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Reasons for cannabis use in first-episode psychosis: Does strength of endorsement change over 12 months?

Published online by Cambridge University Press:  15 April 2020

A. Kolliakou ,
D. Castle ,
H. Sallis ,
C. Joseph ,
J. O’Connor ,
B. Wiffen ,
C. Gayer-Anderson ,
G. McQueen ,
H. Taylor  and
S. Bonaccorso
...Show all authors
A. Kolliakou*
Affiliation:
Department of Psychological Medicine, PO92, Institute of Psychiatry, King's College London, De Crespigny Park, SE5 8AFLondon, UK
D. Castle
Affiliation:
Department of Psychiatry, University of Melbourne, Melbourne, Australia
H. Sallis
Affiliation:
MRC Integrative Epidemiology Unit, School of Social and Community Medicine, University of Bristol, Bristol, UK
C. Joseph
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
J. O’Connor
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
B. Wiffen
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
C. Gayer-Anderson
Affiliation:
Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
G. McQueen
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
H. Taylor
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
S. Bonaccorso
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
F. Gaughran
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
S. Smith
Affiliation:
Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London, London, UK
K. Greenwood
Affiliation:
School of Psychology, University of Sussex, Sussex, UK
R.M. Murray
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
M. Di Forti
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
Z. Atakan
Affiliation:
Department of Neuroimaging, Institute of Psychiatry, King’s College London, London, UK
K. Ismail
Affiliation:
Department of Psychological Medicine, PO92, Institute of Psychiatry, King's College London, De Crespigny Park, SE5 8AFLondon, UK
*
*Corresponding author. Tel.: +44 0 2032288561. E-mail address:anna.kolliakou@kcl.ac.uk (A. Kolliakou).
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Abstract

Background:

Why patients with psychosis use cannabis remains debated. The self-medication hypothesis has received some support but other evidence points towards an alleviation of dysphoria model. This study investigated the reasons for cannabis use in first-episode psychosis (FEP) and whether strength in their endorsement changed over time.

Methods:

FEP inpatients and outpatients at the South London and Maudsley, Oxleas and Sussex NHS Trusts UK, who used cannabis, rated their motives at baseline (n = 69), 3 months (n = 29) and 12 months (n = 36). A random intercept model was used to test the change in strength of endorsement over the 12 months. Paired-sample t-tests assessed the differences in mean scores between the five subscales on the Reasons for Use Scale (enhancement, social motive, coping with unpleasant affect, conformity and acceptance and relief of positive symptoms and side effects), at each time-point.

Results:

Time had a significant effect on scores when controlling for reason; average scores on each subscale were higher at baseline than at 3 months and 12 months. At each time-point, patients endorsed ‘enhancement’ followed by ‘coping with unpleasant affect’ and ‘social motive’ more highly for their cannabis use than any other reason. ‘Conformity and acceptance’ followed closely. ‘Relief of positive symptoms and side effects’ was the least endorsed motive.

Conclusions:

Patients endorsed their reasons for use at 3 months and 12 months less strongly than at baseline. Little support for the self-medication or alleviation of dysphoria models was found. Rather, patients rated ‘enhancement’ most highly for their cannabis use.

Keywords

PsychosisSchizophreniaCannabis useReasons for cannabis useSelf-medicationAlleviation of dysphoria
Type
Original article
Information
European Psychiatry , Volume 30 , Issue 1 , January 2015 , pp. 152 - 159
Copyright
Copyright © European Psychiatric Association 2020

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