Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users

Marta Di Forti, Hannah Sallis, Fabio Allegri, Antonella Trotta, Laura Ferraro, Simona A Stilo, Arianna Marconi, Caterina La Cascia, Tiago Reis Marques, Carmine Pariante, Paola Dazzan, Valeria Mondelli, Alessandra Paparelli, Anna Kolliakou, Diana Prata, Fiona Gaughran, Anthony S David, Craig Morgan, Daniel Stahl, Mizanur KhondokerJames H MacCabe, Robin M Murray

Research output: Contribution to journalArticle (Academic Journal)peer-review

224 Citations (Scopus)

Abstract

UNLABELLED: Cannabis use is associated with an earlier age of onset of psychosis (AOP). However, the reasons for this remain debated.

METHODS: We applied a Cox proportional hazards model to 410 first-episode psychosis patients to investigate the association between gender, patterns of cannabis use, and AOP.

RESULTS: Patients with a history of cannabis use presented with their first episode of psychosis at a younger age (mean years = 28.2, SD = 8.0; median years = 27.1) than those who never used cannabis (mean years = 31.4, SD = 9.9; median years = 30.0; hazard ratio [HR] = 1.42; 95% CI: 1.16-1.74; P < .001). This association remained significant after controlling for gender (HR = 1.39; 95% CI: 1.11-1.68; P < .001). Those who had started cannabis at age 15 or younger had an earlier onset of psychosis (mean years = 27.0, SD = 6.2; median years = 26.9) than those who had started after 15 years (mean years = 29.1, SD = 8.5; median years = 27.8; HR = 1.40; 95% CI: 1.06-1.84; P = .050). Importantly, subjects who had been using high-potency cannabis (skunk-type) every day had the earliest onset (mean years = 25.2, SD = 6.3; median years = 24.6) compared to never users among all the groups tested (HR = 1.99; 95% CI: 1.50- 2.65; P < .0001); these daily users of high-potency cannabis had an onset an average of 6 years earlier than that of non-cannabis users.

CONCLUSIONS: Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users.

Original languageEnglish
Pages (from-to)1509-17
Number of pages9
JournalSchizophrenia Bulletin
Volume40
Issue number6
DOIs
Publication statusPublished - Nov 2014

Bibliographical note

© The Author 2013. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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