Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-13T09:28:23.622Z Has data issue: false hasContentIssue false

Prenatal marijuana exposure, age of marijuana initiation, and the development of psychotic symptoms in young adults

Published online by Cambridge University Press:  23 December 2014

N. L. Day*
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
L. Goldschmidt
Affiliation:
University of Pittsburgh Medical Center, Pittsburgh, PA, USA
R. Day
Affiliation:
Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
C. Larkby
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
G. A. Richardson
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
*
* Address for correspondence: Dr N. L. Day, Department of Psychiatry, Webster Hall, Suite 108, 4415 Fifth Avenue, Pittsburgh, PA 15213, USA. (Email: [email protected])

Abstract

Background

Studies have demonstrated that an early age of onset of marijuana use (EAOM) is associated with a higher risk of developing psychotic symptoms (PS) compared to initiating marijuana use at a later age or not at all. Research has also found that prenatal marijuana exposure (PME) predicts EAOM. This report evaluates the relationships among PME, EAOM, and PS.

Method

Subjects were initially interviewed in their fourth prenatal month. Women and offspring who completed the birth assessment (n = 763) were selected for follow-up. Women and their offspring were followed until the offspring were 22 years of age: 596 offspring were evaluated. At age 22, PS were assessed in the offspring with the Diagnostic Interview Schedule using DSM-IV criteria. Analyses controlled for significant covariates including other prenatal substance exposures, race, gender, and offspring substance use at 22 years.

Results

PME and EAOM significantly predicted increased rates of PS at 22 years controlling for other significant covariates. The direct effect of PME on PS was marginally significant (p = 0.06) when EAOM was entered into the model and other covariates were fixed. In the mediation analysis, EAOM did not significantly mediate the association between PME and PS, controlling for significant covariates, nor was the indirect pathway significant when structural equation modeling was used. The total effect of the direct and indirect pathways was significant.

Conclusions

In addition to EAOM, PME may also play a role in the association between marijuana use and the development of PS. This could highlight a new area for prevention.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arseneault, L, Cannon, M, Poulton, R, Murray, R, Caspi, A, Moffitt, TE (2002). Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. British Medical Journal 325, 12121213.CrossRefGoogle ScholarPubMed
Berghuis, P, Rajnicek, AM, Morozov, YM, Ross, RA, Mulder, J, Urban, GM, Monory, K, Marsicano, G, Matteoli, M, Canty, A, Irving, AJ, Katona, I, Yanagawa, Y, Rakic, P, Lutz, B, Mackie, K, Harkany, T (2007). Hardwiring the brain: endocannabinoids shape neuronal connectivity. Science 316, 12121216.Google Scholar
Biegon, A, Kerman, HA (2001). Autoradiographic study of pre- and postnatal distribution of cannabinoid receptors in human brain. Neuroimage 14, 14631468.Google Scholar
Bossong, MG, Niesink, RJ (2010). Adolescent brain maturation, the endogenous cannabinoid system and the neurobiology of cannabis-induced schizophrenia. Progress in Neurobiology 92, 370385.CrossRefGoogle ScholarPubMed
Caspi, A, Moffitt, TE, Cannon, M, McClay, J, Murray, R, Harrington, H, Taylor, A, Arseneault, L, Williams, B, Braithwaite, A, Poulton, R, Craig, IW (2005). Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudial evidence of a gene x environment interaction. Biological Psychiatry 57, 11171127.CrossRefGoogle Scholar
Day, N, Richardson, G, Goldschmidt, L, Robles, N, Taylor, P, Stoffer, D, Cornelius, M, Geva, D (1994). The effect of prenatal marijuana exposure on the cognitive development of offspring at age three. Neurotoxicology and Teratology 16, 169175.Google Scholar
Day, N, Wagener, D, Taylor, P (1985). Measurement of substance use during pregnancy: methodologic issues. In Consequences of Maternal Drug Abuse (ed. Pinkert, T.M.), pp. 3640. NIDA Research Monograph, 59.Google Scholar
Day, NL, Goldschmidt, L, Thomas, CA (2006). Prenatal marijuana exposure contributes to the prediction of marijuana use at age 14. Addiction 101, 13131322.Google Scholar
Day, NL, Leech, SL, Goldschmidt, L (2011). The effects of prenatal marijuana exposure on delinquent behaviors are mediated by measures of neurocognitive functioning. Neurotoxicology and Teratology 33, 129136.CrossRefGoogle ScholarPubMed
Fisher, HL, Caspi, A, Poulton, R, Meier, MH, Houts, R, Harrington, H, Arseneault, L, Moffitt, TE (2013). Specificity of childhood psychotic symptoms for predicting schizophrenia by 38 years of age: a birth cohort study. Psychological Medicine 43, 20772086.CrossRefGoogle ScholarPubMed
Fride, E (2002). Endocannabinoids in the central nervous system – an overview. Prostaglandins, Leukotrienes, and Essential Fatty Acids 667, 221233.Google Scholar
Gale, CK, Wells, JE, McGee, MA, Oakley Browne, MA (2011). A latent class analysis of psychosis-like experiences in the New Zealand Mental Health Survey. Acta Psychiatrica Scandinavica 124, 205213.CrossRefGoogle ScholarPubMed
Giedd, JN, Keshavan, M, Paus, T (2006). Why do many psychiatric disorders emerge during adolescence? Nature Reviews: Neuroscience 9, 947957.Google Scholar
Giordano, GN, Ohlsson, H, Sundquist, K, Sundquist, J, Kendler, KS (2014). The association between cannabis abuse and subsequent schizophrenia: a Swedish national co-relative control study. Psychological Medicine. Published online: 03 07 2014 . doi: 10.1017/S0033291714001524.Google ScholarPubMed
Gold, MS (1989). Marijuana. Medical Book Company: New York.Google Scholar
Goldschmidt, L, Day, NL, Richardson, GA (2000). Effects of prenatal marijuana exposure on child behavior problems at age 10. Neurotoxicology and Teratology 22, 325336.CrossRefGoogle ScholarPubMed
Gray, KA, Day, NL, Leech, S, Richardson, GA (2005). Prenatal marijuana exposure: effect on child depressive symptoms at ten years of age. Neurotoxicology and Teratology 27, 439448.CrossRefGoogle ScholarPubMed
Harkany, T, Mackie, K, Doherty, P (2008). Wiring and firing neuronal networks: endocannabinoids take center stage. Current Opinion in Neurobiology 18, 338345.Google Scholar
Henquet, C, Di Forti, M, Morrison, P, Kuepper, R, Murray, RM (2008). Gene-environment interplay between cannabis and psychosis (2008). Schizophrenia Bulletin 34, 11111121.CrossRefGoogle Scholar
Henquet, C, Krabbendam, L, Spauwen, J, Kaplan, C, Lieb, R, Wittchen, HU, van Os, J (2005). Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. British Medical Journal 330, 11.Google Scholar
Hides, L, Lubman, DI, Buckby, J, Yuen, HP, Cosgrave, E, Baker, K, Yung, AR (2009). The association between early cannabis use and psychotic-like experiences in a community adolescent sample. Schizophrenia Research 112, 130135.CrossRefGoogle Scholar
Johnston, LD, O'Malley, PM, Miech, RA, Bachman, JG, Schulenberg, JE (2014). Monitoring the Future National Results on Drug Use: 1975–2013: Overview, Key Findings on Adolescent Drug Use. Institute for Social Research, University of Michigan: Ann Arbor, MI.Google Scholar
Jones, E, Sigall, H (1971). The bogus pipeline: a new paradigm for measuring affect and attitude. Psychological Bulletin 76, 349364.Google Scholar
Julien, RM (1997). A Primer of Drug Action. A Concise, Nontechnical Guide to the Actions, Uses, and Side Effects of Psychoactive Drugs, 8th edn, pp. 319349. WH Freeman: New York.Google Scholar
Kilmer, B, Caulkins, JP, Liccardo Pacula, R, MacCoun, RJ, Reuter, PH (2010). Altered State? Assessing how Marijuana Legalization in California could Influence Marijuana Consumption and Public Budgets. Rand Corporation: Santa Monica, CA.CrossRefGoogle Scholar
Konings, M, Henquet, C, Maharajh, HD, Hutchinson, G, van Os, J (2008). Early exposure to cannabis and risk for psychosis in young adolescents in Trinidad. Acta Psychiatrica Scandinavica 118, 209213.CrossRefGoogle ScholarPubMed
Kumar, RN, Chambers, WA, Pertwee, RG (2001). Pharmacological actions and therapeutic uses of cannabis and cannabinoids. Anesthesia 56, 10591068.Google Scholar
Larkby, C, Goldschmidt, L, Day, NL (2007). The relation between prenatal marijuana exposure and PTSD: real or confounded? Neurotoxicology and Teratology 29, 395.CrossRefGoogle Scholar
Linscott, RJ, van Os, J (2013). An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychological Medicine 43, 11331149.Google Scholar
Luna, B, Garver, KE, Urban, TA, Lazar, NA, Sweeney, JA (2004). Maturation of cognitive processes from late childhood to adulthood. Child Development 75, 13571372.Google Scholar
Lynskey, MT, Heath, AC, Bucholz, KK, Slutske, WS, Madden, PAF, Nelson, EC, Statham, DJ, Martin, NG (2003). Escalation of drug in early-onset cannabis users vs. co-twin controls. Journal of the American Medical Association 289, 427433.Google Scholar
Malone, DT, Hill, MN, Rubino, T (2010). Adolescent cannabis use and psychosis: epidemiology and neurodevelopmental models. British Journal of Pharmacology 160, 511522.Google Scholar
Mehmedic, Z, Chandra, S, Slade, D, Denham, H, Foster, S, Patel, AS, Ross, SA, Khan, IA, El Sohly, MA (2010). Potency trends of Δ9-THC and other cannabinoids in confiscated cannabis preparations from 1993 to 2008. Journal of Forensic Science 55, 12091217.CrossRefGoogle ScholarPubMed
Navarrete, M, Araque, A (2008). Endocannabinoids mediate neuron-astrocyte communication. Neuron 57, 883893.CrossRefGoogle ScholarPubMed
Office of National Drug Control and Policy (ONDCP) (2014). Marijuana Resource Center: State Laws Related to Marijuana. (http://www.whitehouse.gov/ondcp/state-laws-related-to-marijuana). Accessed 14 June 2014.Google Scholar
Proal, AC, Fleming, J, Galvez-Buccolllini, JA, DeLisi, LE (2014). A controlled family study of cannabis users with and without psychosis. Schizophrenia Research 152, 283288.Google Scholar
Radhakrishnan, R, Wilkinson, ST, D'Souza, DC (2014). Gone to pot – a review of the association between cannabis and psychosis. Frontiers in Psychiatry 5, 124.Google Scholar
Richardson, GA, Huestis, MA, Day, NL (2006). Assessing in utero exposure to cannabis and cocaine. In Human Developmental Neurotoxicology (ed. Bellinger, D.C.), pp. 287301. Taylor & Francis: New York.Google Scholar
Richardson, GA, Ryan, C, Willford, JA, Day, NL, Goldschmidt, L (2002). Prenatal alcohol and marijuana exposure: effects on neuropsychological outcomes at 10 years. Neurotoxicology and Teratology 24, 309320.Google Scholar
Robins, LN, Cottler, LB, Bucholz, KK, Compton, WM, North, CS, Rourke, KM (2000). Diagnostic Interview Schedule for DSM-IV. Washington University School of Medicine: St. Louis, MO.Google Scholar
Rossler, W, Riecher-Rossler, A, Angst, J, Murray, R, Gamma, A, Eich, D, van Os, J, Gross, VA (2007). Psychotic experiences in the general population: a twenty-year prospective community study. Schizophrenia Research 92, 114.CrossRefGoogle ScholarPubMed
Shapiro, GK, Buckley-Hunter, L (2010). What every adolescent needs to know: cannabis can cause psychosis. Journal of Psychosomatic Research 69, 533539.CrossRefGoogle ScholarPubMed
Skinner, R, Conlon, L, Gibbons, D, McDonald, C (2011). Cannabis use and non-clinical dimensions of psychosis in university students presenting to primary care. Acta Psychiatrica Scandinavica 23, 2127.Google Scholar
Spear, LP (2000). The adolescent brain and age-related behavioral manifestations. Neuroscience and Biobehavioral Reviews 24, 417463.Google Scholar
Stefanis, NC, Delespaul, P, Henquet, C, Bakoula, C, Stevanis, CN, van Os, J (2004). Early adolescent cannabis exposure and positive and negative dimensions of psychosis. Addiction 99, 13331341.CrossRefGoogle ScholarPubMed
Substance Abuse and Mental Health Services Administration (SAMHSA) (2012). SAMHSA NSDUH 2011-2012 Surveys (http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm). Accessed 14 October 2014.Google Scholar
Substance Abuse and Mental Health Services Administration (SAMHSA) (2013). Results from the 2012 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Substance Abuse and Mental Health Services Administration: Rockville, MD.Google Scholar
Tennes, L, Avitable, N, Blackard, C, Boyles, C, Hassoun, B, Holmes, L, Kreye, M (1985). Marijuana: prenatal and postnatal exposure in the human. In Consequences of Maternal Drug Abuse (ed. Pinkert, T.M.). NIDA Research Monograph 59, pp. 4860. National Institute on Drug Abuse: Rockville, MD.Google Scholar
Trezza, V, Campolongo, P, Cassano, T, Macheda, T, Dipasquale, P, Carratu, MR, Gaetani, S, Cuomo, V (2008). Effects of perinatal exposure to delta-9-tetrahydrocannabinol on the emotional reactivity of the offspring: a longitudinal behavioral study in Wistar rats. Psychopharmacology 98, 529537.CrossRefGoogle Scholar
Yurgelun-Todd, D (2007). Emotional and cognitive changes during adolescence. Current Opinion in Neurobiology 2, 251257.CrossRefGoogle Scholar
Zammit, S, Allebeck, P, Andréasson, S, Lundberg, I, Lewis, G (2002). Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. British Medical Journal 325, 11991203.Google Scholar
Zuckerman, B (1985). Developmental consequences of maternal drug use during pregnancy. In Consequences of Maternal Drug Abuse (ed. Pinkert, T.M.). NIDA Research Monograph 59, pp. 96106. National Institute on Drug Abuse: Rockville, MD.Google Scholar