Premorbid social adjustment is better in cannabis-using than non-using psychotic patients across Europe

Abstract

Introduction A number of authors have hypothesized that psychotic patients who consume cannabis constitute a differentiated subgroup of patients that have better cognitive and social skills, necessary to engage inillegal drug consumption, than non-using patients. Objectives Given that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to study First Episode Psychosis (FEP) cannabis-using and non-using patients coming from different European countries as part of the EUGEI-STUDY. Aims We tested the hypothesis of better premorbid social adjustment in cannabis using FEP patients, by comparing them to FEP non cannabis users and to their respective healthy controls. Methods 1.745 people (746 cases; 999 controls) completed the assessment for premorbid adjustment (Premorbid Adjustment Scale – PAS) and cannabis use (CEQ-Revised). We first extracted the Premorbid Social Adjustment Factor (PSA) from PAS and then performedlinear mixed models with PSA as dependent variable and cannabis lifetime (Yes/No) and subject status (Cases/Controls) as independent variables. We then considered “Country” as random intercept. Results Across all countries, PSA scores were better in patients who had smoked cannabis in their lifetime than patients who had not (p=0.009). The difference in PSA score between cannabis users and non users was significantly greater in cases than controls (p=0.038). The relationship between PSA, cannabis lifetime (Yes/No) and subject status among nations (random intercept) is shown in Figure 1. Conclusions Cannabis-using psychotic patients show better premorbid social adjustment than non-using patients, across 5 European countries.