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Linking substance use with symptoms of sub-clinical psychosis in a community cohort over 30 years


Rössler, W; Hengartner, M P; Angst, J; Ajdacic-Gross, V (2012). Linking substance use with symptoms of sub-clinical psychosis in a community cohort over 30 years. Addiction, 107(6):1174-1184.

Abstract

Aims The aim of the study was to examine the temporal associations between substance use and subclinical psychosis symptoms.

Design Data from a prospective community study sampled within a single cohort over 30 years (1978–2008) were analysed with discrete-time hazard models.

Setting General population-based sample.

Participants At initial sampling in 1978 males (n = 292) were 19 and females (n = 299) were 20 years old.

Measurements Two psychosis syndromes representing ‘schizotypal signs’ and ‘schizophrenia nuclear symptoms’ and various substance use variables including cannabis, alcohol, tobacco and multiple-drug use (i.e. cannabis combined with other drugs).

Findings In bivariate analyses, schizotypal signs were predominantly associated with regular cannabis use in adolescence (OR = 2.29, 95% CI 1.32–3.97). Schizophrenia nuclear symptoms were mainly related to alcohol (OR = 1.84, 95% CI 1.00–3.38) and multiple-drug use (OR = 2.35, 95% CI 1.38–4.02) during adolescence. Multivariate analyses showed that, in particular, regular cannabis use during adolescence was associated with the occurrence of subsequent schizotypal symptoms over a 30-year period (OR = 2.60, 95% CI; 1.59–4.23), whereas multiple-drug use in adolescence was associated predominantly with schizophrenia nuclear symptoms (OR = 1.75, 95% CI 1.01–3.03). Alcohol misuse was only slightly associated with the onset of such symptoms.

Conclusions A significant portion of the occurrence of subclinical psychosis symptoms in adulthood can be attributed to excessive cannabis and multiple-drug use during adolescence. This is in line with the hypothesis that long-term sensitization of dopaminergic brain receptors plays a role in developing psychotic symptoms.

Abstract

Aims The aim of the study was to examine the temporal associations between substance use and subclinical psychosis symptoms.

Design Data from a prospective community study sampled within a single cohort over 30 years (1978–2008) were analysed with discrete-time hazard models.

Setting General population-based sample.

Participants At initial sampling in 1978 males (n = 292) were 19 and females (n = 299) were 20 years old.

Measurements Two psychosis syndromes representing ‘schizotypal signs’ and ‘schizophrenia nuclear symptoms’ and various substance use variables including cannabis, alcohol, tobacco and multiple-drug use (i.e. cannabis combined with other drugs).

Findings In bivariate analyses, schizotypal signs were predominantly associated with regular cannabis use in adolescence (OR = 2.29, 95% CI 1.32–3.97). Schizophrenia nuclear symptoms were mainly related to alcohol (OR = 1.84, 95% CI 1.00–3.38) and multiple-drug use (OR = 2.35, 95% CI 1.38–4.02) during adolescence. Multivariate analyses showed that, in particular, regular cannabis use during adolescence was associated with the occurrence of subsequent schizotypal symptoms over a 30-year period (OR = 2.60, 95% CI; 1.59–4.23), whereas multiple-drug use in adolescence was associated predominantly with schizophrenia nuclear symptoms (OR = 1.75, 95% CI 1.01–3.03). Alcohol misuse was only slightly associated with the onset of such symptoms.

Conclusions A significant portion of the occurrence of subclinical psychosis symptoms in adulthood can be attributed to excessive cannabis and multiple-drug use during adolescence. This is in line with the hypothesis that long-term sensitization of dopaminergic brain receptors plays a role in developing psychotic symptoms.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Clinical and Social Psychiatry Zurich West (former)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:09 Mar 2012 15:25
Last Modified:07 Dec 2017 12:07
Publisher:Wiley-Blackwell
ISSN:0965-2140
Additional Information:The definitive version is available at www.onlinelibrary.wiley.com
Publisher DOI:https://doi.org/10.1111/j.1360-0443.2011.03760.x

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