Use of antipsychotic medication, benzodiazepines, and psychiatric hospitalization in cannabis-related versus cannabis-unrelated schizophrenia - a nationwide, register-based cohort study. | LitMetric
Background: Evidence suggests that cannabis may be a causal factor for development of schizophrenia. We aimed to investigate whether use of antipsychotic medication, benzodiazepines, and psychiatric service use differs among patients with schizophrenia depending on whether psychosis was precipitated by a diagnosis of cannabis use disorder (CUD).
Methods: We utilized the nationwide Danish registries to identify all individuals with an incident diagnosis of schizophrenia from 1995 to 2016. We also collected information on whether first CUD diagnosis preceded schizophrenia and thus defined a group of potentially cannabis-related schizophrenia. We compared the cannabis-related schizophrenia group both with all non-cannabis-related patients with schizophrenia and with non-cannabis-related patients with schizophrenia that were propensity-score matched to cases using a range of potentially confounding variables.
Results: We included 35 714 people with incident schizophrenia, including 4116 (11.5%) that were cannabis-related. In the unmatched-comparison analyses, there were no clear differences over time in use of antipsychotics and benzodiazepines related to whether the diagnosis of schizophrenia was cannabis-related. After propensity-score matching, use of antipsychotics and benzodiazepines was significantly lower among cannabis-related cases of schizophrenia. In the unmatched comparison, the cannabis-related group had significantly more days admitted than the non-cannabis-related group. This was markedly attenuated after propensity-score matching.
Conclusions: Our findings indicate the importance of considering cannabis-related cases of schizophrenia as a potentially distinct disorder in terms of prognosis. It is unclear, however, if these differences are due to different biological types of schizophrenia being compared or if they rather indicate behavioral differences such as reduced adherence and treatment-seeking.
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Background: Impairments in theory of mind (ToM) are highly prevalent among individuals with schizophrenia, resulting in substantial functional deficits. However, research on impairments in individuals with schizotypy has yielded inconsistent findings, with some studies finding ToM deficits in overall schizotypy, other studies finding ToM deficits in only specific schizotypy dimensions, and yet other studies finding no ToM deficits at all. One potential key factor that may account for this discrepancy is the use of schizotypy measures that do not adequately measure specific schizotypy dimensions.
Barcelona Clinic Schizophrenia Unit, Institute of Neurosciences, Hospital Clinic, Barcelona, Spain; Institut d'Investigacions Mèdiques August Pi i Sunyer (IDIBAPS), Fundació Clínic, Barcelona, Spain; Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain. Electronic address:
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Bipolar and Depressive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Spain; Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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