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Cannabis Use and Symptomatic Relapse in First Episode Schizophrenia: Trigger or Consequence? Data From the OPTIMISE
Linda Levi1, Mor Bar-Haim1, Inge Winter-van Rossum2
1Psychiatry Department, Sheba Medical Center, Ramat Gan, Israel.
Schizophrenia Bulletin
|March 31, 2023
Summary
Cannabis use significantly increases relapse risk in patients with first-episode psychosis, even those compliant with antipsychotics. This use precedes worsening symptoms and social functioning decline.
Area of Science:
- Psychiatry and Mental Health
- Neuroscience
- Clinical Psychology
Background:
- Examined the impact of cannabis use on relapse risk in patients with first-episode schizophrenia, schizophreniform, or schizoaffective disorder.
- Focused on individuals in remission following initial treatment.
Purpose of the Study:
- To investigate the relationship between cannabis consumption, antipsychotic adherence, and relapse risk.
- To understand the temporal sequence of cannabis use, symptom worsening, and social functioning changes.
Main Methods:
- Utilized data from the European OPTiMiSE study involving first-episode psychosis patients.
- Employed cross-lagged and mediation models to analyze temporal relationships.
- Assessed patients for symptomatic remission and followed up for 1 year.
Main Results:
- Cannabis use was associated with a 3-fold increased risk of relapse (HR=3.03), irrespective of antipsychotic compliance.
- Cannabis use preceded symptomatic worsening and decline in social functioning.
- Positive and Negative Syndrome Scale scores worsened at 1-year follow-up in cannabis users.
Conclusions:
- Cannabis use elevates relapse rates in patients with first-episode psychosis, affecting both compliant and non-compliant individuals.
- Cannabis use is a predictor of future relapse, non-compliance, and decreased social functioning.
- Precision psychiatry approaches may help identify high-risk patients for targeted interventions.
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