Failure to find association between childhood abuse and cognition in first-episode psychosis patients

AbstractThis study investigated the relationship between severe childhood abuse and cognitive functions in first-episode psychosis patients and geographically-matched controls. Reports of any abuse were associated with lower scores in the executive function domain in the control group. However, in contrast with our hypothesis, no relationships were found amongst cases.

Better IQ but worse Premorbid Academic Adjustment in cannabis-users psychotic patients: another brick in the intuition

Purpose: several studies report that patients with psychosis who used cannabis in their lifetime have a better cognitive performance than those who did not and this association is most likely due to a better premorbid functioning. We aimed to test the hypothesis of a better premorbid functioning in First Episode Psychosis (FEP) cannabis-using and non-using patients coming from different European countries. Materials and Methods: 1.745 people (746 cases; 999 healthy controls) completed the assessment for Intellectual Quotient (IQ) (WAIS-brief version) premorbid adjustment (Premorbid Adjustment Scale – PAS) and cannabis use (CEQ-Revised). We first obtained two main factors from PAS: “Premorbi…

What drives the higher incidence of psychosis in London compared to Palermo?

Background: Incidence of psychosis seems to be lower in Italy than in other European countries (Tansella et al. 1991; Lasalvia et al. 2012, Tarricone et al. 2012); however there are no studies comparing the incidence of psychotic disorder in Northern and Southern Europe. Methods: Incidence and socio-demographic data on all psychotic patients presenting for the first time to the mental health services of Palermo were collected over a period of three years. Palermo incidence rates were compared to South London rates obtained from the AESOP study (Kirkbride et al 2006). South London rates were reanalyzed excluding people aged 16-17 years and substance related psychoses. Second generation migra…

Plenary Session

Interaction between cannabis consumption and childhood abuse in psychotic disorders:preliminary findings on the role of different patterns of cannabis use

Aim: Several studies have suggested that lifetime cannabis consumption and childhood abuse synergistically contribute to the risk for psychotic disorders. This study aimed to extend existing findings regarding an additive interaction between childhood abuse and lifetime cannabis use by investigating the moderating role of type and frequency of cannabis use. Methods: Up to 231 individuals presenting for the first time to mental health services with psychotic disorders and 214 unaffected population controls from South London, United Kingdom, were recruited as part of the Genetics and Psychosis study. Information about history of cannabis use was collected using the Cannabis Experiences Questi…

P.0171 The independent and joint effect of the endocannabinoid system and daily cannabis use on the risk of psychosis

The influence of risk factors on the onset and outcome of psychosis: What we learned from the GAP study

The GAP multidisciplinary study carried out in South London, recruited 410 first episode of psychosis patients and 370 controls; the aim was to elucidate the multiple genetic and environmental factors influencing the onset and outcome of psychosis. The study demonstrated the risk increasing effect of adversity in childhood (especially parental loss, abuse, and bullying) on onset of psychosis especially positive symptoms. Adverse life events more proximal to onset, being from an ethnic minority, and cannabis use also played important roles; indeed, one quarter of new cases of psychosis could be attributed to use of high potency cannabis. The “jumping to conclusions” bias appeared to mediate …

Low incidence of psychosis in Italy: confirmation from the first epidemiological study in Sicily

Purpose: The incidence of psychotic disorders varies in different geographical areas. As there have been no reports from Southern Italy, this study aimed to determine the incidence rate of first-episode psychosis in Palermo, Sicily. Methods: All patients, aged 18–65 years, presenting with a first episode of psychosis (FEP) (ICD-10 F20–29, F30–33) to mental health services in Palermo, were recorded over a 3-year period. Incidence rates of psychotic disorders and their 95% confidence intervals (95% CI) were estimated. Poisson regression was applied to estimate the differences in incidence rate ratio (IRR) by age, sex and migrant status. Results: Two hundred and four FEP participants were iden…

Transdiagnostic dimensions of psychopathology at first episode psychosis: Findings from the multinational EU-GEI study

The EU-GEI Project was funded by the European Community’s Seventh Framework Programme under grant agreement No.HEALTH-F2-2010-241909 (Project EU-GEI). The work was further funded by: Clinician Scientist Medical Research Council fellowship (project reference MR/M008436/1) to MDF; Veni grant from the Netherlands Organisation for Scientific Research (grant no. 451-13-022) to UR; Sir Henry Dale Fellowship, jointly funded by the Wellcome Trust and the Royal Society (grant no. 101272/Z/13/Z) to JBK; National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King’s College London. The Brazilian study was funded b…

Genetic and psychosocial stressors have independent effects on the level of subclinical psychosis: findings from the multinational EU-GEI study.

the Spanish Ministry of Science and Innovation. Instituto de Salud Carlos III (SAM16PE07CP1, PI16/02012, PI19/024), co-financed by ERDF Funds from the European Commission, ‘A way of making Europe’, CIBERSAM. Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds. European Union Seventh Framework Program under grant agreements FP7-4-HEALTH-2009-2.2.1-2-241909 (Project EU-GEI) and FP7-HEALTH-2013-2.2.1-2-603196 (Project PSYSCAN); and European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking (grant agreement No 115916, Project PRISM, and grant agreement No 777394, Project AIMS-2-TRIALS) (...)

Abstract # 3128 Metabolic-inflammatory status as predictor of clinical outcome at 1-year follow-up in patients with first episode psychosis

Metabolic abnormalities and peripheral inflammation have been increasingly reported in patients at their first episode of psychosis (FEP) and associated with increased mortality. However, the impact of an abnormal metabolic-inflammatory status on the psychiatric outcome of FEP is understudied. This study aimed 1) to combine metabolic and inflammatory variables in factors accounting for an overall metabolic-inflammatory status in FEP patients; 2) to explore the association between these factors and clinical outcome at 1 year. We recruited 43 FEP patients and 50 healthy controls (HC). At baseline (T1) we measured high sensitivity C-reactive protein (hsCRP) as inflammatory biomarker, and body …

Cannabis consumption and the risk of psychosis

Summary Objectives: Cannabis is the most widely used illicit drug globally and its use has been linked to an increased risk for psychotic disorders. An association between cannabis consumption and psychotic symptoms was consistently reported by several studies. This case-control study aimed to widen the current findings about the impact of cannabis exposure on the risk of psychosis, by investigating the pattern of cannabis consumption in a sample of first-episode of psychosis (FEP) patients compared to healthy controls. Material and methods: 68 individuals who presented for the first time to mental health services of Palermo (Italy) with an ICD-10 diagnosis of psychotic disorders and 74 hea…

Smoke High-Potency Cannabis and Become Psychotic Younger?

PURPOSE: 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% …

What does augment the risk to use cannabis on an everyday-basis in psychotic patients?

Introduction There are strong enough evidences of the fact that risk of psychosis is augmented by cannabis use. In a recent analysis, the strongest predictor of case-control status was daily-skunk use, i.e. the ORs for skunk users increase with the frequency of use5. We know also that FEP who smoked cannabis in their lifetime are less neuropsychologically impaired i.e. they have better premorbid and current IQ6. In this study we wanted to test what augments the probability to be everyday users, taking into account premorbid social and academic adjustment and cognition as predictors, along with age at first cannabis-use and % of THC in cannabis used. Methods The sample was made of 834 First …

P.0170 Distinct polygenic risk scores in clusters of psychotic subjects with different premorbid trajectories and current IQ

Better social but worse academic premorbid adjustment in cannabis-users psychotic patients across Europe

Background: Several studies report that patients with psychosis who used cannabis have a better cognitive performance than those whodid not (Rabin et al. 2011). In a previous study we found out a higher premorbid IQ, and a better IQ in psychotic patients who smoked cannabis in their lifetime, and our findings were consistent with the idea that this association is due to a better premorbid functioning rather than to an ameliorative effect of cannabis use on cognitive performance (Ferraro et al., 2013). A number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to e…

Premorbid social adjustment is better in cannabis-using than non-using psychotic patients across Europe

IntroductionA number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage in illegal drug consumption, than non-using patients.ObjectivesGiven that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to study first-episode psychosis (FEP) cannabis-using and non-using patients coming from different European countries as part of the EUGEI-STUDY.AimsWe tested the hypothesis of better premorbid social adjustment in cannabis-using FEP patients, by comparing them to FEP non cannabis users and to their respective healthy controls.Methods…

INCIDENCE OF PSYCHOTIC DISORDERS IN PALERMO: PRELIMINARY DATA

Background: The incidence of psychotic disorders varies in different geographical areas (McGrath 2004). Recent data suggest that the incidence is higher in males, migrant minorities and in urban areas. There aren’t many available epidemiological data on the incidence of psychotic disorders in Italy. This is the first incidence study on psychotic disorders carried out in Palermo, the capital of Sicily. Methods: we screened all patients presenting with their first episode of psychosis to the mental health services of our catchment area (5 inpatient, 5 outpatient units and 3 private psychiatric hospitals) over a period of three years (2008-2011). The diagnosis of psychosis was defined using th…

ADDITIVE INTERACTION BETWEEN LIFETIME CANNABIS USE AND CHILDHOOD TRAUMA IN INCREASING THE RISK FOR PSYCHOSIS. A REPLICATION ANALYSIS ON A SAMPLE OF FIRST EPISODE OF PSYCHOSIS PATIENTS

Background: Additive interaction between childhood trauma and cannabis use in increasing risk for psychotic disorders has been recently demonstrated in a prospective (Harley et al., 2009) and a cross sectional study (Konigs et al., 2011), although not replicated in another survey (Kuepper et al., 2011). This study aimed to analyse additive interaction between lifetime cannabis and severe child abuse in increasing the risk for psychosis in a sample of first episode psychosis patients and geographically matched controls. In addition, analyses were re-run separately for males and females in order to investigate whether the association was moderated by gender. Methods: The sample consisted of 2…

Differences in cannabis-related experiences between patients with a first episode of psychosis and controls

BackgroundMany studies have reported that cannabis use increases the risk of a first episode of psychosis (FEP). However, only a few studies have investigated the nature of cannabis-related experiences in FEP patients, and none has examined whether these experiences are similar in FEP and general populations. The aim of this study was to explore differences in self-reported cannabis experiences between FEP and non-psychotic populations.MethodA total of 252 subjects, who met International Classification of Diseases (ICD)-10 criteria for FEP, and 217 controls who reported cannabis use were selected from the Genetics and Psychosis (GAP) study. The Medical Research Council Social Schedule and t…

DOES CANNABIS USE WORSEN PSYCHOTIC SYMPTOM PRESENTATION?

Background: While the relationship between cannabis and psychosis is well established, there is a lack of studies into whether cannabis use is associated with a particular pattern of symptoms at psychosis onset. Moreover, there is much evidence that psychotic experiences are common in the healthy population, and again their relationship with exposure to cannabis has been scarcely studied. We hypothesized that psychopathology in first-episode psychosis patients (FEP), and psychotic experiences in controls, would be qualitatively and quantitatively affected by pattern of cannabis use. Methods: The Operational CRITeria (OPCRIT) system, the CAPE (Community Assessment of Psychic Experiences), an…

Does age of first cannabis use and frequency of use influence age of first-episode psychosis (FEP)?

Background: Cannabis is one of the most commonly used drugs among young people across Europe (EMCDDA data 2014), Moreover, it is one of the most abused illicit drugs among patients suffering from schizophrenia (Linszen et al., 1994) and, particularly, in patients at their first episode of psychosis (Donoghue et al., 2011). Furthermore, patients suffering from psychosis with a history of cannabis use have an earlier age of onset of psychosis (AOP) than those who never used it (Di Forti et al., 2013). We aim to investigate if the reported association between use of cannabis and AOP is consistent across to European samples with expected differences in pattern of cannabis use (i.e. age at first…

Psychosis onset: Use of Cannabis X COMT Interaction. Case-only Design analysis in a First-Episode Psychosis Sample.