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Annotation

Thirthalli J, Benegal V. Psychosis among substance users. Curr Opin Psychiatry . 2006 May 1 ; 19(3):239-45. PubMed Abstract

Comments on Related News
Related News: Meta-analysis Supports Case for Cannabis in Etiology of Psychosis

Comment by:  Jim van Os
Submitted 8 August 2007 Posted 8 August 2007

This excellent review confirms the previous meta-analysis by Henquet et al. (2005) and as such does not add anything new. The importance lies in the UK context: previously the Lancet has been mostly skeptical with regard to this issue. The fact that the leading UK medical journal now also allows these findings to see daylight is a significant event and helps stimulate further funding for the effort that several groups worldwide have started working on over the last five years: the search for the mechanism explaining the link.

View all comments by Jim van Os


Related News: Meta-analysis Supports Case for Cannabis in Etiology of Psychosis

Comment by:  John McGrath, SRF Advisor
Submitted 9 August 2007 Posted 10 August 2007
  I recommend the Primary Papers

It is reassuring to see that the results of the latest meta-analysis (Moore et al., 2007) are consistent with previous meta-analyses, and that the various meta-analyses are broadly consistent with the now much-tortured primary data. Despite the meta-analysis fatigue, the results are too important to ignore.

When thinking about the impact of cannabis on schizophrenia frequency measures, it is important to remember that cannabis use may translate to an increase in the prevalence of active psychosis via two mechanisms. The data suggest that as the prevalence of cannabis use increases in a population, the incidence of schizophrenia should also increase (Hickman et al., 2007). Furthermore, in those with established schizophrenia, cannabis use is associated with poorer outcomes (i.e., reduced remission rates). Thus, from a modeling perspective, increased cannabis use could lead to an increase in the prevalence of active psychosis via two mechanisms (i.e., increased “inflow” and...  Read more


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Related News: Meta-analysis Supports Case for Cannabis in Etiology of Psychosis

Comment by:  Dana MarchEzra Susser (SRF Advisor)
Submitted 20 August 2007 Posted 20 August 2007

The recent meta-analysis in the Lancet (Moore et al., 2007) regarding cannabis use and psychotic or affective mental health outcomes is, indeed, a necessary contribution. It is the first systematic review restricted to longitudinal studies of cannabis use and mental health outcomes. For this addition to the contours of the literature, Zammit and colleagues are to be commended.

We may be more optimistic than the authors, however, about the potential for future longitudinal studies to shed further light on the question of causality, and perhaps more cautious about the present state of the evidence. Given the public health and policy implications, we propose a concerted effort to complete observational studies that are designed to rule out the main alternative explanations for the association (e.g., genetic or social factors that independently influence both cannabis use and psychosis). The Swedish conscript study (Zammit et al., 2002) is a fine example of one such study. We should...  Read more


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View all comments by Ezra Susser

Related News: Meta-analysis Supports Case for Cannabis in Etiology of Psychosis

Comment by:  Amresh Shrivastava
Submitted 20 October 2007 Posted 24 October 2007

Current interest in cannabis and the onset of psychosis is laudable. The Lancet paper no doubt establishes a causal link based upon what has been known in the literature (Raphael et al., 2005; Roberts et al., 2007; Rey et al., 2004; Wittchen et al., 2007). The authors need to be congratulated for taking extreme care to incorporate most of the studies and also for making conclusions with a sense of skepticism. That is where further questions arise.

1. Cannabis is used only in certain cultures and known to be involved in a maximum 50 percent of cases of psychosis, schizophrenia, and schizophreniform psychosis (Gregg et al., 2007). In that sense, are there two different phenotypes of schizophrenia, a) where exposure to cannabis is necessarily a factor and b) where a different set of potentiating or precipitating factors work, not cannabis?

2. Even if we focus only on the first...  Read more


View all comments by Amresh Shrivastava
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