionThis important nineteenth-century study observed frequency and dose-related effects of cannabis on mental health, particularly psychotic symptoms in young people with a previous or hereditary risk of mental illness. Pathophysiological observations were consistent with current knowledge. As one of the most systematic and detailed studies of the effects of cannabis of the time it foreshadowed contemporary cannabis issues.

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Cannabis consumption and psychosis or schizophrenia development

International Journal of Social Psychiatry ◽

10.1177/0020764018801690 ◽

2018 ◽

Vol 64 (7) ◽

pp. 690-704 ◽

Cited By ~ 11

Author(s):

María Bettina Ortiz-Medina ◽

Marta Perea ◽

Julio Torales ◽

Antonio Ventriglio ◽

Giovanna Vitrani ◽

...

Keyword(s):

Cannabis Use ◽

Psychotic Symptoms ◽

Current State ◽

Gene Environment ◽

Pubmed Database ◽

Increased Risk ◽

Vulnerable People ◽

Cannabis Consumption ◽

The Relationship

Objective: Cannabis consumption produces psychopathology, in some cases psychotic episodes, which are of our interest in this work. However, the relationship between cannabis use and psychosis has not been fully elucidated. The objectives of this work are to (1) review the current state of knowledge on the association of cannabis use with the risk of the development of psychosis or psychotic symptoms in people without schizophrenia and (2) assess the consistency of the hypothesis that cannabis use is associated with increased risk of psychosis in people without schizophrenia. Method: This work included research done in humans until May 2018 with the keywords ‘cannabis’ and ‘psychosis’, published in English and Spanish, in the PubMed database. Results: In all, 66 papers were analyzed, of which 23 were cohort trials and 43 were reviews. Conclusion: Cannabis use doubles the risk of developing psychosis in vulnerable people. There even exists a relationship regarding the dose used and the age of first use. Gene–environment interactions that modulate the association between cannabis use and the presence of psychosis have also been described.

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Cerebrospinal fluid anandamide levels, cannabis use and psychotic-like symptoms

The British Journal of Psychiatry ◽

10.1192/bjp.bp.112.121178 ◽

2013 ◽

Vol 202 (5) ◽

pp. 381-382 ◽

Cited By ~ 51

Author(s):

Celia J. A. Morgan ◽

Emma Page ◽

Carola Schaefer ◽

Katharine Chatten ◽

Amod Manocha ◽

...

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Lower Risk ◽

Endocannabinoid System ◽

Cannabis Use ◽

Psychotic Symptoms ◽

Csf Levels ◽

Drug Free

SummaryAnandamide is a ligand of the endocannabinoid system. Animals show a depletion following repeated Δ9-tetrahydrocannabinol (THC) administration but the effect of cannabis use on central nervous system levels of endocannabinoids has not been previously examined in humans. Cerebrospinal fluid (CSF) levels of the endocannabinoids anandamide, 2-arachidonoylglycerol (2-AG) and related lipids were tested in 33 volunteers (20 cannabis users). Lower levels of CSF anandamide and higher levels of 2-AG in serum were observed in frequent compared with infrequent cannabis users. Levels of CSF anandamide were negatively correlated with persisting psychotic symptoms when drug-free. Higher levels of anandamide are associated with a lower risk of psychotic symptoms following cannabis use.

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