Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta on 3053 individuals
Por:
Argote M, Sescousse G, Brunelin J, Baudin G, Schaub MP, Rabin R, Schnell T, Ringen PA, Andreassen OA, Addington JM, Brambilla P, Delvecchio G, Bechdolf A, Wobrock T, Schneider-Axmann T, Herzig D, Mohr C, Vila R, Usall J, Mallet J, Ricci V, Martinotti G, Knížková K, Rodriguez M, Cookey J, Tibbo P, Scheffler F, Asmal L, Garcia-Rizo C, Amoretti S, Huber C, Thibeau H, Kline E, Fakra E, Jardri R, Nourredine M and Rolland B
Publicada:
1 oct 2023
Ahead of Print:
1 sep 2023
Categoría:
Medicine (miscellaneous)
Resumen:
Background The association between cannabis use and positive symptoms in schizophrenia spectrum disorders is well documented, especially via meta-analyses. Yet, findings are inconsistent regarding negative symptoms, while other dimensions such as disorganization, depression, and excitement, have not been investigated. In addition, meta-analyses use aggregated data discarding important confounding variables which is a source of bias.Methods PubMed, ScienceDirect and PsycINFO were used to search for publications from inception to September 27, 2022. We contacted the authors of relevant studies to extract raw datasets and perform an Individual Participant Data meta-analysis (IPDMA). Inclusion criteria were: psychopathology of individuals with schizophrenia spectrum disorders assessed by the Positive and Negative Syndrome Scale (PANSS); cannabis-users had to either have a diagnosis of cannabis use disorder or use cannabis at least twice a week. The main outcomes were the PANSS subscores extracted via the 3-factor (positive, negative and general) and 5-factor (positive, negative, disorganization, depression, excitement) structures. Preregistration is accessible via Prospero: ID CRD42022329172.Findings Among the 1149 identified studies, 65 were eligible and 21 datasets were shared, totaling 3677 IPD and 3053 complete cases. The adjusted multivariate analysis revealed that relative to non-use, cannabis use was associated with higher severity of positive dimension (3-factor: Adjusted Mean Difference, aMD = 0.34, 95% Confidence Interval, CI = [0.03; 0.66]; 5-factor: aMD = 0.38, 95% CI = [0.08; 0.63]), lower severity of negative dimension (3-factor: aMD = -0.49, 95% CI [-0.90; -0.09]; 5-factor: aMD = -0.50, 95% CI = [-0.91; -0.08]), higher severity of excitement dimension (aMD = 0.16, 95% CI = [0.03; 0.28]). No association was found between cannabis use and disorganization (aMD = -0.13, 95% CI = [-0.42; 0.17]) or depression (aMD = -0.14, 95% CI = [-0.34; 0.06]).Interpretation No causal relationship can be inferred from the current results. The findings could be in favor of both a detrimental and beneficial effect of cannabis on positive and negative symptoms, respectively. Longitudinal designs are needed to understand the role of cannabis is this association. The reported effect sizes are small and CIs are wide, the interpretation of findings should be taken with caution.
Filiaciones:
Argote M:
PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
Université Claude Bernard Lyon 1, Lyon, France
Centre Hospitalier Le Vinatier, Bron, France
Sescousse G:
PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
Université Claude Bernard Lyon 1, Lyon, France
Centre Hospitalier Le Vinatier, Bron, France
Brunelin J:
PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
Université Claude Bernard Lyon 1, Lyon, France
Centre Hospitalier Le Vinatier, Bron, France
Baudin G:
Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, F-92100, France
Schaub MP:
Swiss Research Institute for Public Health and Addiction ISGF, University of Zurich, Zurich, Switzerland
Rabin R:
Department of Psychiatry, McGill University, Montréal, Canada
Schnell T:
Medical School Hamburg, University of Applied Sciences and Medical University, Hamburg, Germany
Ringen PA:
NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
Andreassen OA:
NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hospital and University of Oslo, Oslo, Norway
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
Addington JM:
Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
Brambilla P:
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
Delvecchio G:
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
Bechdolf A:
Department of Psychiatry, Psychotherapy und Psychosomatic, Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Berlin, Germany
Department of Psychiatry and Psychotherapy, CCM, Charite-Universitätsmedizin Berlin, Berlin, Germany
Wobrock T:
Centre for Mental Health, County Hospitals Darmstadt-Dieburg, Groß-Umstadt, Germany
Department of Psychiatry and Psychotherapy, Georg-August University Göttingen, Germany
Schneider-Axmann T:
Department of Psychiatry and Psychotherapy, Ludwig Maximillian University Munich, Munich, Germany
Herzig D:
Clienia Littenheid AG, Psychiatrische Tagesklinik Frauenfeld, 8500, Frauenfeld, Switzerland
Department of Experimental Psychology, University of Bristol, Bristol, UK
Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
Mohr C:
Department of Experimental Psychology, University of Bristol, Bristol, UK
Université de Lausanne, Institute of Psychology (IP), Lausanne, Switzerland
Vila R:
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
Usall J:
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Institut de Recerca Sant Joan de Déu, Spain
Mallet J:
Université Paris Cité, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris France, France
AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France
Ricci V:
Department of Neuroscience, San Luigi Gonzaga University Hospital, 10043, Orbassano, Italy
Martinotti G:
Department of Neuroscience, Imaging, Clinical Sciences, University of Chieti-Pescara, Italy
Knížková K:
National Institute of Mental Health, Klecany, Czech Republic
Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
General University Hospital in Prague, Czech Republic
Rodriguez M:
National Institute of Mental Health, Klecany, Czech Republic
Cookey J:
Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
Tibbo P:
Department of Psychiatry, QEII Health Sciences Centre, Dalhousie University, Halifax, Nova Scotia, Canada
Nova Scotia Early Psychosis Program, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
Scheffler F:
Neuroscience Institute, University of Cape Town, Cape Town, South Africa
Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
Asmal L:
Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Garcia-Rizo C:
Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clínic of Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain
Amoretti S:
Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain
Huber C:
Universitäre Psychiatrische Kliniken (UPK) Basel, Universität Basel, Wilhelm Klein-Str. 27, 4002 Basel, Switzerland
Thibeau H:
Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
Kline E:
Boston Medical Center, Department of Psychiatry, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
Department of Psychiatry, Boston University School of Medicine, 801 Massachusetts Avenue, 4th Floor, Boston, MA, 02118, United States of America
Fakra E:
PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
Pôle Universitaire de Psychiatrie, CHU Saint-Etienne, Saint-Etienne, France
Jardri R:
Lille University, Inserm U1172-LilNcog-Lille Neuroscience & Cognition, Plasticity and Subjectivity Team, F-59000, Lille, France
CHU Lille, Fontan Hospital, Child & Adolescent Psychiatry Department & CURE Research Platform, Lille, France
Nourredine M:
Service de biostatistique, Hospices Civils de Lyon, Lyon, France
Service hospitalo-universitaire de pharmacotoxicologie, Hospices Civils de Lyon, Lyon, France
Université Claude Bernard Lyon 1, Lyon, France
Rolland B:
PSYR, CNRL, INSERM U1028, CNRS UMR5292, UCBL1, Bron, France
Université Claude Bernard Lyon 1, Lyon, France
Centre Hospitalier Le Vinatier, Bron, France
Service Universitaire d'Addictologie de Lyon (SUAL), HCL, CH Le Vinatier, Lyon, France
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