Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls

Musa Sami; Diego Quattrone; Laura Ferraro; Giada Tripoli; Erika La Cascia; Charlotte Gayer-Anderson; Jean-Paul Selten; Celso Arango; Miguel Bernardo; Ilaria Tarricone; Andrea Tortelli; Giusy Gatto; Simona Del Peschio; Cristina Marta Del-Ben; Bart P Rutten; Peter B Jones; Jim van Os; Lieuwe de Haan; Craig Morgan; Cathryn Lewis; Sagnik Bhattacharyya; Tom P Freeman; Michael Lynskey; Robin M Murray; Marta Di Forti

doi:10.1017/S0033291720000847

Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls

Musa Sami, Diego Quattrone, Laura Ferraro, Giada Tripoli, Erika La Cascia, Charlotte Gayer-Anderson, Jean-Paul Selten, Celso Arango, Miguel Bernardo, Ilaria Tarricone, Andrea Tortelli, Giusy Gatto, Simona Del Peschio, Cristina Marta Del-Ben, Bart P Rutten, Peter B Jones, Jim van Os, Lieuwe de Haan, Craig Morgan, Cathryn LewisSagnik Bhattacharyya, Tom P Freeman, Michael Lynskey, Robin M Murray, Marta Di Forti

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Abstract

BACKGROUND: First episode psychosis (FEP) patients who use cannabis experience more frequent psychotic and euphoric intoxication experiences compared to controls. It is not clear whether this is consequent to patients being more vulnerable to the effects of cannabis use or to their heavier pattern of use. We aimed to determine whether extent of use predicted psychotic-like and euphoric intoxication experiences in patients and controls and whether this differs between groups.

METHODS: We analysed data on patients who had ever used cannabis (n = 655) and controls who had ever used cannabis (n = 654) across 15 sites from six countries in the EU-GEI study (2010-2015). We used multiple regression to model predictors of cannabis-induced experiences and to determine if there was an interaction between caseness and extent of use.

RESULTS: Caseness, frequency of cannabis use and money spent on cannabis predicted psychotic-like and euphoric experiences (p ⩽ 0.001). For psychotic-like experiences (PEs) there was a significant interaction for caseness × frequency of use (p < 0.001) and caseness × money spent on cannabis (p = 0.001) such that FEP patients had increased experiences at increased levels of use compared to controls. There was no significant interaction for euphoric experiences (p > 0.5).

CONCLUSIONS: FEP patients are particularly sensitive to increased psychotic-like, but not euphoric experiences, at higher levels of cannabis use compared to controls. This suggests a specific psychotomimetic response in FEP patients related to heavy cannabis use. Clinicians should enquire regarding cannabis related PEs and advise that lower levels of cannabis use are associated with less frequent PEs.

Original language	English
Pages (from-to)	2074 - 2082
Journal	Psychological Medicine
Volume	51
Issue number	12
Early online date	28 Apr 2020
DOIs	https://doi.org/10.1017/S0033291720000847
Publication status	Published - 30 Sept 2021

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Sami, M., Quattrone, D., Ferraro, L., Tripoli, G., Cascia, E. L., Gayer-Anderson, C., Selten, J-P., Arango, C., Bernardo, M., Tarricone, I., Tortelli, A., Gatto, G., Del Peschio, S., Del-Ben, C. M., Rutten, B. P., Jones, P. B., van Os, J., de Haan, L., Morgan, C., ... Forti, M. D. (2021). Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls. Psychological Medicine, 51(12), 2074 - 2082. https://doi.org/10.1017/S0033291720000847

Sami, M, Quattrone, D, Ferraro, L, Tripoli, G, Cascia, EL, Gayer-Anderson, C, Selten, J-P, Arango, C, Bernardo, M, Tarricone, I, Tortelli, A, Gatto, G, Del Peschio, S, Del-Ben, CM, Rutten, BP, Jones, PB, van Os, J, de Haan, L, Morgan, C, Lewis, C, Bhattacharyya, S, Freeman, TP, Lynskey, M, Murray, RM & Forti, MD 2021, 'Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls', Psychological Medicine, vol. 51, no. 12, pp. 2074 - 2082. https://doi.org/10.1017/S0033291720000847

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title = "Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls",

abstract = "BACKGROUND: First episode psychosis (FEP) patients who use cannabis experience more frequent psychotic and euphoric intoxication experiences compared to controls. It is not clear whether this is consequent to patients being more vulnerable to the effects of cannabis use or to their heavier pattern of use. We aimed to determine whether extent of use predicted psychotic-like and euphoric intoxication experiences in patients and controls and whether this differs between groups.METHODS: We analysed data on patients who had ever used cannabis (n = 655) and controls who had ever used cannabis (n = 654) across 15 sites from six countries in the EU-GEI study (2010-2015). We used multiple regression to model predictors of cannabis-induced experiences and to determine if there was an interaction between caseness and extent of use.RESULTS: Caseness, frequency of cannabis use and money spent on cannabis predicted psychotic-like and euphoric experiences (p ⩽ 0.001). For psychotic-like experiences (PEs) there was a significant interaction for caseness × frequency of use (p < 0.001) and caseness × money spent on cannabis (p = 0.001) such that FEP patients had increased experiences at increased levels of use compared to controls. There was no significant interaction for euphoric experiences (p > 0.5).CONCLUSIONS: FEP patients are particularly sensitive to increased psychotic-like, but not euphoric experiences, at higher levels of cannabis use compared to controls. This suggests a specific psychotomimetic response in FEP patients related to heavy cannabis use. Clinicians should enquire regarding cannabis related PEs and advise that lower levels of cannabis use are associated with less frequent PEs.",

author = "Musa Sami and Diego Quattrone and Laura Ferraro and Giada Tripoli and Cascia, {Erika La} and Charlotte Gayer-Anderson and Jean-Paul Selten and Celso Arango and Miguel Bernardo and Ilaria Tarricone and Andrea Tortelli and Giusy Gatto and {Del Peschio}, Simona and Del-Ben, {Cristina Marta} and Rutten, {Bart P} and Jones, {Peter B} and {van Os}, Jim and {de Haan}, Lieuwe and Craig Morgan and Cathryn Lewis and Sagnik Bhattacharyya and Freeman, {Tom P} and Michael Lynskey and Murray, {Robin M} and Forti, {Marta Di}",

year = "2021",

month = sep,

day = "30",

doi = "10.1017/S0033291720000847",

language = "English",

volume = "51",

pages = "2074 -- 2082",

journal = "Psychological Medicine",

issn = "1469-8978",

publisher = "Cambridge University Press",

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TY - JOUR

T1 - Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls

AU - Sami, Musa

AU - Quattrone, Diego

AU - Ferraro, Laura

AU - Tripoli, Giada

AU - Cascia, Erika La

AU - Gayer-Anderson, Charlotte

AU - Selten, Jean-Paul

AU - Arango, Celso

AU - Bernardo, Miguel

AU - Tarricone, Ilaria

AU - Tortelli, Andrea

AU - Gatto, Giusy

AU - Del Peschio, Simona

AU - Del-Ben, Cristina Marta

AU - Rutten, Bart P

AU - Jones, Peter B

AU - van Os, Jim

AU - de Haan, Lieuwe

AU - Morgan, Craig

AU - Lewis, Cathryn

AU - Bhattacharyya, Sagnik

AU - Freeman, Tom P

AU - Lynskey, Michael

AU - Murray, Robin M

AU - Forti, Marta Di

PY - 2021/9/30

Y1 - 2021/9/30

N2 - BACKGROUND: First episode psychosis (FEP) patients who use cannabis experience more frequent psychotic and euphoric intoxication experiences compared to controls. It is not clear whether this is consequent to patients being more vulnerable to the effects of cannabis use or to their heavier pattern of use. We aimed to determine whether extent of use predicted psychotic-like and euphoric intoxication experiences in patients and controls and whether this differs between groups.METHODS: We analysed data on patients who had ever used cannabis (n = 655) and controls who had ever used cannabis (n = 654) across 15 sites from six countries in the EU-GEI study (2010-2015). We used multiple regression to model predictors of cannabis-induced experiences and to determine if there was an interaction between caseness and extent of use.RESULTS: Caseness, frequency of cannabis use and money spent on cannabis predicted psychotic-like and euphoric experiences (p ⩽ 0.001). For psychotic-like experiences (PEs) there was a significant interaction for caseness × frequency of use (p < 0.001) and caseness × money spent on cannabis (p = 0.001) such that FEP patients had increased experiences at increased levels of use compared to controls. There was no significant interaction for euphoric experiences (p > 0.5).CONCLUSIONS: FEP patients are particularly sensitive to increased psychotic-like, but not euphoric experiences, at higher levels of cannabis use compared to controls. This suggests a specific psychotomimetic response in FEP patients related to heavy cannabis use. Clinicians should enquire regarding cannabis related PEs and advise that lower levels of cannabis use are associated with less frequent PEs.

AB - BACKGROUND: First episode psychosis (FEP) patients who use cannabis experience more frequent psychotic and euphoric intoxication experiences compared to controls. It is not clear whether this is consequent to patients being more vulnerable to the effects of cannabis use or to their heavier pattern of use. We aimed to determine whether extent of use predicted psychotic-like and euphoric intoxication experiences in patients and controls and whether this differs between groups.METHODS: We analysed data on patients who had ever used cannabis (n = 655) and controls who had ever used cannabis (n = 654) across 15 sites from six countries in the EU-GEI study (2010-2015). We used multiple regression to model predictors of cannabis-induced experiences and to determine if there was an interaction between caseness and extent of use.RESULTS: Caseness, frequency of cannabis use and money spent on cannabis predicted psychotic-like and euphoric experiences (p ⩽ 0.001). For psychotic-like experiences (PEs) there was a significant interaction for caseness × frequency of use (p < 0.001) and caseness × money spent on cannabis (p = 0.001) such that FEP patients had increased experiences at increased levels of use compared to controls. There was no significant interaction for euphoric experiences (p > 0.5).CONCLUSIONS: FEP patients are particularly sensitive to increased psychotic-like, but not euphoric experiences, at higher levels of cannabis use compared to controls. This suggests a specific psychotomimetic response in FEP patients related to heavy cannabis use. Clinicians should enquire regarding cannabis related PEs and advise that lower levels of cannabis use are associated with less frequent PEs.

U2 - 10.1017/S0033291720000847

DO - 10.1017/S0033291720000847

M3 - Article

C2 - 32340643

SN - 1469-8978

VL - 51

SP - 2074

EP - 2082

JO - Psychological Medicine

JF - Psychological Medicine

IS - 12

ER -

Association of extent of cannabis use and psychotic like intoxication experiences in a multi-national sample of first episode psychosis patients and controls

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