Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people
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OBJECTIVE: To investigate the relation between cannabis use and psychotic symptoms in individuals with above average predisposition for psychosis who first used cannabis during adolescence. DESIGN: Analysis of prospective data from a population based sample. Assessment of substance use, predisposition for psychosis, and psychotic symptoms was based on standardised personal interviews at baseline and at follow up four years later. PARTICIPANTS: 2437 young people (aged 14 to 24 years) with and without predisposition for psychosis. MAIN OUTCOME MEASURE: Psychotic symptoms at follow up as a function of cannabis use and predisposition for psychosis at baseline. RESULTS: After adjustment for age, sex, socioeconomic status, urbanicity, childhood trauma, predisposition for psychosis at baseline, and use of other drugs, tobacco, and alcohol, cannabis use at baseline increased the cumulative incidence of psychotic symptoms at follow up four years later (adjusted odds ratio 1.67, 95% confidence interval 1.13 to 2.46). The effect of cannabis use was much stronger in those with any predisposition for psychosis at baseline (23.8% adjusted difference in risk, 95% confidence interval 7.9 to 39.7, P = 0.003) than in those without (5.6%, 0.4 to 10.8, P = 0.033). The risk difference in the "predisposition" group was significantly greater than the risk difference in the "no predisposition" group (test for interaction 18.2%, 1.6 to 34.8, P = 0.032). There was a dose-response relation with increasing frequency of cannabis use. Predisposition for psychosis at baseline did not significantly predict cannabis use four years later (adjusted odds ratio 1.42, 95% confidence interval 0.88 to 2.31). CONCLUSION: Cannabis use moderately increases the risk of psychotic symptoms in young people but has a much stronger effect in those with evidence of predisposition for psychosis.
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The EDSP study found that any cannabis use at baseline was associated with psychotic symptoms 42 months later.
“The EDSP study found that any cannabis use at baseline was associated with psychotic symptoms 42 months later (19).”
From Association Between Cannabis and Psychosis: Epidemiologic Evidence (2016) · cites this paper as [19]
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- Hans-Ulrich Wittchen professor Correspondence to: J van Os j.vanos@sp.unimaas.nl Papers BMJ Online First bmj.com page 5 of 5 on 8 July 2023 at University of Texas Rio Grande Valley. Protected by copyright. http://www.bmj.com/ BMJ: first published as 10.1136/bmj.38267.664086.63 on 1 December 2004. Downloaded from
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- Authors
- Henquet, C., Krabbendam, L., Spauwen, J., Kaplan, C., Lieb, R., Wittchen, H.-U., & van Os, J.
- Affiliations
- Maastricht University (NL)
- Max Planck Society (DE)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2004-12-01
- Volume
- 330
- Issue
- 7481
- Pages
- 11
- ISSN
- 1756-1833 (ISSN-L)
- 0959-8138
- PMC
- PMC539839
- OpenAlex
- W2146519036
- Cited by
- 765
- References
- 30
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 9 · 2023: 19 · 2022: 17 · 2021: 14 · 2020: 28 · 2019: 20 · 2018: 32 · 2017: 42 · 2016: 32 · 2015: 58 · 2014: 42 · 2013: 39 · 2012: 49
- FWCI
- 25.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Max Planck Institute for Plasma Physics (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- National Institutes of Health
- National Institute on Drug Abuse (R01DA016977)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- cannabis use, psychotic symptoms, youth, adolescence, cannabis use disorder, dose-response relationship, interaction effects, substance use, mental health risk
- MeSH terms
- Adolescent, Adult, Marijuana Abuse, Disease Susceptibility, Female, Follow-Up Studies, Humans, Male, Prospective Studies, Psychoses, Substance-Induced, Risk Factors, Cohort Studies
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