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Differential effects of cannabis exposure during early versus later adolescence on the expression of psychosis in homeless and precariously housed adults.

K. Gicas, Alex Y T Cheng, William J. Panenka, David D. Kim, Jade C Yau, R. Procyshyn, Jacob L. Stubbs, Andrea A. Jones, Simran Bains, A. Thornton, D. Lang, A. Vertinsky, A. Rauscher, William G. Honer, Alasdair M. Barr

Progress in Neuro-psychopharmacology and Biological Psychiatry September 2, 2020 DOI: 10.1016/j.pnpbp.2020.110084 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort Longitudinal Peer reviewed
Sample size 437
Population Homeless and precariously housed adults from single room occupancy hotels in Vancouver, Canada
Topics Cannabis
Key findings Early cannabis exposure (by age 15) increased risk of substance-induced psychosis, while later first use increased risk of schizophrenia or schizoaffective disorder.

Abstract

Longitudinal studies of cannabis exposure during early adolescence in the general population frequently report an increased risk of subsequently developing psychotic symptoms or a psychotic illness. However, there is a dearth of knowledge about the effects of early cannabis exposure on psychosis in homeless and precariously housed adults, who represent a population afflicted with high rates of psychosis. The aim of the present study was to examine how early cannabis exposure (by age 15) compared to later first use (after age 15) affected the expression of adult psychosis in this population. Secondary measures of psychopathology, drug use, cognition and brain structure were also collected. 437 subjects were recruited from single room occupancy hotels in the urban setting of the Downtown Eastside of Vancouver, Canada. Psychiatric diagnoses were determined, and psychotic symptom severity was measured with the 5-factor PANSS. Participants completed a battery of neurocognitive tests, and brain structure was assessed using structural and diffusion tensor imaging MRI scans. Results indicated that early cannabis exposure was associated with an increased risk (OR = 1.09, p < .05) of developing substance induced psychosis, whereas later first use increased risk (OR = 2.19, p < .01) of developing schizophrenia or schizoaffective disorder. There was no group difference in neurocognitive function, although differences were observed in the lateral orbitofrontal cortex and white matter tract diffusivity. These findings indicate that early cannabis exposure in this population may increase the risk of developing drug associated psychoses, which could potentially be mediated in part through altered neurodevelopmental brain changes.