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Exploration of cannabis use and polygenic risk scores on the psychotic symptom progression of a FEP cohort

Alex Gonzalez Segura, Anna Mané, L. Prohens, Natàlia Rodríguez, Gisela Mezquida, Manuel J Cuesta, Eduard Vieta, Sílvia Amoretti, António Lobo, Ana María González-Pinto, Covadonga Martínez Díaz-Caneja, Alexandra Roldán Bejarano, Esther López Jiménez, Immaculada Baeza, Teresa Legido, Jerónimo Saiz-Ruiz, Miquel Bernardo, Sergi Mas

Psychiatry Research May 8, 2023 DOI: 10.1016/j.psychres.2023.115249 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cohort Peer reviewed
Sample size 249
Population Individuals experiencing a first episode of psychosis (FEP)
Duration 12 months
Measures Positive and Negative Severity Scale, EuropASI scale
Topics Cannabis
Citations 5
Key findings Cannabis use was associated with increased positive symptoms, and younger age at cannabis initiation conditioned 12-month symptom progression. Higher polygenic risk scores for cannabis use disorder were associated with greater baseline cannabis use, while scores for lifetime cannabis initiation were associated with the course of negative and general symptoms over follow-up. The authors propose that genetic factors for cannabis initiation and use disorder may be partially independent.

Abstract

Cannabis use is highly prevalent in first-episode psychosis (FEP) and plays a critical role in its onset and prognosis, but the genetic underpinnings promoting both conditions are poorly understood. Current treatment strategies for cannabis cessation in FEP are clearly inefficacious. Here, we aimed to characterize the association between cannabis-related polygenic risk scores (PRS) on cannabis use and clinical course after a FEP. A cohort of 249 FEP individuals were evaluated during 12 months. Symptom severity was measured with the Positive and Negative Severity Scale and cannabis use with the EuropASI scale. Individual PRS for lifetime cannabis initiation (PRSCI) and cannabis use disorder (PRSCUD) were constructed. Current cannabis use was associated with increased positive symptoms. Cannabis initiation at younger ages conditioned the 12-month symptom progression. FEP patients with higher cannabis PRSCUD reported increased baseline cannabis use. PRSCI was associated with the course of negative and general symptomatology over follow-up. Cannabis use and symptom progression after a FEP were modulated by cannabis PRS, suggesting that lifetime initiation and use disorders may have partially independent genetic factors. These exploratory results may be the first step to identify those FEP patients more vulnerable to cannabis use and worse outcomes to ultimately develop tailored treatments.

Comparable studies

Other observational and cohort studies on cannabis, most cited first.

Study Year Design Participants
High-potency cannabis and the risk of psychosis People with first episode of psychosis and healthy controls from the local population 2009 Case-control study n = 454
Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada Rural aboriginal population 2013 Observational study
Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people 2000 Observational
Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study Individuals from the general population in Germany aged 14-24 at baseline 2011 Observational cohort n = 1,923
Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases Patients treated for cannabis-induced psychotic symptoms in Denmark between 1994 and... 2005 Observational cohort n = 535

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