title: Cannabis use in people with severe mental illness: The association with physical and mental health--a cohort study. A Pharmacotherapy Monitoring and Outcome Survey study.
abstract: OBJECTIVE
  In the general population cannabis use is associated with better cardiometabolic outcomes. Patients with severe mental illness frequently use cannabis, but also present increased cardiometabolic risk factors. We explore the association between cannabis use and cardiometabolic risk factors in patients with severe mental illness.
  
  
  METHODS
  A total of 3169 patients with severe mental illness from a Dutch cohort were included in the study. The association of cannabis use with body mass index, waist circumference, blood pressure, cholesterol, triglycerides, glucose, glycated hemoglobin and Positive and Negative Syndrome Scale was examined with separate univariate AN(C)OVA. Changes in metabolic risk factors and Positive and Negative Syndrome Scale were examined after a follow-up interval of 9-24 months, for patients who continued, discontinued, started or were never using cannabis between the two assessments.
  
  
  RESULTS
  Cannabis users at baseline had lower body mass index, smaller waist circumference, lower diastolic blood pressure, and more severe psychotic symptoms than non-users. Patients who discontinued their cannabis use after the first assessment had a greater increase in body mass index, waist circumference, diastolic blood pressure and triglyceride concentrations than other patients, and the severity of their psychotic symptoms had decreased more compared to continued users and non-users.
  
  
  CONCLUSIONS
  Extra attention should be paid to the monitoring and treatment of metabolic parameters in patients who discontinue their cannabis use.
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands j.bruins@umcg.nl.
authors.forename: Jojanneke
authors.initials: J
authors.lastname: Bruins
authors.affiliation: Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands Department of Psychotic Disorders, GGZ Drenthe, Assen, the Netherlands.
authors.forename: Marieke G H M
authors.initials: MG
authors.lastname: Pijnenborg
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands Lentis Mental Health Organization, Groningen, the Netherlands.
authors.forename: Agna A
authors.initials: AA
authors.lastname: Bartels-Velthuis
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Visser
authors.affiliation: Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands.
authors.forename: Edwin R
authors.initials: ER
authors.lastname: van den Heuvel
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Richard
authors.initials: R
authors.lastname: Bruggeman
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands Research Department, Friesland Mental Health Services, Leeuwarden, the Netherlands.
authors.forename: Frederike
authors.initials: F
authors.lastname: Jörg
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D002186:Cannabinoids / Q000009:adverse effects* / Q000627:therapeutic use*; D002188:Cannabis / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000150:complications; D008385:Marijuana Smoking / Q000009:adverse effects; D001523:Mental Disorders / Q000188:drug therapy* / Q000503:physiopathology* / Q000523:psychology*; D008603:Mental Health; D017063:Outcome Assessment, Health Care; D011618:Psychotic Disorders / Q000503:physiopathology / Q000523:psychology; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications; D011795:Surveys and Questionnaires; D055105:Waist Circumference / Q000187:drug effects
chemical_list: D002186:Cannabinoids
keywords: Cannabis; PANSS; metabolic syndrome; psychotic disorders; severe mental illness