Cannabis use in children and adolescents with first episode psychosis: Influence on psychopathology and short-term outcome (CAFEPS study)
Received 6 May 2008; received in revised form 4 April 2009; accepted 7 April 2009. published online 08 May 2009.
Abstract
Objective
To know the prevalence of substance use and its relationship with psychopathology at onset and after six months in children and adolescents with first episode psychosis (FEP).
Method
110 FEP patients, aged 9–17, were assessed for substance use, and with the Positive and Negative Syndrome Scale (PANSS) and other psychopathological and general functioning scales at baseline and after a six-month follow-up.
Results
Patients' substance use at baseline was: tobacco (30.9%), cannabis (29.1%), alcohol (21.8%), cocaine (8.2%), amphetamines (2.7%), LSD (1.8%) and opiates (0.90%). Six months later, there was a decrease in patients' use of cannabis (p=0.004) and other drugs, except tobacco. Patients were divided, according to their baseline cannabis use, into 32 cannabis users (CU) and 78 non-cannabis users (NCU). CU were older (p=0.002) and had higher PANSS positive scores (p=0.002) and lower PANSS negative (p<0.001), PANSS general (p=0.002) and PANSS total (p=0.007) scores than NCU. At six months, CU had significantly lower PANSS positive (p=0.010), negative (p=0.0001), general (p=0.002) and total (p=0.002) scores than NCU. When we divided CU at six months into previous CU (n=16) and current CU (n=15), previous CU had the best outcome, NCU the worst and current CU had an intermediate profile.
Conclusions
Cannabis use may be related to higher positive symptom scores for FEP patients, with greater improvement after six months for those who cease using cannabis.
aDepartment of Child and Adolescent Psychiatry and Psychology, Institut Clinic of Neurosciences, Hospital Clínic Universitari, IDIBAPS, Barcelona, Spain
bCentro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
cSection of Child and Adolescent Psychiatry and Psychology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
dAdolescent Unit, Department of Psychiatry. Hospital General Universitario Gregorio Marañón, Madrid, Spain
eStanley Institute International Mood-Disorders Research Center, 03-RC-003, Hospital Santiago Apóstol, Vitoria, Spain
fChild and Adolescent Mental Health Unit. Department of Psychiatry and Psychology, Hospital Universitario Marqués de Valdecilla, Santander, Spain
gChild and Adolescent Psychiatry Unit, Department of Psychiatry and Medical Psychology, University Clinic, College of Medicine, University of Navarra, Pamplona, Spain
Corresponding author. Department of Child and Adolescent Psychiatry and Psychology, Institut Clínic of Neurosciences, Hospital Clínic Universitari, C/Villarroel, 170, Barcelona 08036, Spain. Tel./fax: +34 93 2279974.
ABSTRACT