Skip to main content
×
×
Home

Prognosis of schizophrenia in persons with and without a history of cannabis use

  • E. Manrique-Garcia (a1), S. Zammit (a2), C. Dalman (a3), T. Hemmingsson (a4) (a5), S. Andreasson (a1) and P. Allebeck (a1)...
Abstract
Background

The aim of the study was to determinate whether schizophrenia patients with a history of cannabis use have a different prognosis, with regards to readmission and hospital duration, compared with those without a history of cannabis use.

Method

The present investigation was a cohort study of 50 087 Swedish men with data on cannabis use at the ages of 18–20 years. A total of 357 cases of schizophrenia were identified from in-patient care and followed up from 1973 to 2007.

Results

Schizophrenia patients with a history of cannabis use had a higher median duration of first hospital episode (59 days v. 30 days). Patients with a history of cannabis use had a higher median rate of readmission (10 times v. four times). Also, total number of hospital days was higher in patients with a history of cannabis use compared with those without (547 days v. 184 days). Patients with a history of cannabis use had an increased odds of having more than 20 hospital readmissions compared with non-users [3.1, 95% confidence interval (CI) 1.3–7.3] as well as an increased odds of hospital admission lasting more than 2 years (2.4, 95% CI 1.1–7.4) after controlling for diagnosis of personality disorders, family socio-economic position, IQ score, civil status, place of residence, risky use of alcohol and use of other drugs. Patients with a history of cannabis use were less likely to have paranoid schizophrenia compared with never users (8% v. 17%) in the first admission.

Conclusions

Schizophrenia patients with a history of cannabis use had a significantly higher burden of lifetime in-patient care than non-cannabis users. Not only does cannabis increase the risk of schizophrenia, but also our findings indicate that the course and prognosis of schizophrenia may be more severe than schizophrenia cases in general.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Prognosis of schizophrenia in persons with and without a history of cannabis use
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Prognosis of schizophrenia in persons with and without a history of cannabis use
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Prognosis of schizophrenia in persons with and without a history of cannabis use
      Available formats
      ×
Copyright
The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution licence .
Corresponding author
* Address for correspondence: E. Manrique-Garcia, M.D., M.P.H., Karolinska Institutet, Department of Public Health, Tomtebodavägen 18 A, Floor 8, 171 77, Stockholm, Sweden. (Email: edison.manrique-garcia@ki.se)
References
Hide All
Allebeck, P, Adamsson, C, Engstrom, A, Rydberg, U (1993). Cannabis and schizophrenia: a longitudinal study of cases treated in Stockholm County. Acta Psychiatrica Scandinavica 88, 2124.
an der Heiden, W, Hafner, H (2000). The epidemiology of onset and course of schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 250, 292303.
Andreasson, S, Allebeck, P, Engstrom, A, Rydberg, U (1987). Cannabis and schizophrenia. A longitudinal study of Swedish conscripts. Lancet ii, 14831486.
Andreasson, S, Allebeck, P, Rydberg, U (1989). Schizophrenia in users and nonusers of cannabis. A longitudinal study in Stockholm County. Acta Psychiatrica Scandinavica 79, 505510.
Arendt, M, Rosenberg, R, Foldager, L, Perto, G, Munk-Jorgensen, P (2005). Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases. British Journal of Psychiatry 187, 510515.
Arseneault, L, Cannon, M, Poulton, R, Murray, R, Caspi, A, Moffitt, TE (2002). Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. British Medical Journal 325, 12121213.
Benson, G, Holmberg, MB (1985). Validity of questionnaires in population studies on drug use. Acta Psychiatrica Scandinavica 71, 918.
Buckley, PF, Miller, BJ, Lehrer, DS, Castle, DJ (2009). Psychiatric comorbidities and schizophrenia. Schizophrenia Bulletin 35, 383402.
Castagnini, A, Berrios, GE (2009). Acute and transient psychotic disorders (ICD-10 F23): a review from a European perspective. European Archives of Psychiatry and Clinical Neuroscience 259, 433443.
Castle, DJ, Sham, PC, Wessely, S, Murray, RM (1994). The subtyping of schizophrenia in men and women: a latent class analysis. Psychological Medicine 24, 4151.
Coldham, EL, Addington, J, Addington, D (2002). Medication adherence of individuals with a first episode of psychosis. Acta Psychiatrica Scandinavica 106, 286290.
Dalman, C, Broms, J, Cullberg, J, Allebeck, P (2002). Young cases of schizophrenia identified in a national inpatient register – are the diagnoses valid? Social Psychiatry and Psychiatric Epidemiology 37, 527531.
Ekholm, B, Ekholm, A, Adolfsson, R, Vares, M, Osby, U, Sedvall, GC, Jonsson, EG (2005). Evaluation of diagnostic procedures in Swedish patients with schizophrenia and related psychoses. Nordic Journal of Psychiatry 59, 457464.
Ferdinand, RF, Sondeijker, F, van der Ende, J, Selten, JP, Huizink, A, Verhulst, FC (2005). Cannabis use predicts future psychotic symptoms, and vice versa. Addiction 100, 612618.
Fergusson, DM, Horwood, LJ, Swain-Campbell, NR (2003). Cannabis dependence and psychotic symptoms in young people. Psychological Medicine 33, 1521.
Foti, DJ, Kotov, R, Guey, LT, Bromet, EJ (2010). Cannabis use and the course of schizophrenia: 10-year follow-up after first hospitalization. American Journal of Psychiatry 167, 987993.
Hall, W, Degenhardt, L (2009). Adverse health effects of non-medical cannabis use. Lancet 374, 13831391.
Henquet, C, Krabbendam, L, Spauwen, J, Kaplan, C, Lieb, R, Wittchen, HU, van Os, J (2005). Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. British Medical Journal 330, 11.
Kamali, M, Kelly, BD, Clarke, M, Browne, S, Gervin, M, Kinsella, A, Lane, A, Larkin, C, O'Callaghan, E (2006). A prospective evaluation of adherence to medication in first episode schizophrenia. European Psychiatry 21, 2933.
Lachin, JM (2011). Analysis of count data. In Biostatistical Methods: The Assessment of Relative Risks, pp. 381427. John Wiley and Sons: Chichester.
Lewis, G, David, AS, Malmberg, A, Allebeck, P (2000). Non-psychotic psychiatric disorder and subsequent risk of schizophrenia. Cohort study. British Journal of Psychiatry 177, 416420.
Marshall, M, Rathbone, J (2011). Early intervention for psychosis. Cochrane Database of Systematic Reviews, Issue 6. Art. No.: CD004718. doi:10.1002/14651858.CD004718.pub3.
Miller, R, Ream, G, McCormack, J, Gunduz-Bruce, H, Sevy, S, Robinson, D (2009). A prospective study of cannabis use as a risk factor for non-adherence and treatment dropout in first-episode schizophrenia. Schizophrenia Research 113, 138144.
Moore, TH, Zammit, S, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370, 319328.
Otto, U (1980). Function of male youths during military service. A follow-up study of a youth clientele. Acta Psychiatrica Scandinavica (Suppl.) 282, 160.
Pomarol-Clotet, E, Salvador, R, Murray, G, Tandon, S, McKenna, PJ (2010). Are there valid subtypes of schizophrenia? A grade of membership analysis. Psychopathology 43, 5362.
Remschmidt, H, Theisen, F (2012). Early-onset schizophrenia. Neuropsychobiology 66, 6369.
Rosen, JL, Miller, TJ, D'Andrea, JT, McGlashan, TH, Woods, SW (2006). Comorbid diagnoses in patients meeting criteria for the schizophrenia prodrome. Schizophrenia Research 85, 124131.
van Os, J, Bak, M, Hanssen, M, Bijl, RV, de Graaf, R, Verdoux, H (2002). Cannabis use and psychosis: a longitudinal population-based study. American Journal of Epidemiology 156, 319327.
van Os, J, Kapur, S (2009). Schizophrenia. Lancet 374, 635645.
Zalewski, C, Johnson-Selfridge, MT, Ohriner, S, Zarrella, K, Seltzer, JC (1998). A review of neuropsychological differences between paranoid and nonparanoid schizophrenia patients. Schizophrenia Bulletin 24, 127145.
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.
Zammit, S, Moore, TH, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G (2008). Effects of cannabis use on outcomes of psychotic disorders: systematic review. British Journal of Psychiatry 193, 357363.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed