Cannabis use in male and female first episode of non-affective psychosis patients: Long-term clinical, neuropsychological and functional differences.

Esther Setién-Suero,Patricia Correa-Ghisays,Rosa Ayesa-Arriola,Mariluz Ramírez-Bonilla,Karl Neergaard,Benedicto Crespo-Facorro,Lourdes Fañanás,Kenji Hashimoto

doi:10.1371/journal.pone.0183613

Abstract

BackgroundNumerous studies show the existence of a high prevalence of cannabis use among patients with psychosis. However, the differences between men and women who debut with a first episode of psychosis (FEP) regarding cannabis use have not been largely explored. The aim of this study was to identify the specific sex factors and differences in clinical evolution associated with cannabis use.MethodSociodemographic characteristics at baseline were considered in our sample of FEP patients to find differences depending on sex and the use of cannabis. Clinical, functional and neurocognitive variables at baseline, 1-year, and 3-years follow-up were also explored.ResultsA total of 549 patients, of whom 43% (N = 236) were cannabis users, 79% (N = 186) male and 21% (N = 50) female, were included in the study. There was a clear relationship between being male and being a user of cannabis (OR = 5.6). Cannabis users were younger at illness onset. Longitudinal analysis showed that women significantly improved in all three dimensions of psychotic symptoms, both in the subgroup of cannabis users and in the non-users subgroup. Conversely, subgroups of men did not show improvement in the negative dimension. In cognitive function, only men presented a significant time by group interaction in processing speed, showing a greater improvement in the subgroup of cannabis users.ConclusionDespite knowing that there is a relationship between cannabis use and psychosis, due to the high prevalence of cannabis use among male FEP patients, the results showed that there were very few differences in clinical and neurocognitive outcomes between men and women who used cannabis at the start of treatment compared to those who did not.

Highlights

To date, studies of sex differences in the manifestation of psychotic disorders have consistently shown that there are differences between men and women in terms of sociodemographic and clinical characteristics, as well as with both premorbid and cognitive functioning [1,2,3]
Longitudinal analysis showed that women significantly improved in all three dimensions of psychotic symptoms, both in the subgroup of cannabis users and in the non-users subgroup
Despite knowing that there is a relationship between cannabis use and psychosis, due to the high prevalence of cannabis use among male first episode of psychosis (FEP) patients, the results showed that there were very few differences in clinical and neurocognitive outcomes between men and women who used cannabis at the start of treatment compared to those who did not

Summary

Introduction

Studies of sex differences in the manifestation of psychotic disorders have consistently shown that there are differences between men and women in terms of sociodemographic and clinical characteristics, as well as with both premorbid and cognitive functioning [1,2,3]. Numerous studies show the existence of a high prevalence of cannabis use among first episode psychosis (FEP) patients and those with schizophrenia [6,7,8,9,10]. This prevalence is well above the norm found in the Spanish general population, according to the National Plan on Drugs [11], and coincides with trends of substance use in the United States [12, 13]. The aim of this study was to identify the specific sex factors and differences in clinical evolution associated with cannabis use

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Methods

Results

Conclusion