Study register · detailMeta-Analyse · Psychosis Risk · 2016
Cannabis use and transition to psychosis in individuals at ultra-high risk: review and meta-analysis.
Kraan et al.·Psychological medicineImpact 4.3
MixedGRADEHigh121 citations
Samplek = 7 Studien n = 1.171 Pat.
Durationprospective studies, follow-up…
ControlUHR individuals without cannabis use
EndpointTransition rate to psychosis
Blindingunklar
DesignMeta-Analyse
”Key finding
Lifetime cannabis use was not significantly associated with psychosis transition (OR 1.14, p=0.37), but current cannabis abuse/dependence showed significant association (OR 1.75, p=0.01).
Summary
Systematic review + meta-analysis on cannabis in Ultra-High-Risk (UHR) for psychosis, k=7 prospective studies (n=1.171). Lifetime cannabis use NOT significantly associated with psychosis transition (OR=1,14, 95% CI 0,856–1,524, p=0,37). Current cannabis abuse/dependence (DSM-IV), however, significantly predictive (OR=1,75, 95% CI 1,135–2,710, p=0,01) — indication of a dose-response relationship.
P
PopulationPersons with Ultra-High-Risk (UHR) for psychosis, pooled n=1171
I
InterventionCannabis use (lifetime or current abuse/dependence according to DSM-IV)
C
ControlUHR individuals without cannabis use
O
OutcomeLifetime cannabis use not significantly associated with transition to psychosis (OR 1,14, 95%-CI 0,856–1,524, p=0,37); current cannabis abuse/dependence significantly associated (OR 1,75, 95%-CI 1,135–2,710, p=0,01)
Confidence in the evidence
Very lowLowModerateHigh
High
The highest of four GRADE levels, the effect estimate is very reliable.
Quality profile
Sample size★★★★★
Blinding—
Effect sizeMixed
Citations / year★★★★★
Authors
Kraan T, Velthorst E, Koenders L, Zwaart K, Ising HK, van den Berg D, de Haan L, van der Gaag M
Background: Previous research has established the relationship between cannabis use and psychotic disorders. Whether cannabis use is related to transition to psychosis in patients at ultra-high risk (UHR) for psychosis remains unclear. The present study aimed to review the existing evidence on the association between cannabis use and transition to psychosis in UHR samples.
Method: A search of PsychInfo, Embase and Medline was conducted from 1996 to August 2015. The search yielded 5559 potentially relevant articles that were selected on title and abstract. Subsequently 36 articles were screened on full text for eligibility. Two random-effects meta-analyses were performed. First, we compared transition rates to psychosis of UHR individuals with lifetime cannabis use with non-cannabis-using UHR individuals. Second, we compared transition rates of UHR individuals with a current DSM-IV cannabis abuse or dependence diagnosis with lifetime users and non-using UHR individuals.
Results: We found seven prospective studies reporting on lifetime cannabis use in UHR subjects (n = 1171). Of these studies, five also examined current cannabis abuse or dependence. Lifetime cannabis use was not significantly associated with transition to psychosis [odds ratio (OR) 1.14, 95% confidence interval (CI) 0.856-1.524, p = 0.37]. A second meta-analysis yielded an OR of 1.75 (95% CI 1.135-2.710, p = 0.01), indicating a significant association between current cannabis abuse or dependence and transition to psychosis.
Conclusions: Our results show that cannabis use was only predictive of transition to psychosis in those who met criteria for cannabis abuse or dependence, tentatively suggesting a dose-response relationship between current cannabis use and transition to psychosis.