title: Subclinical depressive symptoms and continued cannabis use: predictors of negative outcomes in first episode psychosis.
abstract: BACKGROUND
  Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use.
  
  
  METHODS
  64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a) patients with subclinical depressive symptoms at least once during follow-up (DPG), and (b) patients without subclinical depressive symptoms during follow-up (NDPG). Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms using the Hamilton Depression Rating Scale (HDRS)-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF). A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome.
  
  
  RESULTS
  Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001) and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009).
  
  
  CONCLUSIONS
  Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.
authors: Department of Psychiatry, University Hospital of Alava-Santiago, University of the Basque Country, CIBERSAM, Vitoria, Spain.
authors: Itxaso
authors: I
authors: González-Ortega
authors: Department of Psychiatry, University Hospital of Alava-Santiago, University of the Basque Country, CIBERSAM, Vitoria, Spain.
authors: Susana
authors: S
authors: Alberich
authors: Department of Psychiatry, University Hospital of Alava-Santiago, University of the Basque Country, CIBERSAM, Vitoria, Spain.
authors: Enrique
authors: E
authors: Echeburúa
authors: Araba Research Unit, Osakidetza, Vitoria, Spain.
authors: Felipe
authors: F
authors: Aizpuru
authors: Dirección de Asistencia Sanitaria, Osakidetza, Vitoria, Spain.
authors: Eduardo
authors: E
authors: Millán
authors: Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
authors: Eduard
authors: E
authors: Vieta
authors: Achucarro Basque Center for Neuroscience, University of the Basque Country, CIBERNED, Leioa, Spain.
authors: Carlos
authors: C
authors: Matute
authors: Department of Psychiatry, University Hospital of Alava-Santiago, University of the Basque Country, CIBERSAM, Vitoria, Spain.
authors: Ana
authors: A
authors: González-Pinto
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D002189:Marijuana Abuse / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult