Cannabis use as a potential mediator between childhood adversity and first-episode psychosis: results from the EU-GEI case–control study
G. Trotta, Victoria Rodriguez, D. Quattrone, E. Spinazzola, G. Tripoli, C. Gayer-Anderson, Tom P. Freeman, H. Jongsma, L. Sideli, Monica Aas, S. Stilo, C. la Cascia, L. Ferraro, D. la Barbera, A. Lasalvia, S. Tosato, I. Tarricone, G. D’andrea, A. Tortelli, F. Schürhoff, A. Szöke, B. Pignon, J. Selten, E. Velthorst, L. de Haan, P. Llorca, Paulo Rossi Menezes, C. D. del Ben, J. Santos, M. Arrojo, J. Bobes, J. Sanjuán, M. Bernardo, C. Arango, J. Kirkbride, P. Jones, A. Richards, B. Rutten, J. van Os, I. Austin-Zimmerman, Zhikun Li, C. Morgan, Pak C. Sham, E. Vassos, C. Wong, R. Bentall, Helen L. Fisher, R. M. Murray, Luis K. Alameda, M. di Forti
Psychological Medicine May 4, 2023 DOI: 10.1017/s0033291723000995 via Semantic Scholar
Summary
AI-generated from the abstractChildhood adversity and cannabis use are both known risk factors for psychosis. This study examined whether cannabis use might explain the link between childhood adversity and psychotic disorders. Data from 881 first-episode psychosis patients and 1231 controls from the EU-GEI study showed that household discord was associated with psychosis partly through cannabis use. Lifetime cannabis use mediated 17% of the association, cannabis potency mediated 14%, and frequency of use mediated 29%. Similar results appeared for early exposure to household discord. The findings suggest that harmful cannabis use patterns partially explain how household discord leads to psychosis, and children exposed to challenging home environments could benefit from interventions to prevent cannabis misuse.
Study at a glance
| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 2,112 |
| Population | First-episode psychosis patients and controls from the European network of national schizophrenia networks studying Gene–Environment Interactions (EU-GEI) study |
| Keywords | Medicine Psychology |
| Key finding | Harmful patterns of cannabis use mediated the association between household discord and psychosis, with frequency of use showing the largest mediating effect (29%). |
Abstract
Abstract Background Childhood adversity and cannabis use are considered independent risk factors for psychosis, but whether different patterns of cannabis use may be acting as mediator between adversity and psychotic disorders has not yet been explored. The aim of this study is to examine whether cannabis use mediates the relationship between childhood adversity and psychosis. Methods Data were utilised on 881 first-episode psychosis patients and 1231 controls from the European network of national schizophrenia networks studying Gene–Environment Interactions (EU-GEI) study. Detailed history of cannabis use was collected with the Cannabis Experience Questionnaire. The Childhood Experience of Care and Abuse Questionnaire was used to assess exposure to household discord, sexual, physical or emotional abuse and bullying in two periods: early (0–11 years), and late (12–17 years). A path decomposition method was used to analyse whether the association between childhood adversity and psychosis was mediated by (1) lifetime cannabis use, (2) cannabis potency and (3) frequency of use. Results The association between household discord and psychosis was partially mediated by lifetime use of cannabis (indirect effect coef. 0.078, s.e. 0.022, 17%), its potency (indirect effect coef. 0.059, s.e. 0.018, 14%) and by frequency (indirect effect coef. 0.117, s.e. 0.038, 29%). Similar findings were obtained when analyses were restricted to early exposure to household discord. Conclusions Harmful patterns of cannabis use mediated the association between specific childhood adversities, like household discord, with later psychosis. Children exposed to particularly challenging environments in their household could benefit from psychosocial interventions aimed at preventing cannabis misuse.