Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users.
Di Forti et al.·Schizophrenia BulletinImpact 2.2
SchadenGRADENiedrig462 Zitate
Stichproben = 410 Pat.
KontrolleNie-Konsumenten
EndpunktAlter bei Psychosebeginn
Verblindungn.a.
DesignKohortenstudie (Cox-Proportional-Hazards, prospektiv innerhalb FEP-Kohorte)
Cannabinoidvollspektrum
Applikationinhalativ
”Kernaussage
Täglicher Konsum hochpotenten Cannabis verschiebt den Psychosebeginn um durchschnittlich 6 Jahre vor.
Zusammenfassung
n=410 Erstpsychose-Patienten, Cox-Proportional-Hazards-Modell: Cannabiskonsum → früheres Psychose-Erstauftreten HR=1,42 (95%-KI 1,16–1,74; p<0,001). Frühbeginn ≤15 Jahre HR=1,40 (95%-KI 1,06–1,84; p=0,050). Täglicher Hochpotenz-Cannabis (Skunk) → früheste Erstmanifestation: Mittleres Alter 25,2 Jahre vs. 31,4 Jahre bei Nie-Konsumenten (HR=1,99; 95%-KI 1,50–2,65; p<0,0001); Erstmanifestation im Mittel 6 Jahre früher als bei Nicht-Konsumenten.
InterventionCannabiskonsum (täglich, hochpotent [Skunk-Typ], Beginn ≤15 Jahre)
C
KontrolleNie-Konsumenten (keine Cannabisanamnese)
O
OutcomeTäglicher Konsum hochpotenten Cannabis assoziiert mit frühestem Psychosebeginn (HR=1,99; 95%-CI: 1,50–2,65; p<0,0001); Onset durchschnittlich 6 Jahre früher als bei Nicht-Konsumenten
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Autoren
Di Forti M, Sallis H, Allegri F, Trotta A, Ferraro L, Stilo SA, Marconi A, La Cascia C, Reis Marques T, Pariante C, Dazzan P, Mondelli V, Paparelli A, Kolliakou A, Prata D, Gaughran F, David AS, Morgan C, Morgan C, Stahl D, Khondoker M, MacCabe JH, Murray RM.
Design: Kohortenstudie (Cox-Proportional-Hazards, prospektiv innerhalb FEP-Kohorte)
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Abstract
<h4>Unlabelled</h4>Cannabis use is associated with an earlier age of onset of psychosis (AOP). However, the reasons for this remain debated.<h4>Methods</h4>We applied a Cox proportional hazards model to 410 first-episode psychosis patients to investigate the association between gender, patterns of cannabis use, and AOP.<h4>Results</h4>Patients with a history of cannabis use presented with their first episode of psychosis at a younger age (mean years = 28.2, SD = 8.0; median years = 27.1) than those who never used cannabis (mean years = 31.4, SD = 9.9; median years = 30.0; hazard ratio [HR] = 1.42; 95% CI: 1.16-1.74; P < .001). This association remained significant after controlling for gender (HR = 1.39; 95% CI: 1.11-1.68; P < .001). Those who had started cannabis at age 15 or younger had an earlier onset of psychosis (mean years = 27.0, SD = 6.2; median years = 26.9) than those who had started after 15 years (mean years = 29.1, SD = 8.5; median years = 27.8; HR = 1.40; 95% CI: 1.06-1.84; P = .050). Importantly, subjects who had been using high-potency cannabis (skunk-type) every day had the earliest onset (mean years = 25.2, SD = 6.3; median years = 24.6) compared to never users among all the groups tested (HR = 1.99; 95% CI: 1.50- 2.65; P < .0001); these daily users of high-potency cannabis had an onset an average of 6 years earlier than that of non-cannabis users.<h4>Conclusions</h4>Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users.