Abstract

Epidemiological and biological evidence support the association between heavy cannabis use and psychosis. However, it is unclear which cannabis users are susceptible to its psychotogenic effect. Therefore, understanding genetic factors contributing to this relationship might prove an important strategy to identify the mechanisms underlying cannabis-associated psychotic experiences. We aimed to determine how variation in AKT1, COMT and FAAH genotypes, and their interaction with three different groups (first episode psychosis (FEP) patients (n = 143), controls (n = 92) and young adult (YA) cannabis users n = 485)) influenced cannabis experiences, in those who had used cannabis at least once. We investigated the role of AKT1 (rs2494732), COMT Val158Met (rs4680) and FAAH (rs324420) on cannabis experiences by combining data from a large case-control study of FEP patients, with a naturalistic study of YA cannabis users (n = 720). Outcome measures were cannabis-induced psychotic-like experiences (cPLEs) and euphoric experiences (cEEs). We used linear mixed effects models to assess the effects of each genotype and their interaction with group, adjusting for age, sex, ethnicity, age of first cannabis use, years of use and frequency. cPLEs were more frequent in FEP patients than controls and YA cannabis users. cEEs were more prevalent in YA cannabis users than FEP patients or controls. Variation in AKT1, COMT or FAAH was not associated with cPLEs/cEEs. There was no interaction between genotype and group (FEP cases, controls and YA cannabis users) on cPLEs/cEEs. In conclusion, AKT1, COMT or FAAH did not modulate specific psychotomimetic response to cannabis and did not interact with group, contrary to previous research.

Highlights

  • IntroductionHindocha et al Translational Psychiatry (2020)10:143 implies mimicry of a wide range of experiences observed in the psychosis continuum; and these may include paranoia, hallucinations or euphoria[8]

  • The use of cannabis has been associated with a 3.9-fold increase in the risk of schizophrenia and other psychosis-related outcomes among the heaviest cannabis users compared to the nonusers[1,2,3], but only a smallHindocha et al Translational Psychiatry (2020)10:143 implies mimicry of a wide range of experiences observed in the psychosis continuum; and these may include paranoia, hallucinations or euphoria[8]

  • young adult (YA) cannabis users were younger than first episode psychosis (FEP) patients (p < 0.001) and Genetic and Psychosis (GAP) controls (p < 0.001)

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Summary

Introduction

Hindocha et al Translational Psychiatry (2020)10:143 implies mimicry of a wide range of experiences observed in the psychosis continuum; and these may include paranoia, hallucinations or euphoria[8]. These cannabisinduced experiences may be a marker of a vulnerability to psychosis, with those being most vulnerable, experiencing the greatest psychotomimetic effects[9,10,11,12]. Genetic differences in the dopaminergic system may interact with cannabis use to increase the risk for the development of psychosis[13,14]. The COMT rs4680 G/A polymorphism causes a non-synonymous change from a valine (Val) amino acid to a methionine (Met) amino acid

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