Psychosis and cannabis

Alcohol and cannabis misuse is currently the most frequent co-morbidity disorder of schizophrenia. The following four issues will be dealt with: 1) the neurobiological basis of the psychosis-inducing, pathogenic effects of THC, the agent contained in cannabis products. 2) Can cannabis use - and for comparison alcohol abuse - prematurely trigger or even cause schizophrenia? 3) Are persons genetically liable to schizophrenia, psychosis-prone individuals or young persons before completion of brain development at an increased risk? 4) What consequences does cannabis use have on the symptomatology and further course of schizophrenia? Results from recent literature and the ABC Schizophrenia Study show that the risk for cannabis use in schizophrenia is about twice the size in healthy controls. In most cases cannabis use starts before first admission, in a third of cases before schizophrenia onset. There is an increased affinity to misuse already at the prodromal stage. Cannabis can prematurely trigger schizophrenia onset - on average eight years earlier than in non-use - and cause the illness partly in interaction with predisposing factors. Cannabis use in the course of schizophrenia increases positive symptoms and reduces affective flattening, thus leading to dysfunctional coping in some cases.

Schizophrenia: do men and women suffer from the same disease

This article reviews the literature on normal brain development and behavioural development in men and women as well as on aetilogical risk factors for schizophrenia, such as pre-, peri- and postnatal complications. The male-female comparisons of age and type of onset, symptomatology, course and outcome were based on a population-based sample of 232 first illness episodes - the ABC schizophrenia study sample. The probands were assessed using ...

When, how and with what does schizophrenia

The ABC schizphrenia study, launched in 1987 and planned to be continued until end of 1988, focuses among other objectives on the initial symptoms and early course the disorder. It is a systematic investigation proceeding from substudy to substudy on the basis of the results achieved. The IRAOS interview, a standardized instrument applied to threee sources of data, was used to assess age at the appearance of the first sign of the disorder, first psychotic symptom and maximum of the first psychotic episode in a representative sample of 232 first psychotic episode in a representative sample of 232 first-episode cases of widly defined schizophenia. For any of these definitions of onset a significant gendr difference of about 3 to 4 years in age of onset emerged. The difference was explaned by a protective effect of estrogen raising the vunerability threshold for schizophrenia in women. The age distribuition of onsets in men showed an early increase with a peak between ages 15 and 25 years followed by a monotonous fall. Women showed a slightly slower early increase with a firt peak between ages 15 and 30 years and another between ages 45 and 50 years. 3/4 of the cases began with a prodromal phase of 5 years on average. A psychotic prephase, extending from the first positive symptom to the first maximum of positive symptoms, of 1.1 years on average followed. The early onset of the disorder in men hit them at a lower mean level of social development and, irrespective of a similar type of onset and more or less similar symptom-related course, led to a poorer early social course compared with women. This tendency was reinforced by men's illness behavior, frequently socially negative in type. Social disability tended to emerge as early as the prodromal phase. In a case-control study using matched controls fom the general population we were able to slow that it frequently led to social disadventage long before the first psychiatric contact and initiation of therapy or rehabilitation

When, how and with what does schizophrenia begin? / When, how and with what does schizophrenia begin?

The ABC schizophrenia study, lauched in 1987 and planned to be continued until end of 1998, focuses among other objectivies on the influence of age and sex on the initial symptoms and early course of the disorder. It is a systematic investigation proceeding from substudy to substudy on the basis of the results achieved. The IRAOS interview, a standardized instrument applied to three sources of data, was used to assess age at the appearance of the first sign of the disorder, first psychotic symptom and maximum of the first psychotic episode in a representative sample of 232 first-episode cases of widely defined schizophrenia. For any of these definitions of onset a significant gender difference of about 3 to 4 years in age of onset emerged. The difference was explained by a protective effect of estrogen raising the vulnerability threshold for schizophrenia in women. The aged distribuition of onset in men showed an early increase with a peak between ages 15 and 25 years followed by a monotonous fall. Women showed a slightly slower early increase with a first peak between ages 15 and 30 years and another between ages 45 and 50 years. 3/4 of cases began with a prodromal phase of 5 years on average. A psychotic prephase, extending from the first positive symptom to the first maximum of positive symptoms, of 1.1 years on average follwed. The early onset of the disorder in men hit them at a lower mean level of social development and, irrespective of a similar type of onset and more or less similar symptom-related course, led to a poorer early social course compared with women. This tendency was reinforced by men's illness behavior, frequently socially negative in type. Social disability tended to emerge as early as the prodromal phase. In a case-control study using matched controls from the general population we were able to show that it frequently led to social disadvantage long before the first psychiatric contact and initiation of therapy or rehabilitation.