Cannabis use correlates with stronger positive symptoms in first-episode psychosis, but abstinence is associated with the best symptomatic improvement after 6 months.
Summary
n=110 children and adolescents (9–17 years) with first-episode psychosis; prevalence of cannabis use 29,1% (alcohol 21,8%, cocaine 8,2%). Cannabis use decreased after 6 months (p=0.004). Adolescents with cannabis use initially showed stronger PANSS positive symptomatology (p=0.002); abstinence over the course was associated with the best psychopathological outcome (PANSS total p=0.002). Data demonstrate the relevance of cannabis use for psychopathology and short-term course in adolescent first-episode psychosis.
P
PopulationChildren and adolescents (9–17 years) with first-episode psychosis (FEP), n=110
I
InterventionCannabis use at baseline (cannabis users, n=32)
C
ControlNon-cannabis users (NCU, n=78)
O
OutcomeCannabis users showed higher PANSS positive scores at baseline (p=0,002), but after 6 months significantly lower PANSS total scores (p=0,002); strongest improvement in patients who discontinued cannabis
Confidence in the evidence
Very lowLowModerateHigh
Low
The second of four GRADE levels, the effect estimate is of limited reliability.
Quality profile
Sample size★★★★★
Blinding—
Effect sizeMixed
Citations / year★★★★★
Authors
Baeza I, Graell M, Moreno D, Castro-Fornieles J, Parellada M, González-Pinto A, Payá B, Soutullo C, de la Serna E, Arango C.
<h4>Objective</h4>To know the prevalence of substance use and its relationship with psychopathology at onset and after six months in children and adolescents with first episode psychosis (FEP).<h4>Method</h4>110 FEP patients, aged 9-17, were assessed for substance use, and with the Positive and Negative Syndrome Scale (PANSS) and other psychopathological and general functioning scales at baseline and after a six-month follow-up.<h4>Results</h4>Patients' substance use at baseline was: tobacco (30.9%), cannabis (29.1%), alcohol (21.8%), cocaine (8.2%), amphetamines (2.7%), LSD (1.8%) and opiates (0.90%). Six months later, there was a decrease in patients' use of cannabis (p=0.004) and other drugs, except tobacco. Patients were divided, according to their baseline cannabis use, into 32 cannabis users (CU) and 78 non-cannabis users (NCU). CU were older (p=0.002) and had higher PANSS positive scores (p=0.002) and lower PANSS negative (p<0.001), PANSS general (p=0.002) and PANSS total (p=0.007) scores than NCU. At six months, CU had significantly lower PANSS positive (p=0.010), negative (p=0.0001), general (p=0.002) and total (p=0.002) scores than NCU. When we divided CU at six months into previous CU (n=16) and current CU (n=15), previous CU had the best outcome, NCU the worst and current CU had an intermediate profile.<h4>Conclusions</h4>Cannabis use may be related to higher positive symptom scores for FEP patients, with greater improvement after six months for those who cease using cannabis.