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Prospective study of cannabis use in adolescents at clinical high risk for psychosis: impact on conversion to psychosis and functional outcome

Published online by Cambridge University Press:  30 April 2012

A. M. Auther ,
D. McLaughlin ,
R. E. Carrión ,
P. Nagachandran ,
C. U. Correll  and
B. A. Cornblatt
A. M. Auther*
Affiliation:
The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
D. McLaughlin
Affiliation:
The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
R. E. Carrión
Affiliation:
The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA
P. Nagachandran
Affiliation:
Bellevue Hospital System, New York, NY, USA
C. U. Correll
Affiliation:
The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Manhasset, NY, USA The Albert Einstein College of Medicine, Bronx, NY, USA
B. A. Cornblatt
Affiliation:
The Zucker Hillside Hospital, North Shore–Long Island Jewish Health System, Glen Oaks, NY, USA The Feinstein Institute for Medical Research, North Shore–Long Island Jewish Health System, Manhasset, NY, USA The Albert Einstein College of Medicine, Bronx, NY, USA
*
*Address for correspondence: A. Auther, Ph.D., The Zucker Hillside Hospital, Department of Psychiatry Research, 75–59 263rd Street, Glen Oaks, NY 11004, USA. (Email: [email protected])
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Abstract

Background

Clinical and epidemiological studies suggest an association between cannabis use and psychosis but this relationship remains controversial.

Method

Clinical high-risk (CHR) subjects (age 12–22 years) with attenuated positive symptoms of psychosis (CHR+, n=101) were compared to healthy controls (HC, n=59) on rates of substance use, including cannabis. CHR+ subjects with and without lifetime cannabis use (and abuse) were compared on prodromal symptoms and social/role functioning at baseline. Participants were followed an average of 2.97 years to determine psychosis conversion status and functional outcome.

Results

At baseline, CHR+ subjects had significantly higher rates of lifetime cannabis use than HC. CHR+ lifetime cannabis users (n=35) were older (p=0.015, trend), more likely to be Caucasian (p=0.002), less socially anhedonic (p<0.001) and had higher Global Functioning: Social (GF:Social) scores (p<0.001) than non-users (n=61). CHR+ cannabis users continued to have higher social functioning than non-users at follow-up (p<0.001) but showed no differences in role functioning. A small sample of CHR+ cannabis abusers (n=10) showed similar results in that abusers were older (p=0.008), less socially anhedonic (p=0.017, trend) and had higher baseline GF:Social scores (p=0.006) than non-abusers. Logistic regression analyses revealed that conversion to psychosis in CHR+ subjects (n=15) was not related to lifetime cannabis use or abuse.

Conclusions

The current data do not indicate that low to moderate lifetime cannabis use is a major contributor to psychosis or poor social and role functioning in clinical high-risk youth with attenuated positive symptoms of psychosis.

Keywords

Cannabis useconversionhigh riskprodromepsychosissocial functioning
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 12 , December 2012 , pp. 2485 - 2497
Copyright
Copyright © Cambridge University Press 2012

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