Jennifer L Seddon1, Max Birchwood2, Alex Copello3, Linda Everard4, Peter B Jones5, David Fowler6, Tim Amos7, Nick Freemantle8, Vimal Sharma9, Max Marshall10, Swaran P Singh2. 1. National Drug & Alcohol Research Centre, UNSW, Sydney, Australia; jennifer.l.seddon@gmail.com. 2. Mental Health and Wellbeing Warwick Medical School, University of Warwick, Coventry, UK; 3. School of Psychology, University of Birmingham, Birmingham, UK; The Early Intervention Service, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK; 4. The Early Intervention Service, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, UK; 5. Department of Psychiatry, University of Cambridge and CAMEO, Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK; 6. Department of Psychology, University of Sussex, Brighton, UK; 7. Academic Unit of Psychiatry, University of Bristol, Bristol, UK; 8. Department of Primary Care and Population Health, UCL Medical School (Royal Free Campus), London, UK; 9. Early Intervention Service, Cheshire and Wirral NHS Foundation Trust, Chester, UK; Faculty of Health and Social Care, University of Chester, Chester, UK; 10. School of Medicine, University of Manchester, Manchester, UK.
Abstract
OBJECTIVE: The use of cannabis during the early stage of psychosis has been linked with increased psychotic symptoms. This study aimed to examine the use of cannabis in the 12 months following a first-episode of psychosis (FEP) and the link with symptomatic course and outcome over 1 year post psychosis onset. DESIGN AND SETTING: One thousand twenty-seven FEP patients were recruited upon inception to specialized early intervention services (EIS) for psychosis in the United Kingdom. Participants completed assessments at baseline, 6 and 12 months. RESULTS: The results indicate that the use of cannabis was significantly associated with increased severity of psychotic symptoms, mania, depression and poorer psychosocial functioning. Continued use of cannabis following the FEP was associated with poorer outcome at 1 year for Positive and Negative Syndrome Scale total score, negative psychotic symptoms, depression and psychosocial functioning, an effect not explained by age, gender, duration of untreated psychosis, age of psychosis onset, ethnicity or other substance use. CONCLUSION: This is the largest cohort study of FEP patients receiving care within EIS. Cannabis use, particularly "continued use," was associated with poorer symptomatic and functional outcome during the FEP. The results highlight the need for effective and early intervention for cannabis use in FEP.
OBJECTIVE: The use of cannabis during the early stage of psychosis has been linked with increased psychotic symptoms. This study aimed to examine the use of cannabis in the 12 months following a first-episode of psychosis (FEP) and the link with symptomatic course and outcome over 1 year post psychosis onset. DESIGN AND SETTING: One thousand twenty-seven FEP patients were recruited upon inception to specialized early intervention services (EIS) for psychosis in the United Kingdom. Participants completed assessments at baseline, 6 and 12 months. RESULTS: The results indicate that the use of cannabis was significantly associated with increased severity of psychotic symptoms, mania, depression and poorer psychosocial functioning. Continued use of cannabis following the FEP was associated with poorer outcome at 1 year for Positive and Negative Syndrome Scale total score, negative psychotic symptoms, depression and psychosocial functioning, an effect not explained by age, gender, duration of untreated psychosis, age of psychosis onset, ethnicity or other substance use. CONCLUSION: This is the largest cohort study of FEP patients receiving care within EIS. Cannabis use, particularly "continued use," was associated with poorer symptomatic and functional outcome during the FEP. The results highlight the need for effective and early intervention for cannabis use in FEP.
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