Hostname: page-component-76fb5796d-dfsvx Total loading time: 0 Render date: 2024-04-26T18:02:43.556Z Has data issue: false hasContentIssue false
  • English
  • Français

Cannabis use and risk of psychosis: an etiological link?*

Published online by Cambridge University Press:  11 October 2011

Helene Verdoux  and
Marie Tournier
Helene Verdoux*
Affiliation:
Department of Psychiatry, EA 3676 MP2S, IFR99 of Public Health, University Victor Segalen Bordeaux2, Bordeaux, France
Marie Tournier
Affiliation:
Department of Psychiatry, EA 3676 MP2S, IFR99 of Public Health, University Victor Segalen Bordeaux2, Bordeaux, France
*
Address for correspondence: Prof. H.Verdoux, Hôpital Charles Perrens, 121 rue de la Béchade, 33076 Bordeaux Cedex (France). Fax: (33) 556-56-35-46 E-mail: helene.verdoux@ipso.u-bordeaux2.fr
Get access Rights & Permissions [Opens in a new window]

Summary

Objective – The nature of the link between cannabis use and psychosis remains to be clarified. Method – The paper reviews the evidence suggesting that cannabis may be a risk factor for psychosis onset. Results – Cross-sectional and retro- spective epidemiological studies show that individuals with psychosis use cannabis more often than other individuals in the gener- al population. It has long been considered that this association is explained by the self-medication hypothesis, postulating that cannabis is used to self-medicate psychotic symptoms. This hypothesis has been recently challenged by several prospective stud- ies carried out in population-based samples, showing that cannabis exposure is associated with an increased risk of psychosis, pos- sibly by interacting with a pre-existing vulnerability for these disorders. A dose-response relationship was found between cannabis exposure and risk of psychosis, and this association was independent from potential confounding factors such as exposure to other drugs and pre-existence of psychotic symptoms. However, the diagnostic specificity is weak, as cannabis exposure may be a risk factor for the occurrence of a large spectrum of psychiatric disorders, ranging from schizophrenia to mood and anxiety disorders. Conclusion – Considering the growing number of adolescents exposed to cannabis, the impact of this substance on the population mental health should be further explored.

Type
Invited Papers
Information
Epidemiology and Psychiatric Sciences , Volume 13 , Issue 2 , June 2004 , pp. 113 - 119
Copyright
Copyright © Cambridge University Press 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Paper presented at the VI National Congress of the Italian Society of Psychiatric Epidemiology (SIEP), held in Sirmione (BS), 6-8 November 2003.

References

REFERENCES

Allebeck, P., Adamsson, C., Engstrom, A. & Rydberg, U. (1993). Cannabis and schizophrenia: a longitudinal study of cases treated in Stockholm County. Ada Psychiatrica Scandinavica 88, 21–24.CrossRefGoogle ScholarPubMed
Andreasson, S., Allebeck, P., Engstrom, A. & Rydberg, U. (1987). Cannabis and schizophrenia. A longitudinal study of Swedish con- scripts. Lancet 2, 1483–1486.CrossRefGoogle Scholar
Arseneault, L.. Cannon, M, Poulton, R., Murray, R., Caspi, A. & Moffitt, T.E. (2002). Cannabis use in adolescence and risk for adult psy- chosis: longitudinal prospective study. British Medical Journal 325, 1212–1213.CrossRefGoogle Scholar
Bovasso, G. (2001). Cannabis abuse as a risk factor for depressive symp- toms. American Journal of Psychiatry 158, 2033–2037.CrossRefGoogle Scholar
Biihler, B., Hambrecht, M., Loffler, W., An der Heiden, W. & Hafner, H. (2002). Precipitation and determination of the onset and course of schizophrenia by substance abuse-a retrospective and prospective study of 232 population-based first illness episodes. Schizophrenia Research 54, 243–251.CrossRefGoogle Scholar
Croxford, J.L. (2003). Therapeutic potential of cannabinoids in CNS dis- ease. CNS Drugs 17, 179–202.CrossRefGoogle Scholar
Dean, B., Sundram, S., Bradbury, R., Scarr, E. & Copolov, D. (2001). Studies on [3H]CP-55940 binding in the human central nervous sys-tem: regional specific changes in density of cannabinoid-1 receptors associated with schizophrenia and cannabis use. Neuroscience 103, 9–15.CrossRefGoogle Scholar
Degenhardt, L. & Hall, W. (2001). The association between psychosis and problematical drug use among Australian adults: findings from the National Survey of Mental Health and Well-Being. Psychological Medicine 31, 659–668.CrossRefGoogle ScholarPubMed
Dumas, P., Saoud, M., Bouafia, S., Gutknecht, C., Ecochard, R., Dalery, J., Rochet, T. & d'amato, T. (2002). Cannabis use correlates with schizotypal personality traits in healthy students. Psychiatry Research 109, 27–35.CrossRefGoogle ScholarPubMed
Gorriti, M.A., Rodriguez de Fonseca, F., Navarro, M. & Palomo, T. (1999). Chronic (-)-delta9-tetrahydrocannabinol treatment induces sensitization to the psychomotor effects of amphetamine in rats. European Journal of Pharmacology 365, 133–142.CrossRefGoogle Scholar
Hafner, H., Hambrecht, M., Loffler, W., Munk-Jorgensen, P. & Riecher-Rossler, A. (1998). Is schizophrenia a disorder of all ages? A com- parison of first episodes and early course across the life-cycle. Psychological Medicine 28, 351–365.CrossRefGoogle Scholar
Hall, W. & Degenhardt, L. (2003). Medical marijuana initiatives: are they justified? How successful are they likely to be? CNS Drugs 17, 689–697.CrossRefGoogle ScholarPubMed
Hambrecht, M. & Hafner, H. (1996). Substance abuse and the onset of schizophrenia. Biological Psychiatry 40, 1155–1163.CrossRefGoogle ScholarPubMed
Hambrecht, M. & Hafner, H. (2000). Cannabis, vulnerability, and the onset of schizophrenia: an epidemiological perspective. Austrialian New Zealand Journal of Psychiatry 34, 468–475.CrossRefGoogle ScholarPubMed
Hennekens, C. & Buring, J. (1987). Epidemiology in Medicine. Little, Brown and Co: Boston, Massachusetts.Google Scholar
Jablensky, A. (1995). Schizophrenia: recent epidemiologic issues. Epidemiological Review 17, 10–20.CrossRefGoogle ScholarPubMed
Johns, A. (2001). Psychiatric effects of cannabis. British Journal of Psychiatry 178, 116–122.CrossRefGoogle ScholarPubMed
Kwapil, T.R. (1996). A longitudinal study of drug and alcohol use by psychosis-prone and impulsive-nonconforming individuals. Journal of Abnormal Psychology 105, 114–123.CrossRefGoogle ScholarPubMed
Leweke, F.M., Giuffrida, A., Wurster, U., Emrich, H.M. & Piomelli, D. (1999). Elevated endogenous cannabinoids in schizophrenia. Neuroreport 10, 1665–1669.CrossRefGoogle ScholarPubMed
Linszen, D.H., Dingemans, P. & Lenior, M. (1994). Cannabis abuse and the course of recent-onset schizophrenic disorders. Archives of General Psychiatry 51, 273–279.CrossRefGoogle ScholarPubMed
McGuire, P.K., Jones, P., Harvey, I., Bebbington, P., Toone, B., Lewis, S. & Murray, R.M. (1994). Cannabis and acute psychosis. Schizophrenia Research 13, 161–167.CrossRefGoogle ScholarPubMed
McGuire, P.K., Jones, P., Harvey, I., Williams, M., McGuffin, P. & Murray, R.M. (1995). Morbid risk of schizophrenia for relatives of patients with cannabis-associated psychosis. Schizophrenia Research 5, 277–281.CrossRefGoogle Scholar
Nunn, J., Rizza, F. & Peters, E.R. (2001). The incidence of schizotypy among cannabis and alcohol users. Journal of Nervous and Mental Disease 189, 741–748.CrossRefGoogle ScholarPubMed
Observatoire francais des drogues et des toxicomanies (2002). Drogues et Dependances. Indicateurs et Tendances 2002. OFDT: Paris.Google Scholar
Patton, G., Coffey, C., Carlin, J., Degenhardt, L., Lynskey, M. & Hall, W. (2002). Cannabis use and mental health in young people: cohort study. British Medical Journal 325, 1195–1198.CrossRefGoogle ScholarPubMed
Perkonigg, A., Lieb, R., Hofler, M., Schuster, P., Sonntag, H. & Wittchen, H. (1999). Patterns of cannabis use, abuse and dependence over time: incidence, progression and stability in a sample of 1228 ado- lescents. Addiction 94, 1663–1678.CrossRefGoogle Scholar
Rabinowitz, J., Bromet, E., Lavelle, J., Carlson, G., Kovasznay, B. & Schwartz, J.E. (1999). Prevalence and severity of substance use dis- orders and onset of psychosis in first-admission psychotic patients. Psychological Medicine 28, 1411–1419.CrossRefGoogle Scholar
Regier, D., Farmer, M., Rae, D., Locke, B., Keith, S., Judd, L. & Goodwin, F. (1990). Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. Journal of American Medical Association 264, 2511–2518.CrossRefGoogle ScholarPubMed
Robson, P. (2001). Therapeutic aspects of cannabis and cannabinoids. British Journal of Psychiatry 178, 107–115.CrossRefGoogle ScholarPubMed
Rose, G. (1992). The Strategy of Preventive Medicine. Oxford University Press: Oxford.Google Scholar
Skosnik, P.D., Spatz-Glenn, L. & Park, S. (2001). Cannabis use is asso- ciated with schizotypy and attentional disinhibition. Schizophrenia Research 48, 83–92.CrossRefGoogle Scholar
Smart, R. & Ogborne, A. (2000). Drug use and drinking among students in 36 countries. Addictive Behavior 25, 455–460.CrossRefGoogle ScholarPubMed
Tanda, G., Pontieri, F. & Di Chiara, G. (1997). Cannabinoid and heroin activation of mesolimbic dopamine transmission by a common ml opoid receptor mechanism. Science 276, 2048–2050.CrossRefGoogle Scholar
Tennant, F.S. Jr. & Groesbeck, C.J. (1972). Psychiatric effects of hashish. Archives of General Psychiatry 27, 133–136.CrossRefGoogle ScholarPubMed
Thornicroft, G. (1990). Cannabis and psychosis. Is there epidemiologi- cal evidence for an association? British Journal of Psychiatry 157, 25–33.CrossRefGoogle Scholar
Tramer, M., Carroll, D., Campbell, F., Reynolds, D., Moore, R. & McQuay, H. (2001). Cannabinoids for control of chemotherapy induced nau- sea and vomiting: quantitative systematic review. British Medical Journal 323, 16.CrossRefGoogle Scholar
Tsuchiya, K. & Munk-Jorgensen, P. (2002). First-admission rates of schizophrenia in Denmark, 1980–1997: have they been increasing? Schizophrenia Research 54, 187–191.CrossRefGoogle ScholarPubMed
Ujike, H., Takaki, M., Nakata, K., Tanaka, Y., Takeda, T., Kodama, M., Fujiwara, Y., Sakai, A. & Kuroda, S. (2002). CNR1, central cannabi- noid receptor gene, associated with susceptibility to hebephrenic schizophrenia. Molecular Psychiatry 7, 515–518.CrossRefGoogle Scholar
van Os, J., Bak, M., Hanssen, M., Bijl, R.V., de Graaf, R. & Verdoux, H. (2002). Cannabis and psychosis: a longitudinal population-based study. American Journal of Epidemiology 156, 319–327.CrossRefGoogle ScholarPubMed
Verdoux, H. (2003). Cannabis and psychosis proneness. In Marijuana and Madness (ed. Castle, D. and Murray, R.). Cambridge University Press: Cambridge.Google Scholar
Verdoux, H., van Os, J., Maurice-Tison, S., Gay, B., Salamon, R. & Bourgeois, M. (1998). Is early adulthood a critical developmental stage for psychosis proneness? A survey of delusional ideation in normal subjects. Schizophrenia Research 29, 247–254.CrossRefGoogle ScholarPubMed
Verdoux, H., Liraud, F., Gonzales, B., Assens, F., Abalan, F. & van Os, J. (1999). Suicidality and substance misuse in first-admitted subjects with psychotic disorder. Ada Psychiatrica Scandinavica 100, 389–395.CrossRefGoogle ScholarPubMed
Verdoux, H., Gindre, C., Sorbara, F., Tournier, M. & Swendsen, J. (2003a). Cannabis Use and the Expression of Psychosis Vulnerability in Daily Life. Psychological Medicine 33, 23–32.CrossRefGoogle Scholar
Verdoux, H., Sorbara, F., Gindre, C., Swendsen, D. & van Os, J. (2003b). Cannabis and dimensions of psychosis in a non-clinical population of female subjects. Schizophrenia Research 59, 77–84.CrossRefGoogle Scholar
Watson, S., Benson, J.J. & Joy, J. (2000). Marijuana and medicine: assessing the science base: a summary of the 1999 Institute of Medicine report. Archives of General Psychiatry 57, 547–552.CrossRefGoogle Scholar
Webb, E., Ashton, C., Kelly, P. & Kamali, F. (1996). Alcohol and drug use in UK university students. Lancet 348, 922–925.CrossRefGoogle ScholarPubMed
Williams, J.H., Wellman, N.A. & Rawlins, J.N. (1996). Cannabis use cor- relates with schizotypy in healthy people. Addiction 91, 869–877.CrossRefGoogle Scholar
Zammit, S., Allebeck, P., Andreasson, S., Lundberg, I. & Lewis, G. (2002). Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. British Medical Journal 325, 1199.CrossRefGoogle ScholarPubMed