Skip to main content Accessibility help
×
Home

Psychosis reactivity to cannabis use in daily life: an experience sampling study

  • Cécile Henquet (a1), Jim van Os (a2), Rebecca Kuepper (a3), Philippe Delespaul (a4), Maurice Smits (a5), Joost À Campo (a5) and Inez Myin-Germeys (a6)...

Abstract

Background

Little is known about the experiential dynamics of the interaction between cannabis and vulnerability to psychosis.

Aims

To examine the effects of cannabis on psychotic symptoms and mood in patients with psychosis and healthy controls.

Method

Patients with a psychotic disorder (η = 42) and healthy controls (η = 38) were followed in their daily lives using a structured time-sampling technique.

Results

Daily life cannabis use predicted subsequent increases in positive affect and in patients, but not in controls, decreases in negative affect. In patients, but not in controls, cannabis use predicted increased levels of hallucinatory experiences. Mood-enhancing properties of cannabis were acute, whereas psychosis-inducing effects were sub-acute. There was no direct evidence for self-medication effects in daily life.

Conclusions

Patients with psychosis are more sensitive to both the psychosis-inducing and mood-enhancing effects of cannabis. The temporal dissociation between acute rewarding effects and sub-acute toxic influences may be instrumental in explaining the vicious circle of deleterious use in these patients.

  • 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.

      Psychosis reactivity to cannabis use in daily life: an experience sampling study
      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.

      Psychosis reactivity to cannabis use in daily life: an experience sampling study
      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.

      Psychosis reactivity to cannabis use in daily life: an experience sampling study
      Available formats
      ×

Copyright

Corresponding author

Dr Cécile Henquet, Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO BOX 616 (Loc. Vijverdal), 6200 MD Maastricht, The Netherlands. Email: cecile.henquet@sp.unimaas.nl

Footnotes

Hide All

Declaration of interest

None.

Footnotes

References

Hide All
1 Murray, RM, Morrison, PD, Henquet, C, Di Forti, M. Cannabis, the mind and society: the hash realities. Nat Rev Neurosci 2007; 8: 885–95.
2 Grech, A, Van Os, J, Jones, PB, Lewis, SW, Murray, RM. Cannabis use and outcome of recent onset psychosis. Eur Psychiatry 2005; 20: 349–53.
3 Caspari, D. Cannabis and schizophrenia: results of a follow-up study. Eur Arch Psychiatry Clin Neurosci 1999; 249: 45–9.
4 Linszen, DH, Dingemans, PM, Lenior, ME. Cannabis abuse and the course of recent-onset schizophrenic disorders. Arch Gen Psychiatry 1994; 51: 273–9.
5 Compton, MT, Furman, AC, Kaslow, NJ. Lower negative symptom scores among cannabis-dependent patients with schizophrenia-spectrum disorders: preliminary evidence from an African American first-episode sample. Schizophr Res 2004; 71: 61–4.
6 Spencer, C, Castle, D, Michie, PT. Motivations that maintain substance use among individuals with psychotic disorders. Schizophr Bull 2002; 28: 233–47.
7 Ferdinand, RF, Sondeijker, F, van der Ende, J, Selten, JP, Huizink, A, Verhulst, FC. Cannabis use predicts future psychotic symptoms, and vice versa. Addiction 2005; 100: 612–8.
8 Henquet, C, Krabbendam, L, Spauwen, J, Kaplan, C, Lieb, R, Wittchen, HU, et al. Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. BMJ 2005; 330: 11–5.
9 Stefanis, NC, Delespaul, P, Henquet, C, Bakoula, C, Stefanis, CN, Van Os, J. Early adolescent cannabis exposure and positive and negative dimensions of psychosis. Addiction 2004; 99: 1333–41.
10 McGuffin, P, Farmer, A, Harvey, I. A polydiagnostic application of operational criteria in studies of psychotic illness: development and reliability of the OPCRIT system. Arch Gen Psychiatry 1991; 48: 764–70.
11 Spitzer, RL, Endicott, J, Robins, E. Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 1978; 35: 773–82.
12 Kay, SR, Fiszbein, A, Opler, LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261–76.
13 Myin-Germeys, I, van Os, J, Schwartz, JE, Stone, AA, Delespaul, PA. Emotional reactivity to daily life stress in psychosis. Arch Gen Psychiatry 2001; 58: s113744.
14 Myin-Germeys, I, Krabbendam, L, Jolles, J, Delespaul, PA, van Os, J. Are cognitive impairments associated with sensitivity to stress in schizophrenia? An experience sampling study. Am J Psychiatry 2002; 159: 443–9.
15 Delespaul, PAEG. Empirical studies in ESM reliability and validity. In Assessing Schizophrenia in Daily Life: The Experience Sampling Method. (ed. de Vries, MW): 107. Maastricht University Press, 1995.
16 Myin-Germeys, I, Marcelis, M, Krabbendam, L, Delespaul, P, van Os, J. Subtle fluctuations in psychotic phenomena as functional states of abnormal dopamine reactivity in individuals at risk. Biol Psychiatry 2005; 58: 105–10.
17 Van Winkel, R, Henquet, C, Rosa, A, Papiol, S, Fananas, L, De Hert, M, et al. Evidence that the COMT(Val158Met) polymorphism moderates sensitivity to stress in psychosis: an experience-sampling study. Am J Med Genet B Neuropsychiatr Genet 2008; 147: 10–7.
18 Delespaul, P, deVries, M, van Os, J. Determinants of occurrence and recovery from hallucinations in daily life. Soc Psychiatry Psychiatr Epidemiol 2002; 37: 97104.
19 Van Os, J, Bak, M, Hanssen, M, Bijl, RV, de Graaf, R, Verdoux, H. Cannabis use and psychosis: a longitudinal population-based study. Am J Epidemiol 2002; 156: 319–27.
20 D'Souza, DC, Abi-Saab, WM, Madonick, S, Forselius-Bielen, K, Doersch, A, Braley, G, et al. Delta-9-tetrahydrocannabinol effects in schizophrenia: implications for cognition, psychosis, and addiction. Biol Psychiatry 2005; 57: 594608.
21 Romme, MA, Honig, A, Noorthoorn, EO, Escher, AD. Coping with hearing voices: an emancipatory approach. Br J Psychiatry 1992; 161: 99103.
22 Myin-Germeys, I, Delespaul, P, van Os, J. Behavioural sensitization to daily life stress in psychosis. Psychol Med 2005; 35: 733–41.
23 Arseneault, L, Cannon, M, Poulton, R, Murray, R, Caspi, A, Moffitt, TE. Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ 2002; 325: 1212–3.
24 Thewissen, V, Bentall, RP, Lecomte, T, van Os, J, Myin-Germeys, I. Fluctuations in self-esteem and paranoia in the context of daily life. J Abnorm Psychol 2008; 117: 143–53.
25 Giuffrida, A, Leweke, FM, Gerth, CW, Schreiber, D, Koethe, D, Faulhaber, J, et al. Cerebrospinal anandamide levels are elevated in acute schizophrenia and are inversely correlated with psychotic symptoms. Neuropsychopharmacology 2004; 29: 2108–14.
26 Wilson, RI, Nicoll, RA. Endogenous cannabinoids mediate retrograde signalling at hippocampal synapses. Nature 2001; 410: 588–92.
27 Elphick, MR, Egertova, M. The neurobiology and evolution of cannabinoid signalling. Philos Trans R Soc Lond B Biol Sci 2001; 356: 381408.
28 Chevaleyre, V, Takahashi, KA, Castillo, PE. Endocannabinoid-mediated synaptic plasticity in the CNS. Ann Rev Neurosci 2006; 29: 3776.
29 Leweke, FM, Koethe, D. Cannabis and psychiatric disorders: it is not only addiction. Addict Biol 2008; 13: 264–75.
30 Cheer, JF, Wassum, KM, Heien, ML, Phillips, PE, Wightman, RM. Cannabinoids enhance subsecond dopamine release in the nucleus accumbens of awake rats. J Neurosci 2004; 24: 4393–400.
31 Riegel, AC, Lupica, CR. Independent presynaptic and postsynaptic mechanisms regulate endocannabinoid signaling at multiple synapses in the ventral tegmental area. J Neurosci 2004; 24: 11070–8.
32 Kapur, S, Mizrahi, R, Li, M. From dopamine to salience to psychosis: linking biology, pharmacology and phenomenology of psychosis. Schizophr Res 2005; 79: 5968.
33 Bentall, RP, Kinderman, P, Kaney, S. The self, attributional processes and abnormal beliefs: towards a model of persecutory delusions. Behav Res Ther 1994; 32: 331–41.
34 Bossong, MG, van Berckel, BN, Boellaard, R, Zuurman, L, Schuit, RC, Windhorst, AD, et al. Delta 9-tetrahydrocannabinol induces dopamine release in the human striatum. Neuropsychopharmacology 2009; 34: 759–66.
35 Stokes, PR, Mehta, MA, Curran, HV, Breen, G, Grasby, PM. Can recreational doses of THC produce significant dopamine release in the human striatum? NeuroImage 2009; 48: 186–90.
36 Henquet, C, Di Forti, M, Morrison, P, Kuepper, R, Murray, RM. Gene-environment interplay between cannabis and psychosis. Schizophr Bull 2008; 34: 1111–21.
37 Arseneault, L, Cannon, M, Witton, J, Murray, RM. Causal association between cannabis and psychosis: examination of the evidence. Br J Psychiatry 2004; 184: 110–7.
38 Houston, JE, Murphy, J, Adamson, G, Stringer, M, Shevlin, M. Childhood sexual abuse, early cannabis use, and psychosis: testing an interaction model based on the National Comorbidity Survey. Schizophr Bull 2008; 34: 580–5.
39 Harley, M, Kelleher, I, Clarke, M, Lynch, F, Arseneault, L, Connor, D, et al. Cannabis use and childhood trauma interact additively to increase the risk of psychotic symptoms in adolescence. Psychol Med 2009; 9: 18.
40 Caspi, A, Moffitt, TE, Cannon, M, McClay, J, Murray, R, Harrington, H, et al. Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene×environment interaction. Biol Psychiatry 2005; 57: 1117–27.
41 Henquet, C, Rosa, A, Krabbendam, L, Papiol, S, Fananas, L, Drukker, M, et al. An experimental study of catechol-O-methyltransferase Val(158)Met moderation of delta-9-tetrahydrocannabinol-induced effects on psychosis and cognition. Neuropsychopharmacology 2006; 31: 2748–57.
42 Jacobs, N, Nicolson, NA, Derom, C, Delespaul, P, van Os, J, Myin-Germeys, I. Electronic monitoring of salivary cortisol sampling compliance in daily life. Life Sci 2005; 76: 2431–43.
43 Di Forti, M, Morgan, C, Dazzan, P, Pariante, C, Mondelli, V, Marques, TR, et al. High-potency cannabis and the risk of psychosis. Br J Psychiatry 2009; 195: 488–91.
44 Morgan, CJA, Curran, HV. Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis. Br J Psychiatry 2008; 192: 306–7.
45 Bhattacharyya, S, Morrison, PD, Fusar-Poli, P, Martin-Santos, R, Borgwardt, S, Winton-Brown, T, et al. Opposite effects of delta-9-tetrahydrocannabinol and cannabidiol on human brain function and psychopathology. Neuropsychopharmacology 2010; 35: 764–74.
46 D'Souza, DC, Ranganathan, M, Braley, G, Gueorguieva, R, Zimolo, Z, Cooper, T, et al. Blunted psychotomimetic and amnestic effects of delta-9-tetrahydrocannabinol in frequent users of cannabis. Neuropsychopharmacology 2008; 33: 2505–16.
47 Barrowclough, C, Haddock, G, Tarrier, N, Lewis, SW, Moring, J, O'Brien, R, et al. Randomized controlled trial of motivational interviewing, cognitive behavior therapy, and family intervention for patients with comorbid schizophrenia and substance use disorders. Am J Psychiatry 2001; 158: 1706–13.

Psychosis reactivity to cannabis use in daily life: an experience sampling study

  • Cécile Henquet (a1), Jim van Os (a2), Rebecca Kuepper (a3), Philippe Delespaul (a4), Maurice Smits (a5), Joost À Campo (a5) and Inez Myin-Germeys (a6)...

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

Psychosis reactivity to cannabis use in daily life: an experience sampling study

  • Cécile Henquet (a1), Jim van Os (a2), Rebecca Kuepper (a3), Philippe Delespaul (a4), Maurice Smits (a5), Joost À Campo (a5) and Inez Myin-Germeys (a6)...
Submit a response

eLetters

Psychosis reactivity to cannabis use in daily life

Dr Osama Hammer, Psychiatrist
30 June 2010

Dear EditorReally I congratulate Cécile Henquet, et al for their study which concluded that; Patients with psychosis are more sensitive to both the psychosis-inducing and mood-enhancing effects of cannabis. Data suggest that the positive effects of cannabis on mood are acute, whereas its association with psychotic experiences is sub-acute. For long years it hasbeen known that there is a reciprocal interaction between the endocannabinoid and dopamine system which may explain the psychotogenic effects of cannabis in individuals and it thought to play a crucial role in attributing salience to stimuli in the environment. On the other hand patients with a psychotic disorder are more sensitive to the hallucinogenic effects of cannabis than others. In addition epidemiological studies has identified several factors that co-participate with THC in causing psychosis, as pre-existing psychotic symptoms, exposure to childhood trauma and a functional polymorphism in the catechol-O-methyltransferase gene have been shown to moderate the effects of cannabis on psychosis outcome. “Cannabis increases risk of psychosis in teens” was the title of a cross-sectional study of more than6,000 young people in Finland which suggests that teen users had a greater risk of the “prodromal”, or warning symptoms, of psychosis than older users. However, the findings add to the evidence that there is a link between use of cannabis and mental health. The researchers also foundthat more intensive cannabis use was more strongly associated with these symptoms. The researchers concluded that lifetime cannabis use is associated with the incidence of early warning symptoms of psychosis . When the findings are considered in light of a growing body of evidence ofa link between cannabis use and mental health problems such as schizophrenia, mood disorders it seems wise to limit the use of the drug. This is not only because of considerations of the effects on mental health, but also the well-established risks for cancer and other diseases that are associated with cannabis use. Report of Government Crackdown on Cannabis revealed that Cannabis use has fallen significantly across all age ranges and this is a testament to the success of the previous ten yearDrug Strategy. However, the reduction in cannabis use must not be allowed to reverse. Reclassification of cannabis reflects the fact that skunk, a much stronger type of the drug, now dominates the cannabis market. It accounts for 81 per cent of cannabis available on our streets compared to just 30 per cent in 2002. The average age of first use is 13 years old andyoung people may binge on skunk in the same way as alcohol, trying to achieve the maximum effect. If they do, the independent Advisory Council on the Misuse of Drugs found that the consequences of this 'may be seriousto their mental health.'(Source ;The Home Office).Regarding medicinal use of cannabis The Home Secretary has made it clear that he is willing to amend the misuse of drugs legislation as necessary, to allow the prescribing of a cannabis-based medicine as a form of pain relief.

Our mental health users should be educated that:•Cannabis remains illegal and it is a criminal offence to possess cannabis. •Passing drugs among friends is an offence. •Driving a vehicle while unfit through drugs, including cannabis, is an arrestable offence.•A drug conviction could affect your job prospects, or prevent you getting a visa to travel abroad.Cannabis has Harmful effects which include damage to people's ability to learn and carry out many tasks, including operating machinery and driving vehicles. Acute cannabis intoxication can also lead to panic attacks, paranoia and confused feelings. The chronic effects include damage to mental functioning and in particular to learning difficulties, which in prolonged and heavy users may not necessarily be reversible.It is clear that most users of the more dangerous drugs used cannabis earlier in their careers, but most cannabis users do not go on to use other drugs regularly. References

1.Stokes PR, Mehta MA, Curran HV, Breen G, Grasby PM. Can recreational doses of THC produce significant dopamine release in the human striatum? NeuroImage 2009; 48: 186 –90.[CrossRef][Medline] 2.Henquet C, Di Forti M, Morrison P, Kuepper R, Murray RM. Gene-environment interplay between cannabis and psychosis. Schizophr Bull 2008;34: 1111 –21.3.Arseneault L, Cannon M, Witton J, Murray RM. Causal association betweencannabis and psychosis: examination of the evidence. Br J Psychiatry 2004;184: 110 –7. Dr Osama Hammer MBBch.,MSc.,MRCPsych
... More

Conflict of interest: None Declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *