title: Are cannabis use disorders associated with an earlier age at onset of psychosis? A study in first episode schizophrenia.
abstract: BACKGROUND
  The purpose of this study is to determine if an earlier age at onset of positive symptoms in schizophrenia is associated with cannabis use disorders (CUD).
  
  
  METHODS
  49 first-episode schizophrenia subjects with CUD were compared to 51 first-episode schizophrenia subjects with no substance use disorders for demographic and clinical variables. A multivariate logistic regression was performed to determine the joint relationship between variables significantly associated with CUD on univariate testing and ascertain if these variables independently predict CUD. Significance level was set at p<0.05.
  
  
  RESULTS
  74% of CUD subjects had the onset of CUD before the onset of positive symptoms. Compared to non-substance abusing subjects, CUD subjects were predominantly male, younger at study entry, had an earlier age at onset of positive symptoms, less educational attainment, a lower self-socioeconomic status, better premorbid childhood social adjustment, a trend for poorer premorbid childhood academic adjustment, less motor abnormalities but more severe hallucinations and delusions. In the multivariate analysis, only male gender, worse socio-economic status, better premorbid childhood social adjustment, and more severe positive symptoms at study entry were associated with a lifetime history of CUD.
  
  
  CONCLUSIONS
  Although cannabis use precedes the onset of illness in most patients, there was no significant association between onset of illness and CUD that was not accounted for by demographic and clinical variables. Previous studies implicating CUD in the onset of schizophrenia may need to more comprehensively assess the relationship between CUD and schizophrenia, and take into account additional variables that we found associated with CUD.
authors.affiliation: The Zucker Hillside Hospital of the North Shore Long Island Jewish Health System, Psychiatry Research, Glen Oaks, NY 11004, USA. Sevy@lij.edu
authors.forename: Serge
authors.initials: S
authors.lastname: Sevy
authors.forename: Delbert G
authors.initials: DG
authors.lastname: Robinson
authors.forename: Barbara
authors.initials: B
authors.lastname: Napolitano
authors.forename: Raman C
authors.initials: RC
authors.lastname: Patel
authors.forename: Handan
authors.initials: H
authors.lastname: Gunduz-Bruce
authors.forename: Rachel
authors.initials: R
authors.lastname: Miller
authors.forename: Joanne
authors.initials: J
authors.lastname: McCormack
authors.forename: Beth S
authors.initials: BS
authors.lastname: Lorell
authors.forename: John
authors.initials: J
authors.lastname: Kane
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D039721:Diagnostic and Statistical Manual of Mental Disorders; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000209:etiology*; D008570:Memory, Short-Term / Q000502:physiology; D009483:Neuropsychological Tests; D000077152:Olanzapine; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012189:Retrospective Studies; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine
references.citation: Psychol Med. 1998 Nov;28(6):1411-9
references.pmid: 9854282
references.citation: Schizophr Bull. 2008 Jan;34(1):52-9
references.pmid: 18024468
references.citation: Psychiatry Res. 2007 May 15;155(1):57-66
references.pmid: 17398079
references.citation: Br J Psychiatry. 2006 Sep;189:229-34
references.pmid: 16946357
references.citation: Am J Psychiatry. 1993 May;150(5):752-7
references.pmid: 8480821
references.citation: Acta Psychiatr Scand. 2001 Nov;104(5):367-74
references.pmid: 11722318
references.citation: BMC Neurol. 2009 Dec 04;9:59
references.pmid: 19961570
references.citation: Schizophr Bull. 1997;23(2):195-201
references.pmid: 9165630
references.citation: Acta Psychiatr Scand. 1993 Jul;88(1):21-4
references.pmid: 8372691
references.citation: Am J Epidemiol. 2002 Aug 15;156(4):319-27
references.pmid: 12181101
references.citation: Schizophr Res. 2009 Feb;107(2-3):173-8
references.pmid: 18945593
references.citation: Schizophr Res. 1996 May;20(1-2):21-8
references.pmid: 8794490
references.citation: Clin Psychol Rev. 2000 Mar;20(2):207-34
references.pmid: 10721498
references.citation: Br J Psychiatry. 1999 Feb;174:150-3
references.pmid: 10211169
references.citation: BMJ. 2002 Nov 23;325(7374):1212-3
references.pmid: 12446537
references.citation: Psychol Med. 1974 Aug;4(3):255-61
references.pmid: 4427973
references.citation: Lancet. 1987 Dec 26;2(8574):1483-6
references.pmid: 2892048
references.citation: Acta Psychiatr Scand. 1998 Aug;98(2):156-64
references.pmid: 9718243
references.citation: Biol Psychiatry. 2001 Jul 15;50(2):71-83
references.pmid: 11526998
references.citation: Arch Gen Psychiatry. 1994 Apr;51(4):273-9
references.pmid: 8161287
references.citation: Front Hum Neurosci. 2009 Nov 24;3:53
references.pmid: 19956405
references.citation: Schizophr Res. 2006 Jan 31;81(2-3):157-66
references.pmid: 16309895
references.citation: Br J Psychiatry. 2007 Jun;190:515-20
references.pmid: 17541112
references.citation: Arch Gen Psychiatry. 1982 Feb;39(2):141-7
references.pmid: 7065828
references.citation: J Clin Psychiatry. 2003 Apr;64(4):459-65
references.pmid: 12716250
references.citation: Br J Psychiatry Suppl. 1989 Nov;(7):49-58
references.pmid: 2695141
references.citation: Psychiatr Rehabil J. 2001 Summer;25(1):60-7
references.pmid: 11529454
references.citation: Br J Pharmacol. 2009 Apr;156(7):1029-40
references.pmid: 19220290
references.citation: Neuropsychiatry Neuropsychol Behav Neurol. 1997 Apr;10(2):107-12
references.pmid: 9150511
references.citation: Schizophr Res. 2006 Jan 31;81(2-3):145-50
references.pmid: 16298107
references.citation: Schizophr Bull. 1982;8(3):470-84
references.pmid: 7134891
references.citation: Acta Psychiatr Scand Suppl. 1970;212:11-9
references.pmid: 4917967
references.citation: Schizophr Res. 2007 May;92(1-3):74-84
references.pmid: 17379482
references.citation: Pharmacopsychiatry. 2002 Mar;35(2):57-61
references.pmid: 11951146
references.citation: BMJ. 2002 Nov 23;325(7374):1199
references.pmid: 12446534
references.citation: Psychol Med. 1992 May;22(2):379-88
references.pmid: 1615105
references.citation: Am J Psychiatry. 1998 Oct;155(10):1392-7
references.pmid: 9766771
references.citation: Clin Pract Epidemiol Ment Health. 2006 Mar 23;2:4
references.pmid: 16556300
references.citation: Am J Public Health. 2007 Oct;97(10):1756-7
references.pmid: 17895405
references.citation: Mov Disord. 2010 Jun 15;25(8):1068-76
references.pmid: 20222137
references.citation: Am J Psychiatry. 1977 May;134(5):546-9
references.pmid: 848583
references.citation: Br J Psychiatry. 2000 Dec;177:511-5
references.pmid: 11102325
references.citation: Br J Psychiatry. 1989 May;154:672-6
references.pmid: 2574607
references.citation: Am J Psychiatry. 2006 Dec;163(12):2096-102
references.pmid: 17151160
references.citation: Schizophr Res. 2004 Feb 1;66(2-3):125-35
references.pmid: 15061244
references.citation: Schizophr Bull. 2000;26(3):551-6
references.pmid: 10993396
references.citation: Br J Psychiatry. 2004 Sep;185:215-9
references.pmid: 15339825
references.citation: Biol Psychiatry. 1996 Dec 1;40(11):1155-63
references.pmid: 8931919
references.citation: Acta Psychiatr Scand. 1989 May;79(5):505-10
references.pmid: 2787581
references.citation: Br J Psychiatry. 2006 Mar;188:237-42
references.pmid: 16507965
references.citation: Nat Neurosci. 1999 Apr;2(4):358-63
references.pmid: 10204543
references.citation: J Psychopharmacol. 2005 May;19(3):277-85
references.pmid: 15888513
references.citation: Am J Psychiatry. 2008 May;165(5):579-87
references.pmid: 18413704
references.citation: Am J Psychiatry. 1991 Feb;148(2):224-30
references.pmid: 1987823
references.citation: Biol Psychiatry. 2005 May 15;57(10):1117-27
references.pmid: 15866551
references.citation: Am J Med Genet. 2002 Dec 8;114(8):949-55
references.pmid: 12457392
references.citation: Schizophr Res. 2002 Apr 1;54(3):243-51
references.pmid: 11950549
references.citation: Soc Psychiatry Psychiatr Epidemiol. 2004 Jan;39(1):69-72
references.pmid: 15022049
references.citation: Am J Psychiatry. 2004 Mar;161(3):501-6
references.pmid: 14992976
references.citation: Science. 1997 Jun 27;276(5321):2048-50
references.pmid: 9197269
references.citation: Neuroscience. 2001;103(1):9-15
references.pmid: 11311783
references.citation: J Clin Psychiatry. 2000;61 Suppl 4:10-4
references.pmid: 10739325
references.citation: Schizophr Res. 2008 Nov;106(1):29-32
references.pmid: 18207703
references.citation: Psychol Med. 2009 Jul;39(7):1065-76
references.pmid: 19000340
references.citation: Biol Psychiatry. 2006 Sep 1;60(5):463-71
references.pmid: 16566898
references.citation: Am J Psychiatry. 1995 May;152(5):698-703
references.pmid: 7726309
references.citation: J Nerv Ment Dis. 1990 Oct;178(10):642-8
references.pmid: 2230749