Fewer neurological soft signs among first episode psychosis patients with heavy cannabis use.
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.
Ruiz-Veguilla
Miguel
M
Psychiatry and Neurosciences Research Group (CTS-549), Institute of Neurosciences, University of Granada, and Psychiatry Service, San Cecilio University Hospital, Granada, Spain.
Gurpegui
Manuel
M
Barrigón
María Luisa
ML
Ferrín
Maite
M
Marín
Esther
E
Rubio
José Luis
JL
Gutiérrez
Blanca
B
Pintor
Antonio
A
Cervilla
Jorge
J
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