Cannabis use, gender and age of onset of schizophrenia: data from the ÆSOP study.
An earlier age of onset of schizophrenia has been identified as a poor prognostic indicator. The current study examines the interaction effect of gender and cannabis use on age of onset of schizophrenia and schizoaffective disorder. This research forms part of a two-centre epidemiological study of first-episode psychosis and included individuals with a diagnosis of schizophrenia or schizoaffective disorder and an age of onset between age 16 and 45. Kaplan-Meier curves and Cox proportional hazards regression were used to compare the effects of cannabis use and gender on age of first symptom of schizophrenia. Akaike's information criteria were used to find the model with the best fit to the data. Cannabis users had an earlier age of first symptom than non-users. There was an interaction with gender; the gender difference in age of onset was diminished in cannabis smokers compared with non-cannabis smokers. The model including cannabis use interacting with gender was the most parsimonious model, followed by cannabis use alone. The addition of other illegal drug use did not improve the model. Cannabis use is associated with an earlier age of onset of schizophrenia, and the gender difference in age of onset is reduced among cannabis smokers.
Addictions Department, Institute of Psychiatry, King's College London, 4 Windsor Walk, London SE5 8BB, England, UK. Electronic address: kim.donoghue@kcl.ac.uk.
Kim
K
Donoghue
Division of Psychiatry, University of Nottingham, England, UK.
Gillian A
GA
Doody
Department of Psychosis Studies, Institute of Psychiatry, King's College London, England, UK.
Robin M
RM
Murray
Department of Psychiatry, University of Cambridge, England, UK.
Peter B
PB
Jones
Section of Social Psychiatry, Institute of Psychiatry, King's College London, England, UK.
Craig
C
Morgan
Department of Psychosis Studies, Institute of Psychiatry, King's College London, England, UK.
Paola
P
Dazzan
Section of Social Psychiatry, Institute of Psychiatry, King's College London, England, UK.
Jozella
J
Hart
Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Italy.
Rodolfo
R
Mazzoncini
Department of Psychosis Studies, Institute of Psychiatry, King's College London, England, UK.
James H
JH
Maccabe
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002186:Cannabinoids; D002188:Cannabis / Q000009:adverse effects*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D008875:Middle Aged; D016016:Proportional Hazards Models; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D012044:Regression Analysis; D012559:Schizophrenia / Q000175:diagnosis* / Q000209:etiology; D012737:Sex Factors
D002186:Cannabinoids
First-episode; Onset; Positive symptoms; Psychosis; Substance misuse