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Psychotic patients who used cannabis frequently before illness onset have higher genetic predisposition to schizophrenia than those who did not

Published online by Cambridge University Press:  02 October 2017

M. Aas ,
I. Melle ,
F. Bettella ,
S. Djurovic ,
S. Le Hellard ,
T. Bjella ,
P. A. Ringen ,
T. V. Lagerberg ,
O. B. Smeland  and
I. Agartz
...Show all authors
M. Aas*
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
I. Melle
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
F. Bettella
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
S. Djurovic
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
S. Le Hellard
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
T. Bjella
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
P. A. Ringen
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
T. V. Lagerberg
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
O. B. Smeland
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
I. Agartz
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
O. A. Andreassen
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
M. Tesli
Affiliation:
NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway Department of Psychiatry, Lovisenberg Hospital, Oslo, Norway
*
*Address for correspondence: M. Aas, Ph.D., NORMENT KG Jebsen Psychosis Research Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine, Bygg 49, Ullevål sykehus, PO Box 4956 Nydalen, 0424 Oslo, Norway. (Email: [email protected])
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Abstract

Background

Schizophrenia (SZ) and bipolar disorder (BD) are heritable, polygenic disorders with shared clinical and genetic components, suggesting a psychosis continuum. Cannabis use is a well-documented environmental risk factor in psychotic disorders. In the current study, we investigated the relationship between SZ genetic load and cannabis use before illness onset in SZ and BD spectrums. Since frequent early cannabis use (age <18 years) is believed to increase the risk of developing psychosis more than later use, follow-up analyses were conducted comparing early use to later use and no use.

Methods

We assigned a SZ-polygenic risk score (PGRS) to each individual in our independent sample (N = 381 SZ spectrum cases, 220 BD spectrum cases and 415 healthy controls), calculated from the results of the Psychiatric Genomics Consortium (PGC) SZ case–control study (N = 81 535). SZ-PGRS in patients who used cannabis weekly to daily in the period before first illness episode was compared with that of those who never or infrequently used cannabis.

Results

Patients with weekly to daily cannabis use before illness onset had the highest SZ-PGRS (p = 0.02, Cohen's d = 0.33). The largest difference was found between patients with daily or weekly cannabis use before illness onset <18 years of age and patients with no or infrequent use of cannabis (p = 0.003, Cohen's d = 0.42).

Conclusions

Our study supports an association between high SZ-PGRS and frequent cannabis use before illness onset in psychosis continuum disorders.

Keywords

Bipolar disorderscannabispolygenic risk scoreschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 1 , January 2018 , pp. 43 - 49
Copyright
Copyright © Cambridge University Press 2017 

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