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Cannabis use and age of diagnosis of schizophrenia

Published online by Cambridge University Press:  16 April 2020

Gisela Sugranyes ,
Itziar Flamarique ,
Eduard Parellada ,
Immaculada Baeza ,
Javier Goti ,
Emilio Fernandez-Egea  and
Miquel Bernardo
Gisela Sugranyes*
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain
Itziar Flamarique*
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain
Eduard Parellada
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain Centro de Investigación Biomédica en Red de Salud mental (CIBER-SAM), Spain
Immaculada Baeza
Affiliation:
Centro de Investigación Biomédica en Red de Salud mental (CIBER-SAM), Spain Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic i Universitari, Barcelona, Spain
Javier Goti
Affiliation:
Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic i Universitari, Barcelona, Spain
Emilio Fernandez-Egea*
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain Cambridgeshire and Peterborough NHS Foundation Trust, Cambridgeshire, United Kingdom
Miquel Bernardo
Affiliation:
Programa Esquizofrènia Clínic, Servei de Psiquiatria, Institut de Neurociències, Hospital Clínic i Universitari, Barcelona, Spain Centro de Investigación Biomédica en Red de Salud mental (CIBER-SAM), Spain Institut d'Investigacions Biomèdiques Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain
*
*Correspondence to: Emilio Fernandez-Egea, Programa Esquizofrenia Clinic, Sala d'Hospitalitzacio (G096), Servei de Psiquiatria, Institut de Neurociencies, Hospital Clínic, 08036 Barcelona, Spain. Tel.: +34 932275477; fax: +34 932275548. E-mail address: 32924efe@comb.es (E. Fernandez-Egea).
*Correspondence to: Emilio Fernandez-Egea, Programa Esquizofrenia Clinic, Sala d'Hospitalitzacio (G096), Servei de Psiquiatria, Institut de Neurociencies, Hospital Clínic, 08036 Barcelona, Spain. Tel.: +34 932275477; fax: +34 932275548. E-mail address: 32924efe@comb.es (E. Fernandez-Egea).
*Correspondence to: Emilio Fernandez-Egea, Programa Esquizofrenia Clinic, Sala d'Hospitalitzacio (G096), Servei de Psiquiatria, Institut de Neurociencies, Hospital Clínic, 08036 Barcelona, Spain. Tel.: +34 932275477; fax: +34 932275548. E-mail address: 32924efe@comb.es (E. Fernandez-Egea).
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Abstract

Background and objectives

Observational studies have reported earlier onset of psychosis in schizophrenic patients with a history of cannabis use. Earlier age of onset of schizophrenia has been associated with a poorer outcome. We aimed to examine whether cannabis use determined an earlier onset of schizophrenia in a sample of first episode patients, in an area with one of Europe's highest rates of cannabis use.

Methods

116 subjects with first episode psychosis and subsequent diagnosis of schizophrenia (after a 12-month follow-up) were included Age at first antipsychotic treatment (A1T) was used as proxy for age of psychosis onset, and acted as dependent variable for the statistical analysis. Cannabis use was evaluated retrospectively, and divided into three groups according to peak frequency (never, sporadic/frequent, daily).

Results

46 (39.7%) subjects had never used cannabis, 23 (19.9%) had done so sporadically/frequently, and 47 (40.5%) daily. A1T differed between the three groups (mean, in years and [SD]: 27.0 [4.94]; 25.7 [4.44] and 24.5 [4.36]; p = 0.033) and diminished as cannabis use increased (linear tendency; p = 0.009). Post-hoc analysis showed that cannabis use (irrespective of frequency) was significantly associated with decrease in A1T (p = 0.033), as shown by the first contrast [1 −1/2 −1/2]. Post-hoc contrast showed that cannabis users had a significantly lower age of onset of psychosis (mean decrease, in years: 1.93; CI (confidence interval) 95%: 0.17–3.70; p = 0.033).

Conclusions

Cannabis use was significantly associated with a decrease in age of onset of schizophrenia. Age of onset of the disease correlated with frequency of cannabis use.

Keywords

EpidemiologyPsychosisSubstance abuseFirst episodeSchizophrenia
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 5 , June 2009 , pp. 282 - 286
Copyright
Copyright © Elsevier Masson SAS 2009

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