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Cigarette smoking and cannabis use are equally strongly associated with psychotic-like experiences: a cross-sectional study in 1929 young adults

Published online by Cambridge University Press:  18 February 2013

W. A. van Gastel ,
J. H. MacCabe ,
C. D. Schubart ,
A. Vreeker ,
W. Tempelaar ,
R. S. Kahn  and
M. P. M. Boks
W. A. van Gastel*
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
J. H. MacCabe
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
C. D. Schubart
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
A. Vreeker
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
W. Tempelaar
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
R. S. Kahn
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
M. P. M. Boks
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
*
*Address for correspondence: W. A. van Gastel, M.Sc., Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, HP A01.468, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. (Email: W.vanGastel@umcutrecht.nl)
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Abstract

Background

Cannabis use is associated with increased risk for psychotic-like experiences (PLEs) and psychotic disorders. It remains unclear whether this relationship is causal or due to confounding.

Method

A total of 1929 young adults aged 18–30 years participated in a nationwide internet-based survey in The Netherlands and gave information on demographics, substance use and parental psychiatric illness and completed the Community Assessment of Psychic Experiences (CAPE).

Results

Cigarette smoking and cannabis use were equally strongly associated with the frequency of PLEs in a fully adjusted model (β = 0.098 and 0.079 respectively, p < 0.05). Cannabis use was associated with distress from PLEs in a model adjusted for an elaborate set of confounders excluding smoking (β = 0.082, p < 0.05). However, when cigarette smoking was included in the model, cannabis use was not a significant predictor of distress from PLEs. Cigarette smoking remained associated with distress from PLEs in a fully adjusted model (β = 0.107, p < 0.001).

Conclusions

Smoking is an equally strong independent predictor of frequency of PLEs as monthly cannabis use. Our results suggest that the association between moderate cannabis use and PLEs is confounded by cigarette smoking.

Keywords

Cannabis useconfoundingnicotinepsychosispsychotic-like experiencesreverse causalityrisksmoking
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 11 , November 2013 , pp. 2393 - 2401
Copyright
Copyright © Cambridge University Press 2013 

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