scholarly journals Psychotic symptom and cannabis relapse in recent-onset psychosis

2006 ◽  
Vol 189 (2) ◽  
pp. 137-143 ◽  
Author(s):  
L. Hides ◽  
S. Dawe ◽  
D. J. Kavanagh ◽  
R. M. Young
Keyword(s):  
Medication Adherence ◽  
Psychotic Symptom ◽  
Symptom Severity ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Recent Onset ◽  
Face To Face ◽  
Relative Contribution ◽  
Increase Risk ◽  
Symptom Relapse

BackgroundCannabis use appears to exacerbate psychotic symptoms and increase risk of psychotic relapse. However, the relative contribution of cannabis use compared with other risk factors is unclear. The influence of psychotic symptoms on cannabis use has received little attention.AimsTo examine the influence of cannabis use on psychotic symptom relapse and the influence of psychotic symptom severity on relapse in cannabis use in the 6 months following hospital admission.MethodAt baseline, 84 participants with recent-onset psychosis were assessed and 81 were followed up weekly for 6 months, using telephone and face-to-face interviews.ResultsA higher frequency of cannabis use was predictive of psychotic relapse, after controlling for medication adherence, other substance use and duration of untreated psychosis. An increase in psychotic symptoms was predictive of relapse to cannabis use, and medication adherence reduced cannabis relapse risk.ConclusionsThe relationship between cannabis use and psychosis may be bidirectional, highlighting the need for early intervention programmes to target cannabis use and psychotic symptom severity in this population.

scholarly journals Salience attribution and its relationship to cannabis-induced psychotic symptoms

2016 ◽  
Vol 46 (16) ◽  
pp. 3383-3395 ◽  
Author(s):  
M. A. P. Bloomfield ◽  
E. Mouchlianitis ◽  
C. J. A. Morgan ◽  
T. P. Freeman ◽  
H. V. Curran ◽  
...  
Keyword(s):  
Psychotic Symptom ◽  
Symptom Severity ◽  
Learning Task ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Dopamine Synthesis ◽  
Influx Rate ◽  
Increased Risk ◽  
Significant Difference ◽  
Aberrant Salience

BackgroundCannabis is a widely used drug associated with increased risk for psychosis. The dopamine hypothesis of psychosis postulates that altered salience processing leads to psychosis. We therefore tested the hypothesis that cannabis users exhibit aberrant salience and explored the relationship between aberrant salience and dopamine synthesis capacity.MethodWe tested 17 cannabis users and 17 age- and sex-matched non-user controls using the Salience Attribution Test, a probabilistic reward-learning task. Within users, cannabis-induced psychotic symptoms were measured with the Psychotomimetic States Inventory. Dopamine synthesis capacity, indexed as the influx rate constant Kicer, was measured in 10 users and six controls with 3,4-dihydroxy-6-[18F]fluoro-l-phenylalanine positron emission tomography.ResultsThere was no significant difference in aberrant salience between the groups [F1,32 = 1.12, p = 0.30 (implicit); F1,32 = 1.09, p = 0.30 (explicit)]. Within users there was a significant positive relationship between cannabis-induced psychotic symptom severity and explicit aberrant salience scores (r = 0.61, p = 0.04) and there was a significant association between cannabis dependency/abuse status and high implicit aberrant salience scores (F1,15 = 5.8, p = 0.03). Within controls, implicit aberrant salience was inversely correlated with whole striatal dopamine synthesis capacity (r = −0.91, p = 0.01), whereas this relationship was non-significant within users (difference between correlations: Z = −2.05, p = 0.04).ConclusionsAberrant salience is positively associated with cannabis-induced psychotic symptom severity, but is not seen in cannabis users overall. This is consistent with the hypothesis that the link between cannabis use and psychosis involves alterations in salience processing. Longitudinal studies are needed to determine whether these cognitive abnormalities are pre-existing or caused by long-term cannabis use.

Cannabis use and outcome of recent onset psychosis

2005 ◽  
Vol 20 (4) ◽  
pp. 349-353 ◽  
Author(s):  
Anton Grech ◽  
Jim Van Os ◽  
Peter B. Jones ◽  
Shon W. Lewis ◽  
Robin M. Murray
Keyword(s):  
Negative Symptoms ◽  
Small Sample Size ◽  
Small Sample ◽  
Reference Points ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Recent Onset ◽  
Male Subjects

AbstractPurposeTo test the hypothesis that recent onset psychotic patients who use cannabis will have psychotic symptoms that are more severe and more persistent than those who do not use cannabis.Subjects and methodsWe carried out a 4-year follow-up study of a cohort of 119 patients with recent onset of psychosis. The patients were divided into four groups according to duration of cannabis use, taking index admission and follow-up as reference points.ResultsThose subjects who persisted in the use of cannabis had more positive (but not negative) symptoms and a more continuous illness at follow-up.LimitationsThe main limitations of the study were: the relatively small sample size, and that the excess of male subjects and the presence of cannabis induced psychosis could have a confusing impact on the interpretation of the results.ConclusionIt is possible that psychotic patients who use cannabis are at a greater risk of a more continuous illness with more positive symptoms than those who do not.

scholarly journals M98. IS THERE A DEVELOPMENTAL TRAUMAGENIC PHENOTYPE OF PSYCHOSIS?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S172-S172
Author(s):  
Michael Bloomfield ◽  
Mustapha Modaffar ◽  
Franca Onyeama ◽  
Ting-Yun Chang ◽  
Joseph Dickson ◽  
...  
Keyword(s):  
Psychotic Symptom ◽  
Symptom Severity ◽  
Grey Matter ◽  
Adult Survivors ◽  
Secondary Outcome ◽  
Psychotic Symptoms ◽  
Grey Matter Volume ◽  
Symptom Expression ◽  
Neurocognitive Deficits ◽  
Developmental Trauma

Abstract Background Developmental trauma (DT) induces vulnerability to psychosis in adulthood. Adult survivors of DT with psychosis (ASDTP) have worse prognosis across a range of outcomes compared to individuals with psychosis without DT exposure. It has been suggested that this may reflect a developmental ‘traumatogenic’ psychosis phenotype, distinct from idiopathic schizophrenia. Given the implications for precision medicine, we therefore sought to test this hypothesis by conducting systematic reviews and meta-analyses of the literature comparing psychotic symptoms and neuroimaging findings between adults with psychosis diagnoses with and without developmental trauma. Methods We registered our search protocols in PROSPERO (CRD42018105021 and CRD42019131245). We systematically searched literature databases for relevant studies published up to July 2019. “Embase”, “MEDLINE”, and “PsychINFO” were systematically searched. Reference lists, OpenGrey, and Google scholar were hand-searched. Phenomenological outcomes of interests were quantitative and/or qualitative differences in psychotic symptom expression (primary outcome) and other domains of psychopathology (secondary outcome) between ASDTP and people with psychosis who did not report developmental trauma. Neuroimaging outcomes of interest including markers of brain volume and function (e.g. task-induced blood-oxygen dependent signal). Results Seventeen studies of symptomatology were included. Of these, four were meta-analysed. There was a relationship between DT and greater positive (Hedges g=0.53; p<0.001) and negative (Hedges g =0.41; p=0.001) symptom severity. ASDTP had greater neurocognitive deficits and symptom severity in other domains of psychopathology compared to individuals without DT. There was evidence that psychotic symptom content related to traumatic memories in those with experiences of DT. We identified twenty-seven imaging studies (n = 1,438 psychosis patients, n = 1,114 healthy controls or healthy siblings). DT was associated with global and regional differences in grey matter; corticolimbic structural dysconnectivity; a potentiated threat detection system; dysfunction in regions associated with mentalization; and elevated striatal dopamine synthesis capacity. Meta-analysis indicated that developmental trauma is associated with reductions of cortical thickness, global grey matter volume, and hippocampal volumes in patients with psychosis. Discussion Adult survivors of developmental trauma have more severe psychotic symptoms than those without developmental trauma histories. Alongside findings of differences in symptom expression and neuroimaging, the evidence suggests that there may be developmental traumatogenic psychosis phenotype. However, a key mechanistic gap remains how clinical and neuroimaging findings relate to each other. Nonetheless, alternative interpretations, such as an underdiagnosis of post-traumatic stress disorder, could also be plausible. These findings warrant further research to elucidate vulnerability and resilience mechanisms for psychosis in adult survivors of developmental trauma.

Self-Reported Insight Is Associated With Medication Adherence in Recent-Onset Schizophrenia

2012 ◽  
Author(s):  
Nicole R. Detore ◽  
Kenneth L. Subotnik ◽  
Denise Gretchen-Doorly ◽  
Laurie R. Casaus ◽  
John S. Luo ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Recent Onset

scholarly journals General psychopathology links burden of recent life events and psychotic symptoms in a network approach

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Linda T. Betz ◽  
◽  
Nora Penzel ◽  
Lana Kambeitz-Ilankovic ◽  
Marlene Rosen ◽  
...  
Keyword(s):  
Life Events ◽  
Childhood Trauma ◽  
Negative Symptoms ◽  
Psychotic Symptoms ◽  
Network Approach ◽  
General Psychopathology ◽  
Recent Onset ◽  
Syndrome Scale ◽  
Before And After ◽  
The Individual

AbstractRecent life events have been implicated in the onset and progression of psychosis. However, psychological processes that account for the association are yet to be fully understood. Using a network approach, we aimed to identify pathways linking recent life events and symptoms observed in psychosis. Based on previous literature, we hypothesized that general symptoms would mediate between recent life events and psychotic symptoms. We analyzed baseline data of patients at clinical high risk for psychosis and with recent-onset psychosis (n = 547) from the Personalised Prognostic Tools for Early Psychosis Management (PRONIA) study. In a network analysis, we modeled links between the burden of recent life events and all individual symptoms of the Positive and Negative Syndrome Scale before and after controlling for childhood trauma. To investigate the longitudinal associations between burden of recent life events and symptoms, we analyzed multiwave panel data from seven timepoints up to month 18. Corroborating our hypothesis, burden of recent life events was connected to positive and negative symptoms through general psychopathology, specifically depression, guilt feelings, anxiety and tension, even after controlling for childhood trauma. Longitudinal modeling indicated that on average, burden of recent life events preceded general psychopathology in the individual. In line with the theory of an affective pathway to psychosis, recent life events may lead to psychotic symptoms via heightened emotional distress. Life events may be one driving force of unspecific, general psychopathology described as characteristic of early phases of the psychosis spectrum, offering promising avenues for interventions.

scholarly journals Association between age of cannabis initiation and gray matter covariance networks in recent onset psychosis

2021 ◽  
Author(s):  
Nora Penzel ◽  
◽  
Linda A. Antonucci ◽  
Linda T. Betz ◽  
Rachele Sanfelici ◽  
...  
Keyword(s):  
Gray Matter ◽  
Inferior Frontal Gyrus ◽  
Brain Networks ◽  
Developmental Trajectory ◽  
Cannabis Use ◽  
Brain Maturation ◽  
Confounding Factors ◽  
Recent Onset ◽  
Increased Risk ◽  
Structural Brain

AbstractCannabis use during adolescence is associated with an increased risk of developing psychosis. According to a current hypothesis, this results from detrimental effects of early cannabis use on brain maturation during this vulnerable period. However, studies investigating the interaction between early cannabis use and brain structural alterations hitherto reported inconclusive findings. We investigated effects of age of cannabis initiation on psychosis using data from the multicentric Personalized Prognostic Tools for Early Psychosis Management (PRONIA) and the Cannabis Induced Psychosis (CIP) studies, yielding a total sample of 102 clinically-relevant cannabis users with recent onset psychosis. GM covariance underlies shared maturational processes. Therefore, we performed source-based morphometry analysis with spatial constraints on structural brain networks showing significant alterations in schizophrenia in a previous multisite study, thus testing associations of these networks with the age of cannabis initiation and with confounding factors. Earlier cannabis initiation was associated with more severe positive symptoms in our cohort. Greater gray matter volume (GMV) in the previously identified cerebellar schizophrenia-related network had a significant association with early cannabis use, independent of several possibly confounding factors. Moreover, GMV in the cerebellar network was associated with lower volume in another network previously associated with schizophrenia, comprising the insula, superior temporal, and inferior frontal gyrus. These findings are in line with previous investigations in healthy cannabis users, and suggest that early initiation of cannabis perturbs the developmental trajectory of certain structural brain networks in a manner imparting risk for psychosis later in life.

Psychosocial and pharmacological treatments for cannabis use disorder and mental health comorbidities: a narrative review

2021 ◽  
pp. 1-12
Author(s):  
Rachel Lees ◽  
Lindsey A. Hines ◽  
Deepak Cyril D'Souza ◽  
George Stothart ◽  
Marta Di Forti ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Decision Making ◽  
Treatment Compliance ◽  
Narrative Review ◽  
Cannabis Use ◽  
Psychotic Symptoms ◽  
Motivational Enhancement Therapy ◽  
Cannabis Use Disorder ◽  
Pharmacological Treatments ◽  
Health Comorbidities

Abstract Cannabis is the most widely used illicit drug worldwide, and it is estimated that up to 30% of people who use cannabis will develop a cannabis use disorder (CUD). Demand for treatment of CUD is increasing in almost every region of the world and cannabis use is highly comorbid with mental disorders, where sustained use can reduce treatment compliance and increase risk of relapse. In this narrative review, we outline evidence for psychosocial and pharmacological treatment strategies for CUD, both alone and when comorbid with psychosis, anxiety or depression. Psychosocial treatments such as cognitive behavioural therapy, motivational enhancement therapy and contingency management are currently the most effective strategy for treating CUD but are of limited benefit when comorbid with psychosis. Pharmacological treatments targeting the endocannabinoid system have the potential to reduce cannabis withdrawal and cannabis use in CUD. Mental health comorbidities including anxiety, depression and psychosis hinder effective treatment and should be addressed in treatment provision and clinical decision making to reduce the global burden of CUDs. Antipsychotic medication may decrease cannabis use and cannabis craving as well as psychotic symptoms in patients with CUD and psychosis. Targeted treatments for anxiety and depression when comorbid with CUD are feasible.

Sexual minority status and psychotic symptoms: findings from the Netherlands Mental Health Survey and Incidence Studies (NEMESIS)

2013 ◽  
Vol 44 (2) ◽  
pp. 421-433 ◽  
Author(s):  
M. J. Gevonden ◽  
J. P. Selten ◽  
I. Myin-Germeys ◽  
R. de Graaf ◽  
M. ten Have ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychotic Symptom ◽  
Sexual Minorities ◽  
Mental Health Problems ◽  
Psychotic Symptoms ◽  
Minority Status ◽  
Foreign Born ◽  
Cross Sectional Survey ◽  
Increased Risk ◽  
Incidence Studies

BackgroundEthnic minority position is associated with increased risk for psychotic outcomes, which may be mediated by experiences of social exclusion, defeat and discrimination. Sexual minorities are subject to similar stressors. The aim of this study is to examine whether sexual minorities are at increased risk for psychotic symptoms and to explore mediating pathways.MethodA cross-sectional survey was performed assessing cumulative incidence of psychotic symptoms with the Composite International Diagnostic Interview in two separate random general population samples (NEMESIS-1 and NEMESIS-2). Participants were sexually active and aged 18–64 years (n = 5927, n = 5308). Being lesbian, gay or bisexual (LGB) was defined as having sexual relations with at least one same-sex partner during the past year. Lifetime experience of any psychotic symptom was analysed using logistic regression, adjusted for gender, educational level, urbanicity, foreign-born parents, living without a partner, cannabis use and other drug use.ResultsThe rate of any psychotic symptom was elevated in the LGB population as compared with the heterosexual population both in NEMESIS-1 [odds ratio (OR) 2.56, 95% confidence interval (CI) 1.71–3.84] and NEMESIS-2 (OR 2.30, 95% CI 1.42–3.71). Childhood trauma, bullying and experience of discrimination partly mediated the association.ConclusionsThe finding that LGB orientation is associated with psychotic symptoms adds to the growing body of literature linking minority status with psychosis and other mental health problems, and suggests that exposure to minority stress represents an important mechanism.

An examination of the relative contribution of saturation and selective attention to memory deficits in patients with recent-onset schizophrenia and their unaffected parents.

2010 ◽  
Vol 119 (1) ◽  
pp. 60-70 ◽  
Author(s):  
Caroline Cellard ◽  
Andrée-Anne Lefèbvre ◽  
Michel Maziade ◽  
Marc-André Roy ◽  
Sébastien Tremblay
Keyword(s):  
Selective Attention ◽  
Memory Deficits ◽  
Recent Onset ◽  
Relative Contribution

Aberrant Salience among Young Healthy Postgraduate University Students: The Role of Cannabis Use, Psychotic-Like Experiences, and Personality

2022 ◽  
pp. 1-7
Author(s):  
Andrea Patti ◽  
Gabriele Santarelli ◽  
Giulio D’Anna ◽  
Andrea Ballerini ◽  
Valdo Ricca
Keyword(s):  
University Students ◽  
Personality Traits ◽  
Cannabis Use ◽  
Positive Symptom ◽  
Psychotic Symptoms ◽  
Symptom Frequency ◽  
Character Inventory ◽  
Aberrant Salience ◽  
Self Transcendence

Aberrant salience (AS) is an anomalous world experience which plays a major role in psychotic proneness. In the general population, a deployment of this construct – encompassing personality traits, psychotic-like symptoms, and cannabis use – could prove useful to outline the relative importance of these factors. For this purpose, 106 postgraduate university students filled the AS Inventory (ASI), the Community Assessment of Psychic Experiences (CAPE), the Temperament and Character Inventory (TCI), and the Symptom Checklist 90-Revised (SCL-90-R). Lifetime cannabis users (<i>n</i> = 56) and individuals who did not use cannabis (<i>n</i> = 50) were compared. The role of cannabis use and psychometric indexes on ASI total scores was tested in different subgroups (overall sample, cannabis users, and nonusers). The present study confirmed that cannabis users presented higher ASI scores. The deployment of AS proved to involve positive symptom frequency (assessed through CAPE), character dimensions of self-directedness and self-transcendence (TCI subscales), and cannabis use. Among nonusers, the role of personality traits (assessed through the TCI) was preeminent, whereas positive psychotic-like experiences (measured by means of CAPE) had a major weight among cannabis users. The present study suggests that pre-reflexive anomalous world experiences such as AS are intertwined with reflexive self-consciousness, personality traits, current subclinical psychotic symptoms, and cannabis use. In the present study, subthreshold psychotic experiences proved to play a major role among cannabis users, whereas personality appeared to be more relevant among nonusers.

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