The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study.

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Abstract

Cannabis use is associated with increased risk of later psychotic disorder but whether it affects incidence of the disorder remains unclear. We aimed to identify patterns of cannabis use with the strongest effect on odds of psychotic disorder across Europe and explore whether differences in such patterns contribute to variations in the incidence rates of psychotic disorder.

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Most cited references 36

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Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review.

Max Marshall, Shôn Lewis, Austin Lockwood … (2005)

Duration of untreated psychosis (DUP) is the time from manifestation of the first psychotic symptom to initiation of adequate treatment. It has been postulated that a longer DUP leads to a poorer prognosis. If so, outcome might be improved through earlier detection and treatment. To establish whether DUP is associated with prognosis and to determine whether any association is explained by confounding with premorbid adjustment. The CINAHL (Cumulative Index to Nursing and Allied Health), EMBASE, MEDLINE, and PsychLIT databases were searched from their inception dates to May 2004. Eligible studies reported the relationship between DUP and outcome in prospective cohorts recruited during their first episode of psychosis. Twenty-six eligible studies involving 4490 participants were identified from 11 458 abstracts, each screened by 2 reviewers. Data were extracted independently and were checked by double entry. Sensitivity analyses were conducted excluding studies that had follow-up rates of less than 80%, included affective psychoses, or did not use a standardized assessment of DUP. Independent meta-analyses were conducted of correlational data and of data derived from comparisons of long and short DUP groups. Most data were correlational, and these showed a significant association between DUP and several outcomes at 6 and 12 months (including total symptoms, depression/anxiety, negative symptoms, overall functioning, positive symptoms, and social functioning). Long vs short DUP data showed an association between longer DUP and worse outcome at 6 months in terms of total symptoms, overall functioning, positive symptoms, and quality of life. Patients with a long DUP were significantly less likely to achieve remission. The observed association between DUP and outcome was not explained by premorbid adjustment. There is convincing evidence of a modest association between DUP and outcome, which supports the case for clinical trials that examine the effect of reducing DUP.

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Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis.

Arianna Marconi, Marta Di Forti, Cathryn Lewis … (2016)

Cannabis use has been reported to induce long-lasting psychotic disorders and a dose-response relationship has been observed. We performed a systematic review of studies that investigate the association between the degree of cannabis consumption and psychosis and a meta-analysis to quantify the magnitude of effect. Published studies were identified through search of electronic databases, supplemented by manual searches of bibliographies. Studies were considered if they provided data on cannabis consumption prior to the onset of psychosis using a dose criterion (frequency/amount used) and reported psychosis-related outcomes. We performed random effects meta-analysis of individual data points generated with a simulation method from the summary data of the original studies. From 571 references, 18 studies fulfilled inclusion criteria for the systematic review and 10 were inserted in the meta-analysis, enrolling a total of 66 816 individuals. Higher levels of cannabis use were associated with increased risk for psychosis in all the included studies. A logistic regression model gave an OR of 3.90 (95% CI 2.84 to 5.34) for the risk of schizophrenia and other psychosis-related outcomes among the heaviest cannabis users compared to the nonusers. Current evidence shows that high levels of cannabis use increase the risk of psychotic outcomes and confirms a dose-response relationship between the level of use and the risk for psychosis. Although a causal link cannot be unequivocally established, there is sufficient evidence to justify harm reduction prevention programs.

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A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system.

P. McGuffin, A. Farmer, I. Harvey (1991)

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Author and article information

Journal

Journal ID (iso-abbrev): Lancet Psychiatry

Title: The lancet. Psychiatry

Publisher: Elsevier BV

ISSN (Electronic): 2215-0374

ISSN (Print): 2215-0366

Publication date (Electronic): May 2019

Volume: 6

Issue: 5

Affiliations

[1 ] Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK. Electronic address: marta.diforti@kcl.ac.uk.

[2 ] Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK.

[3 ] Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.

[4 ] Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.

[5 ] Department of Health Service and Population Research, Institute of Psychiatry, King's College London, London, UK.

[6 ] Department of Psychiatry, University of Cambridge, Cambridge, UK; Psylife Group, Division of Psychiatry, University College London, London, UK.

[7 ] Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.

[8 ] Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy.

[9 ] INSERM U955, Equipe 15, Institut National de la Santé et de la Recherche Médicale, Créteil, Paris, France.

[10 ] Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), Madrid, Spain.

[11 ] Etablissement Public de Santé Maison Blanche, Paris, France.

[12 ] Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands.

[13 ] Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital clinic, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.

[14 ] Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.

[15 ] Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.

[16 ] Rivierduinen Institute for Mental Health Care, Leiden, Netherlands.

[17 ] Department of Psychiatry, University of Cambridge, Cambridge, UK; CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK.

[18 ] Psylife Group, Division of Psychiatry, University College London, London, UK.

[19 ] Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, Netherlands.

[20 ] Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK; Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

[21 ] Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK; Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands.

[22 ] Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK.

[23 ] Department of Addiction, Institute of Psychiatry, King's College London, London, UK.

[24 ] Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK.

Article

Publisher Item ID: S2215-0366(19)30048-3

DOI: 10.1016/S2215-0366(19)30048-3

PubMed ID: 30902669

SO-VID: d0641ef2-bc48-43af-bd3b-10a3176f25d1

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The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study.

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UCL: UN SDG 03 Good Health and Well-Being

Most cited references 36

Association between duration of untreated psychosis and outcome in cohorts of first-episode patients: a systematic review.

Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis.

A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system.

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Cited by 225