title: Fewer neurological soft signs among first episode psychosis patients with heavy cannabis use.
abstract: BACKGROUND
  Although neurological soft signs (NSS) have been consistently associated with schizophrenia and a variety of risk factors, few studies have focused on the association between NSS and environmental factors such as cannabis use, particularly in patients with first episode psychosis.
  
  
  METHODS
  We administered the Neurological Evaluation Scale (NES) to 92 patients during their first episode of functional psychosis. Psychopathology was assessed with the Positive And Negative Syndrome Scale (PANSS) and the family history of psychotic disorder was established on the basis of the Family Interview for Genetic Studies (FIGS). We also assessed lifetime cannabis and cocaine use utilizing that specific section of the Composite International Diagnostic Interview. The outcome variable was the presence of high NSS, defined by a score above the median split of the NES score (>21).
  
  
  RESULTS
  Most patients (80/92, 87%) presented a non-affective psychosis. The presence of high NSS showed a significant independent association with not having been a heavy cannabis user (OR=8.3; 95% CI, 2.4-33.3), family history of psychosis (OR=4.3; 95% CI, 1.2-14.9), male sex (OR=4.0; 95% CI, 1.2-14.0), lower score in verbal fluency and higher score in negative symptoms (both p<0.01).
  
  
  CONCLUSIONS
  Our cross-sectional results support the hypothesis that potentially different pathways associated with the emergence of first episode psychosis may exist, including neurological premorbid alteration and environmental cannabis abuse.
authors.affiliation: Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, and Psychiatry Service, San Cecilio University Hospital, Granada, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Ruiz-Veguilla
authors.forename: Manuel
authors.initials: M
authors.lastname: Gurpegui
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Barrigón
authors.forename: Maite
authors.initials: M
authors.lastname: Ferrín
authors.forename: Esther
authors.initials: E
authors.lastname: Marín
authors.forename: José Luis
authors.initials: JL
authors.lastname: Rubio
authors.forename: Blanca
authors.initials: B
authors.lastname: Gutiérrez
authors.forename: Antonio
authors.initials: A
authors.lastname: Pintor
authors.forename: Jorge
authors.initials: J
authors.lastname: Cervilla
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001925:Brain Damage, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D019970:Cocaine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology*; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology*; D012565:Schizophrenic Psychology; D012737:Sex Factors; D055815:Young Adult