Abstract
BackgroundIn addition to the biological plausibility widely described through a very large number of studies, the causal link between cannabis uses and schizophrenia disorders has become illicit internationally and given the scarcity of similar studies in Morocco. Our study consists of a prospective descriptive study in the psychiatric department of the Moulay ben Abdallah Hospital in Essaouira. The sample consisted of 95 patients diagnosed with schizophrenia according to the DSM5 criteria. The diagnostic assessment included the Positive and Negative Syndrome Scale to assess the severity of positive and negative symptoms of schizophrenia as well as the patient’s general psychopathology, the Clinician-Rated Dimensions of Psychosis Symptom Severity to assess the symptom severity of the psychotic dimensions according, and the Cannabis Abuse Screening Test to assess the extent of cannabis use.ResultsThe mean age of the patients recruited in the study was 33.7 ± 9.37 years with a clear male predominance (p < 0.0001). Cannabis users compared to non-users were younger and comprised only men. Cannabis users also have a lower educational and economic level than non-users. Furthermore, a clear dose effect of cannabis uses on the onset of positive and negative symptoms of schizophrenia. The temporality criterion is clear in our study, since the predictivity of the parameter: “age of onset of cannabis use” is highly significant (p = 0.000). These results suggest that cannabis use can be considered as the most illicit risk factor for the development and/or onset of schizophrenia.ConclusionsThese results suggest that there is a causal relationship between cannabis use and/or dependence (problematic use) and the onset and/or worsening of schizophrenic disorder. This means that problematic cannabis use can be considered as a real risk factor for the emergence and development of schizophrenic disorder.
Highlights
In addition to the biological plausibility widely described through a very large number of studies, the causal link between cannabis uses and schizophrenia disorders has become illicit internationally and given the scarcity of similar studies in Morocco
Given the lack of official data on addictive comorbidities in schizophrenic patients and the scarcity of studies on this subject, our study aims firstly to draw up a socioeconomic profile of schizophrenic patients in the study area and secondly to assess the role of cannabis as a “risk factor” in the development of schizophrenic disorder or the emergence of psychotic symptoms related to schizophrenia
The temporality criterion is clear in our study, as the predictivity of the parameter: “age of onset of cannabis use” is highly significant (p = 0.000), which means that there is probably a causal relationship between cannabis use and the onset of schizophrenia, that is, exposure to cannabis use precedes the emergence of the schizophrenic disorder
Summary
In addition to the biological plausibility widely described through a very large number of studies, the causal link between cannabis uses and schizophrenia disorders has become illicit internationally and given the scarcity of similar studies in Morocco. The diagnostic assessment included the Positive and Negative Syndrome Scale to assess the severity of positive and negative symptoms of schizophrenia as well as the patient’s general psychopathology, the Clinician-Rated Dimensions of Psychosis Symptom Severity to assess the symptom severity of the psychotic dimensions according, and the Cannabis Abuse Screening Test to assess the extent of cannabis use. Ouanouche et al Middle East Current Psychiatry (2022) 29:12 et al showed that daily cannabis use increased the risk of developing anxiety-depressive mood disorders (negative schizophrenia disorders) by five times (OR = 5.6; 95% CI: 2.6–12). This risk is only twice as high for weekly users [6]. Follow-up studies show the stability of addictive behaviours acquired during adolescence in patients suffering from schizophrenia, which may explain the switch to other products, alcohol, which is easier to access than cannabis
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