Abstract
Although recent studies have shown a moderately strong association between cannabis use and violence among people with severe mental disorders, the direction of this association has not been investigated prospectively in a population with schizophrenia. Therefore, this study aims to determine, using cross-lag models, whether a temporal relationship between cumulative cannabis use and violence exists in a population with schizophrenia. The authors reported findings covering an 18-month period from a randomized, double-blind clinical trial of antipsychotic medications for schizophrenia treatment. Among the 1460 patients enrolled in the trial, 965 were followed longitudinally. Although persistent cannabis use predicted subsequent violence, violence did not predict cannabis use. The relationship was therefore unidirectional and persisted when controlling for stimulants and alcohol use. Finally, a significant body of evidence suggests a link between persistent cannabis use and violence among people with mental illnesses. Studies to further investigate the mechanisms underlying this association should be conducted.
Highlights
Cannabis is markedly the most frequently abused illicit drug worldwide
In the sample of 965 participants having completed a follow-up visit at 6 and/or 12 months, the average age was of 41.06 years (SD = 11.01; range = 18–67 years old) and the majority were men (72.3%)
A minority of participants were violent during period 1 (11.5%) and the prevalence of violent acts progressively decreased (6.0% during period 2 and 5.3% during period 3)
Summary
Cannabis is markedly the most frequently abused illicit drug worldwide. about 2.5% of the world population consumes cannabis yearly, whereas the annual prevalence of cocaine use, such as that of opiates, is of 0.2%1. Among individuals with mental illnesses, cannabis use is associated with more severe symptomatology[5,8] and with violent behaviors[9,10]. Based on findings in populations with severe mental illnesses, we hypothesized that cumulative cannabis use increases the risk of violence across time in a subsample from the Clinical
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