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Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals
M. Argote, G. Sescousse, J. Brunelin, G. Baudin, MP. Schaub, R. Rabin, T. Schnell, PA. Ringen, OA. Andreassen, JM. Addington, P. Brambilla, G. Delvecchio, A. Bechdolf, T. Wobrock, T. Schneider-Axmann, D. Herzig, C. Mohr, R. Vila-Badia, JU. Rodie,...
Status not-indexed Language English Country England, Great Britain
Document type Journal Article
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- Publication type
- Journal Article MeSH
BACKGROUND: The association between cannabis use and positive symptoms in schizophrenia spectrum disorders is well documented, especially via meta-analyses. Yet, findings are inconsistent regarding negative symptoms, while other dimensions such as disorganization, depression, and excitement, have not been investigated. In addition, meta-analyses use aggregated data discarding important confounding variables which is a source of bias. METHODS: PubMed, ScienceDirect and PsycINFO were used to search for publications from inception to September 27, 2022. We contacted the authors of relevant studies to extract raw datasets and perform an Individual Participant Data meta-analysis (IPDMA). Inclusion criteria were: psychopathology of individuals with schizophrenia spectrum disorders assessed by the Positive and Negative Syndrome Scale (PANSS); cannabis-users had to either have a diagnosis of cannabis use disorder or use cannabis at least twice a week. The main outcomes were the PANSS subscores extracted via the 3-factor (positive, negative and general) and 5-factor (positive, negative, disorganization, depression, excitement) structures. Preregistration is accessible via Prospero: ID CRD42022329172. FINDINGS: Among the 1149 identified studies, 65 were eligible and 21 datasets were shared, totaling 3677 IPD and 3053 complete cases. The adjusted multivariate analysis revealed that relative to non-use, cannabis use was associated with higher severity of positive dimension (3-factor: Adjusted Mean Difference, aMD = 0.34, 95% Confidence Interval, CI = [0.03; 0.66]; 5-factor: aMD = 0.38, 95% CI = [0.08; 0.63]), lower severity of negative dimension (3-factor: aMD = -0.49, 95% CI [-0.90; -0.09]; 5-factor: aMD = -0.50, 95% CI = [-0.91; -0.08]), higher severity of excitement dimension (aMD = 0.16, 95% CI = [0.03; 0.28]). No association was found between cannabis use and disorganization (aMD = -0.13, 95% CI = [-0.42; 0.17]) or depression (aMD = -0.14, 95% CI = [-0.34; 0.06]). INTERPRETATION: No causal relationship can be inferred from the current results. The findings could be in favor of both a detrimental and beneficial effect of cannabis on positive and negative symptoms, respectively. Longitudinal designs are needed to understand the role of cannabis is this association. The reported effect sizes are small and CIs are wide, the interpretation of findings should be taken with caution. FUNDING: This research did not receive any specific grant or funding. Primary financial support for authors was provided by Le Vinatier Psychiatric Hospital.
AP HP Department of Psychiatry Louis Mourier Hospital Colombes France
Centre for Mental Health County Hospitals Darmstadt Dieburg Groß Umstadt Germany
Centre Hospitalier Le Vinatier Bron France
Clienia Littenheid AG Psychiatrische Tagesklinik Frauenfeld 8500 Frauenfeld Switzerland
Department of Experimental Psychology University of Bristol Bristol UK
Department of Neuroscience Imaging Clinical Sciences University of Chieti Pescara Italy
Department of Neuroscience San Luigi Gonzaga University Hospital 10043 Orbassano Italy
Department of Pathophysiology and Transplantation University of Milan Milan Italy
Department of Psychiatry 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Psychiatry and Mental Health University of Cape Town Cape Town South Africa
Department of Psychiatry and Psychotherapy CCM Charite Universitätsmedizin Berlin Berlin Germany
Department of Psychiatry and Psychotherapy Georg August University Göttingen Germany
Department of Psychiatry and Psychotherapy Ludwig Maximillian University Munich Munich Germany
Department of Psychiatry Hotchkiss Brain Institute University of Calgary Calgary Canada
Department of Psychiatry McGill University Montreal Canada
Department of Psychiatry QEII Health Sciences Centre Dalhousie University Halifax Nova Scotia Canada
Etiopathogenesis and Treatment of Severe Mental Disorders Institut de Recerca Sant Joan de Déu Spain
General University Hospital Prague Czech Republic
Institute of Clinical Medicine University of Oslo Oslo Norway
Laboratoire de Psychopathologie et Processus de Santé Université Paris Cité F 92100 France
Medical School Hamburg University of Applied Sciences and Medical University Hamburg Germany
National Institute of Mental Health Klecany Czech Republic
Neuroscience Institute University of Cape Town Cape Town South Africa
Nova Scotia Early Psychosis Program Nova Scotia Health Authority Halifax Nova Scotia Canada
Parc Sanitari Sant Joan de Déu Sant Boi de Llobregat Spain
Pôle Universitaire de Psychiatrie CHU Saint Etienne Saint Etienne France
Psychiatric Genetics Unit Vall d'Hebron Research Institute Barcelona Spain
PSYR CNRL INSERM U1028 CNRS UMR5292 UCBL1 Bron France
Service de biostatistique Hospices Civils de Lyon Lyon France
Service hospitalo universitaire de pharmacotoxicologie Hospices Civils de Lyon Lyon France
Service Universitaire d'Addictologie de Lyon HCL CH Le Vinatier Lyon France
Université Claude Bernard Lyon 1 Lyon France
Université de Lausanne Institute of Psychology Lausanne Switzerland
Université Paris Cité INSERM UMR1266 Institute of Psychiatry and Neuroscience of Paris France France
References provided by Crossref.org
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