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David Baxter PhD

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Cannabis use linked to adolescent prodromal symptoms of psychosis
By Liam Davenport
06 June 2008
Br J Psychiatry 2008; 192: 470-471

The use of cannabis is associated with prodromal symptoms of psychosis in adolescence, regardless of the presence of other risk factors, say researchers.

Heavy cannabis use is believed to be associated with psychotic symptoms and schizophrenia, but it is not clear whether the drug causes psychoses beyond intoxication, as some studies on the association have been undermined by limitations, explains the team.

Juha Veijola, from the University of Oulu in Helsinki, Finland, and colleagues studied the association between cannabis use and psychotic symptoms among 6330 adolescents aged 15-16 years from a mother-child population-based birth cohort.

The participants completed self-report questionnaires on prodromal symptoms of psychosis and drug use.

In addition, early emotional and behavioral symptoms were collected using the Rutter B2 questionnaire for teachers, and the team gathered information on family type, parental social class based on occupation, history of regular tobacco use, use of other drugs, and parental substance misuse disorder.

The team reports in the British Journal of Psychiatry that 5.6% of the participants reported using cannabis at least once, while 0.9% had used cannabis more than five times. Girls were nonsignificantly more likely to report cannabis use than boys, at 6.1% versus 4.9%.

Participants who had tried cannabis had a significantly higher average number of prodromal symptoms than nonusers, at 3.11 versus 1.88. Analysis revealed that adolescents who had tried cannabis were significantly more likely than those who had not to report at least three prodromal symptoms, at an adjusted odds ratio of 2.23.

Interestingly, the researchers found a dose-response effect with cannabis use, with the proportion of adolescents with high prodromal scores increasing by cannabis use category at an odds ratio of 1.42.

"We showed that these effects are not secondary to confounding effects of other drug use, childhood emotional/behavioural problems or family background," the team concludes.

"The association is therefore unlikely to be caused by these or any closely related factors, supporting the hypothesis that cannabis use may be causal in terms of subsequent psychotic symptoms."

Abstract
 
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