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Clinical correlates of cannabis use among adolescent psychiatric inpatients

Published online by Cambridge University Press:  15 April 2020

S. Lev-Ran ,
A. Aviram ,
Y. Braw ,
U. Nitzan ,
G. Ratzoni  and
S. Fennig
S. Lev-Ran*
Affiliation:
Shalvata Mental Health Center, POB 94 Hod Hasharon,, 45100, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel
A. Aviram
Affiliation:
Rabin Medical Center, Beilinson Hospital, Petah Tikva, 49100, Israel
Y. Braw
Affiliation:
Shalvata Mental Health Center, POB 94 Hod Hasharon,, 45100, Israel Department of Behavioral Sciences, Ariel University Center of Samaria, Ariel, 44837, Israel
U. Nitzan
Affiliation:
Shalvata Mental Health Center, POB 94 Hod Hasharon,, 45100, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel
G. Ratzoni
Affiliation:
Shalvata Mental Health Center, POB 94 Hod Hasharon,, 45100, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel
S. Fennig
Affiliation:
Shalvata Mental Health Center, POB 94 Hod Hasharon,, 45100, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel
*
*Corresponding author. E-mail address: shauli.levran@gmail.com
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Abstract

Objectives

This study sought to determine the clinical correlates of adolescents with cannabis use and no additional drug use (CU) compared to adolescents with no drug use (NDU) among a group of adolescent psychiatric inpatients in Israel.

Methods

Two hundred and thirty-six patients consecutively admitted to an adolescent inpatient unit at a university-affiliated mental health center in Israel during a 3-year period were screened. Individuals with polydrug use were excluded from the study.

Results

Prevalence of cannabis use was 13%. In the CU group, 39% were diagnosed with attention deficit and disruptive behavior disorders compared with 16% in the NDU group. Antipsychotics were the most common medications prescribed in both groups. Mood stabilizers were more frequently prescribed to CU than to NDU patients (39% vs 16%, respectively). A higher prevalence of alcohol abuse and criminal behaviors was found among CU compared to NDU patients (61% and 39% vs 6% and 4%, respectively).

Conclusions

The high prevalence of disruptive behaviors and frequent treatment with antipsychotics and mood stabilizers in the CU group may be related to the strong association between externalizing behavior and cannabis use and the non-specific pharmacological treatment of disruptive behaviors. Formal screening for cannabis use should be considered in psychiatric facilities. Specifically, adolescents with disruptive behaviors could benefit from early interventions, before and after cannabis initiation.

Keywords

CannabisAdolescentInpatientClinical correlates
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 6 , August 2012 , pp. 470 - 475
Copyright
Copyright © Elsevier Masson SAS 2012

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References

Amaladoss, A., Roberts, N., Amaladoss, F.Evidence for use of mood stabilizers and anticonvulsants in the treatment of nonaffective disorders in children and adolescents. Clin Neuropharmacol. 33 6: 2010 303–311.CrossRefGoogle ScholarPubMed
American Psychiatric Association, Diagnostic and statistical manual of mental disorders, Fourth edition, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Association; 2000.CrossRefGoogle Scholar
Arseneault, L., Cannon, M., Poulton, R., Murray, R., Caspi, A., Moffitt, T.E.Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. BMJ. 325 7374: 2002 1212–1213.CrossRefGoogle ScholarPubMed
Bar Hamburger, R., Ezrahi, Y., Roziner, I., Nirel, R.Psychoactive substance use in Israel. Jerusalem: The Israel Anti-Drug Agency; 2009.Google Scholar
Bloch, Y., Levcovitch, Y., Bloch, A.M., Mendlovic, S., Ratzoni, G.Electroconvulsive therapy in adolescents: similarities to and differences from adults. J Am Acad Child Adolesc Psychiatry. 40 11: 2001 1332–1336.CrossRefGoogle ScholarPubMed
Bloch, Y., Mendlovic, S., Strupinsky, S., Altshuler, A., Fennig, S., Ratzoni, G.Injections of depot antipsychotic medications in patients suffering from schizophrenia: do they hurt?. J Clin Psychiatry. 62 11: 2001 855–859.CrossRefGoogle ScholarPubMed
Bovasso, G.B.Cannabis abuse as a risk factor for depressive symptoms. Am J Psychiatry. 158 12: 2001 2033–2037.CrossRefGoogle ScholarPubMed
Brook, J.S., Cohen, P., Brook, D.W.Longitudinal study of co-occurring psychiatric disorders and substance use. J Am Acad Child Adolesc Psychiatry. 37 3: 1998 322–330.CrossRefGoogle ScholarPubMed
Brook, D.W., Brook, J.S., Zhang, C., Cohen, P., Whiteman, M.Drug use and the risk of major depressive disorder, alcohol dependence, and substance use disorders. Arch Gen Psychiatry. 59 11: 2002 1039–1044.CrossRefGoogle ScholarPubMed
Caspi, A., Moffitt, T.E., Cannon, M., McClay, J., Murray, R., Harrington, H.et al.Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene X environment interaction. Biol Psychiatry. 57 10: 2005 1117–1127.CrossRefGoogle ScholarPubMed
Creemers, H.E., van Lier, P.A., Vollebergh, W.A., Ormel, J., Verhulst, F.C., Huizink, A.C.Predicting onset of cannabis use in early adolescence: the interrelation between high-intensity pleasure and disruptive behavior. The TRAILS study. J Stud Alcohol Drugs. 70 6: 2009 850–858.CrossRefGoogle ScholarPubMed
Danielson, C.K., Overholser, J.C., Butt, Z.A.Association of substance abuse and depression among adolescent psychiatric inpatients. Can J Psychiatry. 48 11: 2003 762–765.CrossRefGoogle ScholarPubMed
Daudin, M., Cohen, D., Edel, Y., Bonnet, N., Bodeau, N., Consoli, A.et al.Psychosocial and clinical correlates of substance use disorder in an adolescent inpatient psychiatric population. J Can Acad Child Adolesc Psychiatry. 19 4: 2010 264–273.Google Scholar
Earleywine, M., Newcomb, M.D.Concurrent versus simultaneous polydrug use: prevalence, correlates, discriminant validity, and prospective effects on health outcomes. Exp Clin Psychopharmacol. 5 4: 1997 353–364.CrossRefGoogle ScholarPubMed
Esposito-Smythers, C., Spirito, A.Adolescent substance use and suicidal behavior: a review with implications for treatment research. Alcohol Clin Exp Res. 28 5 Suppl. 2004 77S–88S.CrossRefGoogle ScholarPubMed
European Monitoring Center for drugs and drug addiction. The state of the drugs problem in the accending and candidate countries to the European Union and Norway: annual reports. Luxembourg, Office of the Official Publications of the European Communities 2006.Google Scholar
Fergusson, D.M., Horwood, L.J., Swain-Campbell, N.Cannabis use and psychosocial adjustment in adolescence and young adulthood. Addiction. 97 9: 2002 1123–1135.CrossRefGoogle ScholarPubMed
Fergusson, D.M., Horwood, L.J., Ridder, E.M.Conduct and attentional problems in childhood and adolescence and later substance use, abuse and dependence: results of a 25-year longitudinal study. Drug Alcohol Depend. 88 suppl. 1: 2007 S14–S26.CrossRefGoogle ScholarPubMed
Findling, R.L.Atypical antipsychotic treatment of disruptive behavior disorders in children and adolescents. J Clin Psychiatry. 69 suppl. 4: 2008 9–14.Google ScholarPubMed
Findling, R.L., Steiner, H., Weller, E.B.Use of antipsychotics in children and adolescents. J Clin Psychiatry. 66 suppl. 7: 2005 29–40.Google ScholarPubMed
Flory, K., Lynam, D.R.The relation between attention deficit hyperactivity disorder and substance abuse: what role does conduct disorder play?. Clin Child Fam Psychol Rev. 6 1: 2003 1–16.CrossRefGoogle ScholarPubMed
Forman, E.M., Berk, M.S., Henriques, G.R., Brown, G.K., Beck, A.T.History of multiple suicide attempts as a behavioral marker of severe psychopathology. Am J Psychiatry. 161 3: 2004 437–443.CrossRefGoogle ScholarPubMed
Foti, D.J., Kotov, R., Guey, L.T., Bromet, E.J.Cannabis use and the course of schizophrenia: 10-year follow-up after first hospitalization. Am J Psychiatry. 167 8: 2010 987–993.CrossRefGoogle ScholarPubMed
Gilat, Y., Ben-Dor, D.H., Magen, A., Wolovick, L., Vekslerchik, M., Weizman, A.et al.Trends in prescribing of psychotropic medications for inpatient adolescents in Israel: a 10 years retrospective analysis. Eur Psychiatry. 26 4: 2011 265–269.CrossRefGoogle ScholarPubMed
Goodman, A.Substance use and common child mental health problems: examining longitudinal associations in a British sample. Addiction. 105 8: 2010 1484–1496.CrossRefGoogle Scholar
Grella, C.E., Hser, Y.I., Joshi, V., Rounds-Bryant, J.Drug treatment outcomes for adolescents with comorbid mental and substance use disorders. J Nerv Ment Dis. 189 6: 2001 384–392.CrossRefGoogle ScholarPubMed
Griffith-Lendering, M.F., Huijbregts, S.C., Mooijaart, A., Vollebergh, W.A., Swaab, H.Cannabis use and development of externalizing and internalizing behaviour problems in early adolescence: a TRAILS study. Drug Alcohol Depend. 116 1–3: 2010 11–17.CrossRefGoogle Scholar
Grilo, C.M., Becker, D.F., Walker, M.L., Levy, K.N., Edell, W.S., McGlashan, T.H.Psychiatric comorbidity in adolescent inpatients with substance use disorders. J Am Acad Child Adolesc Psychiatry. 34 8: 1995 1085–1091.CrossRefGoogle ScholarPubMed
Grilo, C.M., Becker, D.F., Fehon, D.C., Edell, W.S., McGlashan, T.H.Conduct disorder, substance use disorders, and coexisting conduct and substance use disorders in adolescent inpatients. Am J Psychiatry. 153 7: 1996 914–920.Google ScholarPubMed
Hazell, P.Review of attention-deficit/hyperactivity disorder comorbid with oppositional defiant disorder. Australas Psychiatry. 18 6: 2010 556–559.CrossRefGoogle ScholarPubMed
Hides, L., Dawe, S., Kavanagh, D.J., Young, R.M.Psychotic symptom and cannabis relapse in recent-onset psychosis. Prospective study. Br J Psychiatry. 2006; 189: 137–143.CrossRefGoogle ScholarPubMed
James, A.C., Crow, T.J., Renowden, S., Wardell, A.M., Smith, D.M., Anslow, P.Is the course of brain development in schizophrenia delayed? Evidence from onsets in adolescence. Schizophr Res. 40 1: 1999 1–10.CrossRefGoogle ScholarPubMed
Johns, A.Psychiatric effects of cannabis. Br J Psychiatry. 2001; 178: 116–212.CrossRefGoogle ScholarPubMed
Johnson, L., O’Mailey, P., Bachman, J., Ahalenberg, I.Monitoring the future national survey results on drug use 1975–2005: volume 1, Secondary school students. Bethesda: NIH Publication No-06-5883. National Institute on drug abuse; 2006.Google Scholar
Kelly, E., Darke, S., Ross, J.A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. Drug Alcohol Rev. 23 3: 2004 319–344.CrossRefGoogle ScholarPubMed
Latimer, W., Zur, J.Epidemiologic trends of adolescent use of alcohol, tobacco, and other drugs. Child Adolesc Psychiatr Clin N Am. 19 3: 2010 451–464.CrossRefGoogle ScholarPubMed
Licanin, I., Music, E., Laslo, E., Berg-Kelly, K., Masic, I., Redzic, A.et al.Suicidal thoughts related to psychoactive substance abuse among adolescents. Med Arh. 57 4: 2003 237–240.Google ScholarPubMed
Lynskey, M., Hall, W.The effects of adolescent cannabis use on educational attainment: a review. Addiction. 95 11: 2000 1621–1630.CrossRefGoogle ScholarPubMed
Malone, D.T., Hill, M.N., Rubino, T.Adolescent cannabis use and psychosis: epidemiology and neurodevelopmental models. Br J Pharmacol. 160 3: 2010 511–522.CrossRefGoogle ScholarPubMed
McGee, R., Williams, S., Poulton, R., Moffitt, T.A longitudinal study of cannabis use and mental health from adolescence to early adulthood. Addiction. 95 4: 2000 491–503.CrossRefGoogle ScholarPubMed
McKay, J.R., Murphy, R.T., Rivinus, T.R., Maisto, S.A.Family dysfunction and alcohol and drug use in adolescent psychiatric inpatients. J Am Acad Child Adolesc Psychiatry. 30 6: 1991 967–972.CrossRefGoogle ScholarPubMed
Moore, T.H., Zammit, S., Lingford-Hughes, A., Barnes, T.R., Jones, P.B., Burke, M.et al.Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 370 9584: 2007 319–328.CrossRefGoogle ScholarPubMed
Niethammer, O., Frank, R.Prevalence of use, abuse and dependence on legal and illegal psychotropic substances in an adolescent inpatient psychiatric population. Eur Child Adolesc Psychiatry. 16 4: 2007 254–259.CrossRefGoogle Scholar
Olfson, M., Blanco, C., Liu, L., Moreno, C., Laje, G.National trends in the outpatient treatment of children and adolescents with antipsychotic drugs. Arch Gen Psychiatry. 63 6: 2006 679–685.CrossRefGoogle ScholarPubMed
Pape, H., Rossow, I., Storvoll, E.E.Under double influence: assessment of simultaneous alcohol and cannabis use in general youth populations. Drug Alcohol Depend. 101 1–2: 2009 69–73.CrossRefGoogle ScholarPubMed
Patton, G.C., Coffey, C., Carlin, J.B., Degenhardt, L., Lynskey, M., Hall, W.Cannabis use and mental health in young people: cohort study. BMJ. 325 7374: 2002 1195–1198.CrossRefGoogle ScholarPubMed
Perrone, J., De Roos, F., Jayaraman, S., Hollander, J.E.Drug screening versus history in detection of substance use in ED psychiatric patients. Am J Emerg Med. 19 1: 2001 49–51.CrossRefGoogle ScholarPubMed
Ramaekers, J.G., Robbe, H.W., O’Hanlon, J.F.Marijuana, alcohol and actual driving performance. Hum Psychopharmacol. 15 7: 2000 551–558.3.0.CO;2-P>CrossRefGoogle ScholarPubMed
Ramaekers, J.G., Berghaus, G., van Laar, M., Drummer, O.H.Dose related risk of motor vehicle crashes after cannabis use. Drug Alcohol Depend. 73 2: 2004 109–119.CrossRefGoogle ScholarPubMed
Rasmussen, H.B., Timm, S., Wang, A.G., Soeby, K., Lublin, H., Fenger, M.et al.Association between the CCR5 32-bp deletion allele and late onset of schizophrenia. Am J Psychiatry. 163 3: 2006 507–511.CrossRefGoogle ScholarPubMed
Rey, J.M., Martin, A., Krabman, P.Is the party over? Cannabis and juvenile psychiatric disorder: the past 10 years. J Am Acad Child Adolesc Psychiatry. 43 10: 2004 1194–1205.CrossRefGoogle ScholarPubMed
Roberts, R.E., Roberts, C.R., Xing, Y.Comorbidity of substance use disorders and other psychiatric disorders among adolescents: evidence from an epidemiologic survey. Drug Alcohol Depend. 88 suppl. 1: 2007 S4–S13.CrossRefGoogle ScholarPubMed
Scourfield, J., Stevens, D.E., Merikangas, K.R.Substance abuse, comorbidity, and sensation seeking: gender differences. Compr Psychiatry. 37 6: 1996 384–392.CrossRefGoogle ScholarPubMed
Semple, D.M., McIntosh, A.M., Lawrie, S.M.Cannabis as a risk factor for psychosis: systematic review. J Psychopharmacol. 19 2: 2005 187–194.CrossRefGoogle ScholarPubMed
Shoval, G., Zalsman, G., Apter, A., Diller, R., Sher, L., Weizman, A.A 10-year retrospective study of inpatient adolescents with schizophrenia/schizoaffective disorder and substance use. Compr Psychiatry. 48 1: 2007 1–7.CrossRefGoogle ScholarPubMed
Shrier, L.A., Harris, S.K., Kurland, M., Knight, J.R.Substance use problems and associated psychiatric symptoms among adolescents in primary care. Pediatrics. 111 6 Pt 1 2003 e699–e705.CrossRefGoogle ScholarPubMed
Stepp, S.D., Burke, J.D., Hipwell, A.E., Loeber, R.Trajectories of Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder Symptoms as Precursors of Borderline Personality Disorder Symptoms in Adolescent Girls. J Abnorm Child Psychol. 2011 10.1007/s10802-011-9530-6 Epub ahead of print.Google Scholar
Stoker, A., Swadi, H.Perceived family relationships in drug abusing adolescents. Drug Alcohol Depend. 25 3: 1990 293–297.CrossRefGoogle ScholarPubMed
Swadi, H.Individual risk factors for adolescent substance use. Drug Alcohol Depend. 55 3: 1999 209–224.CrossRefGoogle ScholarPubMed
Swadi, H., Bobier, C.Substance use disorder comorbidity among inpatient youths with psychiatric disorder. Aust N Z J Psychiatry. 37 3: 2003 294–298.CrossRefGoogle ScholarPubMed
Teichman, M., Rahav, G.The annual survey of substance use in Israel. Jerusalem: The Israel Anti-Drug Agency; 2003.Google Scholar
Turgay, A.Psychopharmacological treatment of oppositional defiant disorder. CNS Drugs. 23 1: 2009 1–17.CrossRefGoogle ScholarPubMed
Van Bockstaele, E.J., Reyes, B.A., Valentino, R.J.The locus coeruleus: a key nucleus where stress and opioids intersect to mediate vulnerability to opiate abuse. Brain Res. 2010; 1314: 162–174.CrossRefGoogle ScholarPubMed
Van Dam, N.T., Earleywine, M., DiGiacomo, G.Polydrug use, cannabis, and psychosis-like symptoms. Hum Psychopharmacol. 23 6: 2008 475–485.CrossRefGoogle ScholarPubMed
Verstraete, A.G.Detection times of drugs of abuse in blood, urine, and oral fluid. Ther Drug Monit. 26 2: 2004 200–205.CrossRefGoogle ScholarPubMed
Weaver, M.F., Dupre, M.A., Cropsey, K.L., Koch, J.R., Sood, B.A., Wiley, J.L.et al.Addiction epidemiology in adolescents receiving inpatient psychiatric treatment. Addict Behav. 32 12: 2007 3107–3113.CrossRefGoogle ScholarPubMed
Wittchen, H.U., Frohlich, C., Behrendt, S., Gunther, A., Rehm, J., Zimmermann, P.et al.Cannabis use and cannabis use disorders and their relationship to mental disorders: a 10-year prospective-longitudinal community study in adolescents. Drug Alcohol Depend. 88 suppl. 1: 2007 S60–S70.CrossRefGoogle ScholarPubMed
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