Kennedy L, Ku B S, Addington J, Amir C M, Bearden C E, Cannon T D, Carrión R, Cornblatt B, Keshavan M, Perkins D, Mathalon D, Stone W, Walker E, Woods S, Cadenhead K S
Department of Psychiatry, University of California San Diego, United States.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.
Schizophr Res. 2024 Sep;271:319-331. doi: 10.1016/j.schres.2024.07.032. Epub 2024 Jul 30.
Neurocognitive deficits have been widely reported in clinical high-risk for psychosis (CHR) populations. Additionally, rates of cannabis use are high among CHR youth and are associated with greater symptom severity. Cannabis use has been sometimes shown to be associated with better neurocognition in more progressed psychosis cohorts, therefore in this study we aimed to determine whether a similar pattern was present in CHR.
CHR participants ages 12-30 from the North American Prodromal Longitudinal Study (NAPLS-3) (N = 698) were grouped according to: "minimal to no cannabis use" (n = 406), "occasional use" (n = 127), or "frequent use" (n = 165). At baseline, cannabis use groups were compared on neurocognitive tests, clinical, and functional measures. Follow-up analyses were used to model relationships between cannabis use frequency, neurocognition, premorbid, and social functioning.
Occasional cannabis users performed significantly better than other use-groups on measures of IQ, with similar trend-level patterns observed across neurocognitive domains. Occasional cannabis users demonstrated better social, global, and premorbid functioning compared to the other use-groups and less severe symptoms compared to the frequent use group. Follow-up structural equation modeling/path analyses found significant positive associations between premorbid functioning, social functioning, and IQ, which in turn was associated with occasional cannabis use frequency.
Better premorbid functioning positively predicts both better social functioning and higher IQ which in turn is associated with a moderate cannabis use pattern in CHR, similar to reports in first-episode and chronic psychosis samples. Better premorbid functioning likely represents a protective factor in the CHR population and predicts a better functional outcome.
神经认知缺陷在临床高危精神病（CHR）人群中已被广泛报道。此外，CHR青年中大麻使用率很高，且与更严重的症状相关。在病情进展更严重的精神病队列中，有时会发现大麻使用与更好的神经认知有关，因此在本研究中，我们旨在确定CHR人群中是否存在类似模式。
来自北美前驱期纵向研究（NAPLS-3）的12至30岁的CHR参与者（N = 698）按以下方式分组：“极少或不使用大麻”（n = 406）、“偶尔使用”（n = 127）或“频繁使用”（n = 165）。在基线时，对大麻使用组在神经认知测试、临床和功能测量方面进行比较。采用随访分析来建立大麻使用频率、神经认知、病前和社会功能之间的关系模型。
在智商测试中，偶尔使用大麻的参与者表现明显优于其他使用组，在各个神经认知领域也观察到类似的趋势水平模式。与其他使用组相比，偶尔使用大麻的参与者表现出更好的社会、整体和病前功能，与频繁使用组相比症状较轻。随访结构方程建模/路径分析发现，病前功能、社会功能和智商之间存在显著的正相关，而智商又与偶尔使用大麻的频率相关。
更好的病前功能正向预测更好的社会功能和更高的智商，这反过来又与CHR人群中适度的大麻使用模式相关，这与首发和慢性精神病样本中的报道相似。更好的病前功能可能代表CHR人群中的一个保护因素，并预测更好的功能结局。
