Study register · detail
Mixed
GRADE
Moderate
40 citations
Samplen = 445 Pat.
ControlHealthy population controls without…
EndpointPsychotic disorder
Blindingn.a.
DesignFall-Kontroll-Studie
Key finding
High-potency and daily cannabis use increases the risk of psychosis partly independently of childhood trauma, but without significant synergistic interaction.
Summary
Case-control study (n=231 first-hospitalised with psychosis + 214 controls); combination of lifetime cannabis use + childhood abuse increased odds of psychosis by almost threefold (adjusted OR=2,94; 95% CI 1,44–6,02; p=0,003); no significant interaction effect (OR=1,46; 95% CI -0,54–3,46; p=0,152). High-potency cannabis (daily) increased risk of psychosis independently of childhood traumatisation.
P
PopulationFirst-time psychiatric presenters with psychotic disorders (n=231) and healthy population controls (n=214), South London, UK
I
InterventionCannabis use (lifetime exposure, frequency, potency) as well as childhood trauma (physical and sexual abuse)
C
ControlHealthy population controls without psychotic disorder
O
OutcomeCombination of both risk factors increased odds of psychosis (adj. OR=2,94; 95%-CI: 1,44–6,02; p=0,003); no significant interaction (adj. OR=1,46; 95%-CI: −0,54 bis 3,46; p=0,152); high-potency cannabis and daily use associated independently of childhood trauma
Confidence in the evidence
Moderate
The third of four GRADE levels, the effect estimate is probably reliable.
Quality profile
Sample size
★★★★★
Blinding
—
Effect size
Mixed
Citations / year
★★★★★
Authors
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Abstract
<h4>Aim</h4>Several studies have suggested that lifetime cannabis consumption and childhood abuse synergistically contribute to the risk for psychotic disorders. This study aimed to extend existing findings regarding an additive interaction between childhood abuse and lifetime cannabis use by investigating the moderating role of type and frequency of cannabis use.<h4>Methods</h4>Up to 231 individuals presenting for the first time to mental health services with psychotic disorders and 214 unaffected population controls from South London, United Kingdom, were recruited as part of the Genetics and Psychosis study. Information about history of cannabis use was collected using the Cannabis Experiences Questionnaire. Childhood physical and sexual abuse was assessed using the Childhood Experience of Care and Abuse Questionnaire.<h4>Results</h4>Neither lifetime cannabis use nor reported exposure to childhood abuse was associated with psychotic disorder when the other environmental variable was taken into account. Although the combination of the two risk factors raised the odds for psychosis by nearly three times (adjusted OR = 2.94, 95% CI: 1.44-6.02, P = 0.003), no evidence of interaction was found (adjusted OR = 1.46, 95% CI: -0.54 to 3.46, P = 0.152). Furthermore, the association of high-potency cannabis and daily consumption with psychosis was at least partially independent of the effect of childhood abuse.<h4>Conclusions</h4>The heavy use of high-potency cannabis increases the risk of psychosis but, in addition, smoking of traditional resin (hash) and less than daily cannabis use may increase the risk for psychosis when combined with exposure to severe childhood abuse.
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