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Cannabis, schizophrenia and other non-affective psychoses: 35 years of follow-up of a population-based cohort

Published online by Cambridge University Press:  17 October 2011

E. Manrique-Garcia ,
S. Zammit ,
C. Dalman ,
T. Hemmingsson ,
S. Andreasson  and
P. Allebeck
E. Manrique-Garcia*
Affiliation:
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden
S. Zammit
Affiliation:
Department of Psychological Medicine and Neurology, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
C. Dalman
Affiliation:
Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Stockholm, Sweden
T. Hemmingsson
Affiliation:
Department of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
S. Andreasson
Affiliation:
Swedish National Institute of Public Health, Sweden
P. Allebeck
Affiliation:
Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Stockholm, Sweden
*
*Address for correspondence: E. Manrique-Garcia, M.D., Karolinska Hospital, Department of Public Health, Norrbacka floor 6, S-17176 Stockholm, Sweden. (Email: [email protected])
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Abstract

Background

There is now strong evidence that cannabis use increases the risk of psychoses including schizophrenia, but the relationship between cannabis and different psychotic disorders, as well as the mechanisms, are poorly known. We aimed to assess types of psychotic outcomes after use of cannabis in adolescence and variation in risk over time.

Method

A cohort of 50 087 military conscripts with data on cannabis use in late adolescence was followed up during 35 years with regard to in-patient care for psychotic diagnoses.

Results

Odds ratios for psychotic outcomes among frequent cannabis users compared with non-users were 3.7 [95% confidence interval (CI) 2.3–5.8] for schizophrenia, 2.2 (95% CI 1.0–4.7) for brief psychosis and 2.0 (95% CI 0.8–4.7) for other non-affective psychoses. Risk of schizophrenia declined over the decades in moderate users but much less so in frequent users. The presence of a brief psychosis did not increase risk of later schizophrenia more in cannabis users compared with non-users.

Conclusions

Our results confirm an increased risk of schizophrenia in a long-term perspective, although the risk declined over time in moderate users.

Keywords

Cannabispsychosisschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 6 , June 2012 , pp. 1321 - 1328
Copyright
Copyright © Cambridge University Press 2011

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