Ferraro Laura, La Cascia Caterina, Quattrone Diego, Sideli Lucia, Matranga Domenica, Capuccio Veronica, Tripoli Giada, Gayer-Anderson Charlotte, Morgan Craig, Sami Musa B, Sham Pak, de Haan Lieuwe, Velthorst Eva, Jongsma Hannah E, Kirkbride James B, Rutten Bart P F, Richards Alexander L, Roldan Laura, Arango Celso, Bernardo Miquel, Bobes Julio, Sanjuan Julio, Santos Jose Luis, Arrojo Manuel, Tarricone Ilaria, Tortelli Andrea, Szöke Andrei, Del-Ben Cristina Marta, Selten Jean-Paul, Lynskey Michael, Jones Peter B, Van Os Jim, La Barbera Daniele, Murray Robin M, Di Forti Marta
Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy.
2Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.
Schizophr Bull. 2020 Apr 10;46(3):517-529. doi: 10.1093/schbul/sbz077.
Psychotic patients with a lifetime history of cannabis use generally show better cognitive functioning than other psychotic patients. Some authors suggest that cannabis-using patients may have been less cognitively impaired and less socially withdrawn in their premorbid life. Using a dataset comprising 948 patients with first-episode psychosis (FEP) and 1313 population controls across 6 countries, we examined the extent to which IQ and both early academic (Academic Factor [AF]) and social adjustment (Social Factor [SF]) are related to the lifetime frequency of cannabis use in both patients and controls. We expected a higher IQ and a better premorbid social adjustment in psychotic patients who had ever used cannabis compared to patients without any history of use. We did not expect such differences in controls. In both patients and controls, IQ was 3 points higher among occasional-users than in never-users (mean difference [Mdiff] = 2.9, 95% CI = [1.2, 4.7]). Both cases and control daily-users had lower AF compared to occasional (Mdiff = -0.3, 95% CI = [-0.5; -0.2]) and never-users (Mdiff = -0.4, 95% CI = [-0.6; -0.2]). Finally, patient occasional (Mdiff = 0.3, 95% CI = [0.1; 0.5]) and daily-users (Mdiff = 0.4, 95% CI = [0.2; 0.6]) had better SF than their never-using counterparts. This difference was not present in controls (Fgroup*frequency(2, 2205) = 4.995, P = .007). Our findings suggest that the better premorbid social functioning of FEP with a history of cannabis use may have contributed to their likelihood to begin using cannabis, exposing them to its reported risk-increasing effects for Psychotic Disorders.
有终生大麻使用史的精神病患者通常比其他精神病患者表现出更好的认知功能。一些作者认为，使用大麻的患者在病前生活中认知受损可能较轻，社交退缩也较少。我们使用了一个包含6个国家的948例首发精神病（FEP）患者和1313名人群对照的数据集，研究了智商以及早期学业成绩（学业因子[AF]）和社会适应能力（社会因子[SF]）与患者和对照中终生大麻使用频率的相关程度。我们预期，与没有任何使用史的患者相比，曾经使用过大麻的精神病患者智商更高，病前社会适应能力更好。我们没有预期在对照中会出现这种差异。在患者和对照中，偶尔使用者的智商比从不使用者高3分（平均差异[Mdiff]=2.9，95%置信区间=[1.2,4.7]）。与偶尔使用者（Mdiff=-0.3，95%置信区间=[-0.5；-0.2]）和从不使用者（Mdiff=-0.4，95%置信区间=[-0.6；-0.2]）相比，病例组和对照组的每日使用者的AF较低。最后，患者偶尔使用者（Mdiff=0.3，95%置信区间=[0.1；0.5]）和每日使用者（Mdiff=0.4，95%置信区间=[0.2；0.6]）的SF比从不使用者更好。对照中不存在这种差异（F组*频率(2,2205)=4.995，P=0.007）。我们的研究结果表明，有大麻使用史的FEP患者病前更好的社会功能可能促使他们开始使用大麻，使他们面临其对精神障碍报告的风险增加效应。
