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Cannabis abuse is associated with decision-making impairment among first-episode patients with schizophrenia-spectrum psychosis.

Abstract

BACKGROUND

Cannabis use appears to be a risk factor for schizophrenia. Moreover, cannabis abusers show impaired decision-making capacities, linked to the orbitofrontal cortex (OFC). Although there is substantial evidence that first-episode schizophrenia patients show impairments in cognitive tasks associated with the dorsolateral prefrontal cortex (DLPFC), it is not clear whether decision making is impaired at schizophrenia onset. In this study, we examined the association between antecedents of cannabis abuse and cognitive impairment in cognitive tasks associated with the DLPFC and the OFC in a sample of first-episode patients with schizophrenia-spectrum disorders.

METHOD

One hundred and thirty-two patients experiencing their first episode of a schizophrenia-spectrum psychosis were assessed with a cognitive battery including DLPFC-related tasks [backward digits, verbal fluency (FAS) and the Trail Making Test (TMT)] and an OFC-related task [the Iowa Gambling Task (GT)]. Performance on these tasks was compared between patients who had and had not abused cannabis before their psychosis onset.

RESULTS

No differences were observed between the two groups on the performance of any of the DLPFC-related tasks. However, patients who had abused cannabis before their psychosis onset showed a poorer total performance on the gambling task and a lower improvement on the performance of the task compared to no-abusers.

CONCLUSIONS

Pre-psychotic cannabis abuse is associated with decision-making impairment, but not working memory and executive function impairment, among first-episode patients with a schizophrenia-spectrum psychosis. Further studies are needed to examine the direction of causality of this impairment; that is, does the impairment make the patients abuse cannabis, or does cannabis abuse cause the impairment?

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  • Authors+Show Affiliations

    ,

    University Hospital Marques de Valdecilla, Department of Psychiatry, School of Medicine, University of Cantabria, Santander, Spain.

    , , , , , , ,

    Source

    Psychological medicine 38:9 2008 Sep pg 1257-66

    MeSH

    Adult
    Cognition
    Cognition Disorders
    Decision Making
    Female
    Humans
    Intelligence Tests
    Male
    Marijuana Abuse
    Neuropsychological Tests
    Prefrontal Cortex
    Psychotic Disorders
    Risk Factors
    Schizophrenia
    Schizophrenic Psychology
    Task Performance and Analysis
    Trail Making Test

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18005495

    Citation

    Mata, I, et al. "Cannabis Abuse Is Associated With Decision-making Impairment Among First-episode Patients With Schizophrenia-spectrum Psychosis." Psychological Medicine, vol. 38, no. 9, 2008, pp. 1257-66.
    Mata I, Rodríguez-Sánchez JM, Pelayo-Terán JM, et al. Cannabis abuse is associated with decision-making impairment among first-episode patients with schizophrenia-spectrum psychosis. Psychol Med. 2008;38(9):1257-66.
    Mata, I., Rodríguez-Sánchez, J. M., Pelayo-Terán, J. M., Pérez-Iglesias, R., González-Blanch, C., Ramírez-Bonilla, M., ... Crespo-Facorro, B. (2008). Cannabis abuse is associated with decision-making impairment among first-episode patients with schizophrenia-spectrum psychosis. Psychological Medicine, 38(9), pp. 1257-66.
    Mata I, et al. Cannabis Abuse Is Associated With Decision-making Impairment Among First-episode Patients With Schizophrenia-spectrum Psychosis. Psychol Med. 2008;38(9):1257-66. PubMed PMID: 18005495.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cannabis abuse is associated with decision-making impairment among first-episode patients with schizophrenia-spectrum psychosis. AU - Mata,I, AU - Rodríguez-Sánchez,J M, AU - Pelayo-Terán,J M, AU - Pérez-Iglesias,R, AU - González-Blanch,C, AU - Ramírez-Bonilla,M, AU - Martínez-García,O, AU - Vázquez-Barquero,J L, AU - Crespo-Facorro,B, Y1 - 2007/11/16/ PY - 2007/11/17/pubmed PY - 2008/10/22/medline PY - 2007/11/17/entrez SP - 1257 EP - 66 JF - Psychological medicine JO - Psychol Med VL - 38 IS - 9 N2 - BACKGROUND: Cannabis use appears to be a risk factor for schizophrenia. Moreover, cannabis abusers show impaired decision-making capacities, linked to the orbitofrontal cortex (OFC). Although there is substantial evidence that first-episode schizophrenia patients show impairments in cognitive tasks associated with the dorsolateral prefrontal cortex (DLPFC), it is not clear whether decision making is impaired at schizophrenia onset. In this study, we examined the association between antecedents of cannabis abuse and cognitive impairment in cognitive tasks associated with the DLPFC and the OFC in a sample of first-episode patients with schizophrenia-spectrum disorders. METHOD: One hundred and thirty-two patients experiencing their first episode of a schizophrenia-spectrum psychosis were assessed with a cognitive battery including DLPFC-related tasks [backward digits, verbal fluency (FAS) and the Trail Making Test (TMT)] and an OFC-related task [the Iowa Gambling Task (GT)]. Performance on these tasks was compared between patients who had and had not abused cannabis before their psychosis onset. RESULTS: No differences were observed between the two groups on the performance of any of the DLPFC-related tasks. However, patients who had abused cannabis before their psychosis onset showed a poorer total performance on the gambling task and a lower improvement on the performance of the task compared to no-abusers. CONCLUSIONS: Pre-psychotic cannabis abuse is associated with decision-making impairment, but not working memory and executive function impairment, among first-episode patients with a schizophrenia-spectrum psychosis. Further studies are needed to examine the direction of causality of this impairment; that is, does the impairment make the patients abuse cannabis, or does cannabis abuse cause the impairment? SN - 0033-2917 UR - https://www.unboundmedicine.com/medline/citation/18005495/Cannabis_abuse_is_associated_with_decision_making_impairment_among_first_episode_patients_with_schizophrenia_spectrum_psychosis_ L2 - https://www.cambridge.org/core/product/identifier/S0033291707002218/type/journal_article DB - PRIME DP - Unbound Medicine ER -