The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study

EU-GEI WP2 Group; Edoardo Spinazzola; Diego Quattrone; Victoria Rodriguez; Giulia Trotta; Luis Alameda; Giada Tripoli; Charlotte Gayer-Anderson; Tom P Freeman; Emma C Johnson; Hannah E Jongsma; Simona Stilo; Caterina La Cascia; Laura Ferraro; Daniele La Barbera; Antonio Lasalvia; Sarah Tosato; Ilaria Tarricone; Giuseppe D'Andrea; Michela Galatolo; Andrea Tortelli; Ilaria Tagliabue; Marco Turco; Maurizio Pompili; Jean-Paul Selten; Lieuwe de Haan; Paulo Rossi Menezes; Cristina M Del Ben; Jose Luis Santos; Manuel Arrojo; Julio Bobes; Julio Sanjuán; Miguel Bernardo; Celso Arango; James B Kirkbride; Peter B Jones; Michael O'Donovan; Bart P Rutten; Jim Van Os; Craig Morgan; Pak C Sham; Isabelle Austin-Zimmerman; Zhikun Li; Evangelos Vassos; Robin M Murray; Marta Di Forti

doi:10.1017/S0033291723001071

The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study

EU-GEI WP2 Group, Edoardo Spinazzola, Diego Quattrone, Victoria Rodriguez, Giulia Trotta, Luis Alameda, Giada Tripoli, Charlotte Gayer-Anderson, Tom P Freeman, Emma C Johnson, Hannah E Jongsma, Simona Stilo, Caterina La Cascia, Laura Ferraro, Daniele La Barbera, Antonio Lasalvia, Sarah Tosato, Ilaria Tarricone, Giuseppe D'Andrea, Michela GalatoloAndrea Tortelli, Ilaria Tagliabue, Marco Turco, Maurizio Pompili, Jean-Paul Selten, Lieuwe de Haan, Paulo Rossi Menezes, Cristina M Del Ben, Jose Luis Santos, Manuel Arrojo, Julio Bobes, Julio Sanjuán, Miguel Bernardo, Celso Arango, James B Kirkbride, Peter B Jones, Michael O'Donovan, Bart P Rutten, Jim Van Os, Craig Morgan, Pak C Sham, Isabelle Austin-Zimmerman, Zhikun Li, Evangelos Vassos, Robin M Murray, Marta Di Forti

Research output: Contribution to journal › Article › peer-review

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Abstract

Abstract
Background: While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis.

Methods: We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status.

Results: Controls (86.1%) and FEPp (75.63%) were most likely to report 'because of friends' as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: 'to feel better' as their RFUC (χ2 = 50.97; p < 0.001). RFUC 'to feel better' was associated with being a FEPp (OR 1.74; 95% CI 1.03-2.95) while RFUC 'with friends' was associated with being a control (OR 0.56; 95% CI 0.37-0.83). The path model indicated an association between RFUC 'to feel better' with heavy cannabis use and with FEPp-control status.

Conclusions: Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use 'to feel better'. People who reported their reason for first using cannabis to 'feel better' were more likely to progress to heavy use and develop a psychotic disorder than those reporting 'because of friends'.

Keywords: Cannabis use; path analysis; psychotic disorders.

Original language	English
Pages (from-to)	7418-7427
Number of pages	10
Journal	Psychological medicine
Volume	53
Issue number	15
Early online date	2 May 2023
DOIs	https://doi.org/10.1017/S0033291723001071
Publication status	Published - Nov 2023

Keywords

Humans
Cannabis/adverse effects
Case-Control Studies
Marijuana Smoking/adverse effects
Psychotic Disorders/epidemiology
Risk Factors

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10.1017/S0033291723001071Licence: CC BY

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EU-GEI WP2 Group, Spinazzola, E., Quattrone, D., Rodriguez, V., Trotta, G., Alameda, L., Tripoli, G., Gayer-Anderson, C., Freeman, T. P., Johnson, E. C., Jongsma, H. E., Stilo, S., La Cascia, C., Ferraro, L., La Barbera, D., Lasalvia, A., Tosato, S., Tarricone, I., D'Andrea, G., ... Di Forti, M. (2023). The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study. Psychological medicine, 53(15), 7418-7427. https://doi.org/10.1017/S0033291723001071

@article{62e2ea76e3b444b098fd7f4a6c3ad458,

title = "The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study",

abstract = "AbstractBackground: While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis.Methods: We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status.Results: Controls (86.1%) and FEPp (75.63%) were most likely to report 'because of friends' as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: 'to feel better' as their RFUC (χ2 = 50.97; p < 0.001). RFUC 'to feel better' was associated with being a FEPp (OR 1.74; 95% CI 1.03-2.95) while RFUC 'with friends' was associated with being a control (OR 0.56; 95% CI 0.37-0.83). The path model indicated an association between RFUC 'to feel better' with heavy cannabis use and with FEPp-control status.Conclusions: Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use 'to feel better'. People who reported their reason for first using cannabis to 'feel better' were more likely to progress to heavy use and develop a psychotic disorder than those reporting 'because of friends'.Keywords: Cannabis use; path analysis; psychotic disorders.",

keywords = "Humans, Cannabis/adverse effects, Case-Control Studies, Marijuana Smoking/adverse effects, Psychotic Disorders/epidemiology, Risk Factors",

author = "{EU-GEI WP2 Group} and Edoardo Spinazzola and Diego Quattrone and Victoria Rodriguez and Giulia Trotta and Luis Alameda and Giada Tripoli and Charlotte Gayer-Anderson and Freeman, {Tom P} and Johnson, {Emma C} and Jongsma, {Hannah E} and Simona Stilo and {La Cascia}, Caterina and Laura Ferraro and {La Barbera}, Daniele and Antonio Lasalvia and Sarah Tosato and Ilaria Tarricone and Giuseppe D'Andrea and Michela Galatolo and Andrea Tortelli and Ilaria Tagliabue and Marco Turco and Maurizio Pompili and Jean-Paul Selten and {de Haan}, Lieuwe and {Rossi Menezes}, Paulo and {Del Ben}, {Cristina M} and Santos, {Jose Luis} and Manuel Arrojo and Julio Bobes and Julio Sanju{\'a}n and Miguel Bernardo and Celso Arango and Kirkbride, {James B} and Jones, {Peter B} and Michael O'Donovan and Rutten, {Bart P} and {Van Os}, Jim and Craig Morgan and Sham, {Pak C} and Isabelle Austin-Zimmerman and Zhikun Li and Evangelos Vassos and Murray, {Robin M} and {Di Forti}, Marta",

note = "Funding Information: This study was funded by the Medical Research Council, the European Community's Seventh Framework Program grant (agreement HEALTH-F2-2009-241909 (Project EU-GEI), Sao Paulo Research Foundation (grant 2012/0417-0), the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, the NIHR BRC at University College London, and the Wellcome Trust (grant 101272/Z/12/Z). ES was supported by Lord Leverhulme's Charitable Trust and the Velvet Foundation and by the Medical Research Council (MRC) – UKRI [MR/T007818/1]. MDF and GT are supported by the Medical Research Council (MRC) – UKRI [MR/T007818/1]. DQ is supported by MRC/UKRI CARP (MRC CARP grant MR/W030608/1). Dr Kirkbride is supported by the National Institute for Health Research (NIHR) University College London (UCL) Biomedical Research Centre (BRC). Dr Emma Johnson receives funding from NIDA: K01DA051759. Publisher Copyright: Copyright {\textcopyright} The Author(s), 2023. Published by Cambridge University Press.",

year = "2023",

month = nov,

doi = "10.1017/S0033291723001071",

language = "English",

volume = "53",

pages = "7418--7427",

journal = "Psychological medicine",

issn = "0033-2917",

publisher = "Cambridge University Press (CUP)",

number = "15",

}

EU-GEI WP2 Group, Spinazzola, E , Quattrone, D , Rodriguez, V , Trotta, G , Alameda, L , Tripoli, G , Gayer-Anderson, C , Freeman, TP, Johnson, EC, Jongsma, HE, Stilo, S, La Cascia, C, Ferraro, L, La Barbera, D, Lasalvia, A, Tosato, S, Tarricone, I, D'Andrea, G, Galatolo, M, Tortelli, A, Tagliabue, I, Turco, M, Pompili, M, Selten, J-P, de Haan, L, Rossi Menezes, P, Del Ben, CM, Santos, JL, Arrojo, M, Bobes, J, Sanjuán, J, Bernardo, M, Arango, C, Kirkbride, JB, Jones, PB, O'Donovan, M, Rutten, BP, Van Os, J , Morgan, C, Sham, PC, Austin-Zimmerman, I , Li, Z , Vassos, E , Murray, RM & Di Forti, M 2023, 'The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study', Psychological medicine, vol. 53, no. 15, pp. 7418-7427. https://doi.org/10.1017/S0033291723001071

TY - JOUR

T1 - The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis

T2 - the EU-GEI case-control study

AU - EU-GEI WP2 Group

AU - Spinazzola, Edoardo

AU - Quattrone, Diego

AU - Rodriguez, Victoria

AU - Trotta, Giulia

AU - Alameda, Luis

AU - Tripoli, Giada

AU - Gayer-Anderson, Charlotte

AU - Freeman, Tom P

AU - Johnson, Emma C

AU - Jongsma, Hannah E

AU - Stilo, Simona

AU - La Cascia, Caterina

AU - Ferraro, Laura

AU - La Barbera, Daniele

AU - Lasalvia, Antonio

AU - Tosato, Sarah

AU - Tarricone, Ilaria

AU - D'Andrea, Giuseppe

AU - Galatolo, Michela

AU - Tortelli, Andrea

AU - Tagliabue, Ilaria

AU - Turco, Marco

AU - Pompili, Maurizio

AU - Selten, Jean-Paul

AU - de Haan, Lieuwe

AU - Rossi Menezes, Paulo

AU - Del Ben, Cristina M

AU - Santos, Jose Luis

AU - Arrojo, Manuel

AU - Bobes, Julio

AU - Sanjuán, Julio

AU - Bernardo, Miguel

AU - Arango, Celso

AU - Kirkbride, James B

AU - Jones, Peter B

AU - O'Donovan, Michael

AU - Rutten, Bart P

AU - Van Os, Jim

AU - Morgan, Craig

AU - Sham, Pak C

AU - Austin-Zimmerman, Isabelle

AU - Li, Zhikun

AU - Vassos, Evangelos

AU - Murray, Robin M

AU - Di Forti, Marta

N1 - Funding Information: This study was funded by the Medical Research Council, the European Community's Seventh Framework Program grant (agreement HEALTH-F2-2009-241909 (Project EU-GEI), Sao Paulo Research Foundation (grant 2012/0417-0), the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, the NIHR BRC at University College London, and the Wellcome Trust (grant 101272/Z/12/Z). ES was supported by Lord Leverhulme's Charitable Trust and the Velvet Foundation and by the Medical Research Council (MRC) – UKRI [MR/T007818/1]. MDF and GT are supported by the Medical Research Council (MRC) – UKRI [MR/T007818/1]. DQ is supported by MRC/UKRI CARP (MRC CARP grant MR/W030608/1). Dr Kirkbride is supported by the National Institute for Health Research (NIHR) University College London (UCL) Biomedical Research Centre (BRC). Dr Emma Johnson receives funding from NIDA: K01DA051759. Publisher Copyright: Copyright © The Author(s), 2023. Published by Cambridge University Press.

PY - 2023/11

Y1 - 2023/11

N2 - AbstractBackground: While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis.Methods: We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status.Results: Controls (86.1%) and FEPp (75.63%) were most likely to report 'because of friends' as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: 'to feel better' as their RFUC (χ2 = 50.97; p < 0.001). RFUC 'to feel better' was associated with being a FEPp (OR 1.74; 95% CI 1.03-2.95) while RFUC 'with friends' was associated with being a control (OR 0.56; 95% CI 0.37-0.83). The path model indicated an association between RFUC 'to feel better' with heavy cannabis use and with FEPp-control status.Conclusions: Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use 'to feel better'. People who reported their reason for first using cannabis to 'feel better' were more likely to progress to heavy use and develop a psychotic disorder than those reporting 'because of friends'.Keywords: Cannabis use; path analysis; psychotic disorders.

AB - AbstractBackground: While cannabis use is a well-established risk factor for psychosis, little is known about any association between reasons for first using cannabis (RFUC) and later patterns of use and risk of psychosis.Methods: We used data from 11 sites of the multicentre European Gene-Environment Interaction (EU-GEI) case-control study. 558 first-episode psychosis patients (FEPp) and 567 population controls who had used cannabis and reported their RFUC.We ran logistic regressions to examine whether RFUC were associated with first-episode psychosis (FEP) case-control status. Path analysis then examined the relationship between RFUC, subsequent patterns of cannabis use, and case-control status.Results: Controls (86.1%) and FEPp (75.63%) were most likely to report 'because of friends' as their most common RFUC. However, 20.1% of FEPp compared to 5.8% of controls reported: 'to feel better' as their RFUC (χ2 = 50.97; p < 0.001). RFUC 'to feel better' was associated with being a FEPp (OR 1.74; 95% CI 1.03-2.95) while RFUC 'with friends' was associated with being a control (OR 0.56; 95% CI 0.37-0.83). The path model indicated an association between RFUC 'to feel better' with heavy cannabis use and with FEPp-control status.Conclusions: Both FEPp and controls usually started using cannabis with their friends, but more patients than controls had begun to use 'to feel better'. People who reported their reason for first using cannabis to 'feel better' were more likely to progress to heavy use and develop a psychotic disorder than those reporting 'because of friends'.Keywords: Cannabis use; path analysis; psychotic disorders.

KW - Humans

KW - Cannabis/adverse effects

KW - Case-Control Studies

KW - Marijuana Smoking/adverse effects

KW - Psychotic Disorders/epidemiology

KW - Risk Factors

UR - http://www.scopus.com/inward/record.url?scp=85179842875&partnerID=8YFLogxK

U2 - 10.1017/S0033291723001071

DO - 10.1017/S0033291723001071

M3 - Article

C2 - 37129249

SN - 0033-2917

VL - 53

SP - 7418

EP - 7427

JO - Psychological medicine

JF - Psychological medicine

IS - 15

ER -

The association between reasons for first using cannabis, later pattern of use, and risk of first-episode psychosis: the EU-GEI case-control study

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