Cannabis use disorders in schizophrenia: Effects on cognition and symptoms

DeRosse, Pamela; Kaplan, Alyson; Burdick, Katherine E.; Lencz, Todd; Malhotra, Anil K.

doi:10.1016/j.schres.2010.04.007

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Volume 120, Issue 1 , Pages 95-100, July 2010

Cannabis use disorders in schizophrenia: Effects on cognition and symptoms

Pamela DeRosse
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
- Corresponding author. The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, 75-59 263rd Street, Glen Oaks, NY 11004, USA. Tel.: +1 718 470 8601; fax: +1718 343 1659.
Alyson Kaplan
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Princeton University, USA
Katherine E. Burdick
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
- Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
Todd Lencz
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
- Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA
Anil K. Malhotra
- Center for Translational Psychiatry, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, The Zucker Hillside Hospital, Division of the North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA
- Department of Psychiatry and Behavioral Science, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY, USA

Received 1 February 2010; received in revised form 9 April 2010; accepted 12 April 2010. published online 20 May 2010.

Abstract

Objective

Despite the controversy surrounding the possible causal link between cannabis use and the onset of schizophrenia (SZ), data seeking to elucidate the effect of cannabis use disorders (CUDs) on the clinical presentation of SZ have produced mixed results. Although several studies have suggested that CUD in patients with SZ may be associated with variation in cognitive function, clinical presentation and course of illness, the effects have been inconsistent.

Methods

We retrospectively ascertained a large cohort (N=455) of SZ patients with either no history of a CUD (CUD−; N=280) or a history of CUD (CUD+; N=175). The groups were initially compared on key demographic variables including sex, race, age, age at onset of SZ, parental socioeconomic status, premorbid IQ, education level and global assessment of functioning. Covarying for any observed differences in demographic variables, we then compared groups on lifetime measures of psychotic symptoms as well as a brief battery of neurocognitive tests.

Results

Compared to the CUD− group the CUD+ group demonstrated significantly better performance on measures of processing speed (Trail Making Tests A and B), verbal fluency (animal naming) and verbal learning and memory (California Verbal Learning Test). Moreover, the CUD+ group had better GAF scores than the CUD group.

Conclusions

Collectively, these findings suggest that SZ patients with comorbid CUD may represent a higher functioning subgroup of SZ. Future prospective studies are needed to elucidate the nature of this relationship.

Keywords: Schizophrenia, Cannabis abuse, Neurocognition