Neurological soft signs in Tunisian patients with first-episode psychosis and relation with cannabis use
Ahmed Mhalla, Bochra Ben Mohamed, Christoph Ulrich Correll, Badii Amamou, Anouar Mechri, Lotfi Gaha
Annals of General Psychiatry July 12, 2017 DOI: 10.1186/s12991-017-0153-3 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Peer reviewed |
|---|---|
| Sample size | 61 |
| Population | Consecutively admitted patients hospitalized for first-episode psychosis |
| Measures | NSS scale (23 items), Composite International Diagnostic Interview (cannabis subsection) |
| Topics | Cannabis |
| Citations | 8 |
| Key findings | Cannabis use was associated with lower neurological soft sign (NSS) scores in first-episode psychosis patients: mean total NSS score was 11.2 in cannabis users versus 16.0 in non-users. The authors argue this negative association supports the hypothesis that a strong environmental risk factor such as cannabis may contribute to psychosis onset even in the presence of lower biological and genetic vulnerability, as indirectly reflected by lower NSS scores. |
Abstract
Neurological soft signs (NSS) are minor non-localizing neurological abnormalities that are conceptualized as neurodevelopmental markers that mediate the biological risk for psychosis. We aimed to explore the relationship between NSS and cannabis use, an environmental risk factor of psychosis. This was a cross-sectional study in consecutively admitted patients hospitalized for first-episode psychosis. NSS were assessed by the NSS scale (23 items exploring motor coordination, motor integrative function, sensory integration, involuntary movements or posture, quality of lateralization). Presence of NSS was defined as a NSS scale total score ≥9.5. Cannabis use was ascertained with the cannabis subsection in the Composite International Diagnostic Interview. Among 61 first-episode psychosis patients (mean age = 28.9 ± 9.4 years; male = 86.9%, antipsychotic-naïve = 75.4%), the prevalence of current cannabis use was 14.8% (heavy use = 8.2%, occasional use = 6.6%). NSS were present in 83.6% of the sample (cannabis users = 66.7% versus cannabis non-users = 85.5%, p = 0.16). The mean total NSS score was 15.3 ± 6.7, with a significant lower total NSS score in cannabis users (11.2 ± 5.6 versus 16.0 ± 6.7, p = 0.048). Differences were strongest for the “motor coordination” ( p = 0.06) and “involuntary movements” ( p = 0.07) sub-scores. This study demonstrated a negative association between cannabis use and NSS, especially regarding motor discoordination. This finding supports the hypothesis that a strong environmental risk factor, such as cannabis, may contribute to the onset of psychosis even in the presence of lower biological and genetic vulnerability, as reflected indirectly by lower NSS scores. Nevertheless, additional studies are needed that explore this interaction further in larger samples and considering additional neurobiological and environmental risk factors.
Comparable studies
Other cross-sectional and survey studies on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Cannabis use before age 15 and subsequent executive functioning 104 chronic cannabis users (49 early-onset before age 15, 55 late-onset after age 15)... | 2011 | Observational cross-sectional study | n = 148 |
| Patterns of simultaneous polysubstance use in drug using university students Drug-using university students | 2006 | Cross-sectional survey | n = 149 |
| Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey Online survey respondents | 2020 | Cross-sectional survey | |
| User perceptions of the benefits and harms of hallucinogenic drug use: A web-based questionnaire study Users of hallucinogenic drugs who completed a web-based questionnaire | 2010 | Cross-sectional survey | n = 600 |
| Illicit Use of LSD or Psilocybin, but not MDMA or Nonpsychedelic Drugs, is Associated with Mystical Experiences in a Dose-Dependent Manner Adults recruited from the MAPS website and newsletter, most reporting use of various... | 2012 | Cross-sectional survey | n = 337 |
Citations in the library
Cites 11
- Causal association between cannabis and psychosis: examination of the evidence The British Journal of Psychiatry January 30, 2004
- A clinical comparison of schizophrenia with and without pre-onset cannabis use disorder: a retrospective cohort study using categorical and dimensional approaches Annals of General Psychiatry December 1, 2015
- Association Between Cannabis and Psychosis: Epidemiologic Evidence. Biological Psychiatry April 1, 2016
- The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability. Frontiers in Psychiatry 2014
- Neurological soft signs in non-psychotic patients with cannabis dependence. Addiction Biology March 2013
and 6 more in the library