Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-21T19:59:51.645Z Has data issue: false hasContentIssue false
  • English
  • Français

Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia

Published online by Cambridge University Press:  06 November 2009

P. A. Ringen ,
A. Vaskinn ,
K. Sundet ,
J. A. Engh ,
H. Jónsdóttir ,
C. Simonsen ,
S. Friis ,
S. Opjordsmoen ,
I. Melle  and
O. A. Andreassen
P. A. Ringen
Affiliation:
Institute of Psychiatry, University of Oslo, N-0318 Oslo, Norway Oslo University Hospital – Aker, Clinic for Mental Health, N-0514 Oslo, Norway
A. Vaskinn
Affiliation:
Oslo University Hospital – Aker, Clinic for Mental Health, N-0514 Oslo, Norway
K. Sundet
Affiliation:
Institute of Psychology, University of Oslo, N-0317 Oslo, Norway
J. A. Engh
Affiliation:
Institute of Psychiatry, University of Oslo, N-0318 Oslo, Norway Oslo University Hospital – Ulleval, Division of Psychiatry, N-0407 Oslo, Norway
H. Jónsdóttir
Affiliation:
Institute of Psychiatry, University of Oslo, N-0318 Oslo, Norway Oslo University Hospital – Ulleval, Division of Psychiatry, N-0407 Oslo, Norway
C. Simonsen
Affiliation:
Institute of Psychology, University of Oslo, N-0317 Oslo, Norway Oslo University Hospital – Ulleval, Division of Psychiatry, N-0407 Oslo, Norway
S. Friis
Affiliation:
Institute of Psychiatry, University of Oslo, N-0318 Oslo, Norway Oslo University Hospital – Ulleval, Division of Psychiatry, N-0407 Oslo, Norway
S. Opjordsmoen
Affiliation:
Institute of Psychiatry, University of Oslo, N-0318 Oslo, Norway Oslo University Hospital – Ulleval, Division of Psychiatry, N-0407 Oslo, Norway
I. Melle
Affiliation:
Institute of Psychiatry, University of Oslo, N-0318 Oslo, Norway Oslo University Hospital – Ulleval, Division of Psychiatry, N-0407 Oslo, Norway
O. A. Andreassen*
Affiliation:
Institute of Psychiatry, University of Oslo, N-0318 Oslo, Norway Oslo University Hospital – Ulleval, Division of Psychiatry, N-0407 Oslo, Norway
*
*Address for correspondence: O. A. Andreassen, Psychosis Research Section – TOP, Building 49, Department of Psychiatry, Oslo University Hospital – Ulleval, Kirkeveien 166, N-0407 Oslo, Norway. (Email: o.a.andreassen@medisin.uio.no)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cannabis use is associated with altered neurocognitive functioning in severe mental disorders, but data are still inconclusive and there are no studies of bipolar disorder. The aim of this study was to investigate the association between cannabis use and neurocognition in bipolar disorder compared with schizophrenia in a naturalistic setting.

Method

A total of 133 patients with bipolar disorder and 140 patients with schizophrenia underwent neuropsychological assessments and clinical characterization including measures of substance use. Relationships between cannabis users and neurocognitive function were explored in the two diagnostic groups. Possible interactions between diagnosis and cannabis use were investigated, and findings were controlled for possible confounders.

Results

In bipolar disorder subjects, cannabis use was associated with better neurocognitive function, but the opposite was the case for the schizophrenia subjects. There was a statistically significant interaction effect of diagnosis and cannabis use on focused attention (p=0.019), executive functioning (verbal fluency – set shifting) (p=0.009), logical memory-learning (p=0.007) and on logical memory-recall (p=0.004). These differences in neurocognitive function could not be explained by putative confounders.

Conclusions

The findings suggest that cannabis use may be related to improved neurocognition in bipolar disorder and compromised neurocognition in schizophrenia. The results need to be replicated in independent samples, and may suggest different underlying disease mechanisms in the two disorders.

Keywords

Bipolar disordercannabisneurocognitionschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 8 , August 2010 , pp. 1337 - 1347
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, revised. American Psychological Association: Washington, DC.Google Scholar
Brill, N, Reichenberg, A, Rabinowitz, J, Harary, E, Lubin, G, Davidson, M, Weiser, M (2007). Accuracy of self-reported premorbid functioning in schizophrenia. Schizophrenia Research 97, 103–108.CrossRefGoogle ScholarPubMed
Cahill, CM, Malhi, GS, Ivanovski, B, Lagopoulos, J, Cohen, M (2006). Cognitive compromise in bipolar disorder with chronic cannabis use: cause or consequence? Expert Review of Neurotherapeutics 6, 591–598.CrossRefGoogle ScholarPubMed
Cannon-Spoor, HE, Potkin, SG, Wyatt, RJ (1982). Measurement of premorbid adjustment in chronic schizophrenia. Schizophrenia Bulletin 8, 470–484.CrossRefGoogle ScholarPubMed
Carey, KB, Carey, MP, Simons, JS (2003). Correlates of substance use disorder among psychiatric outpatients: focus on cognition, social role functioning, and psychiatric status. Journal of Nervous and Mental Disease 191, 300–308.CrossRefGoogle ScholarPubMed
Cerullo, MA, Strakowski, SM (2007). The prevalence and significance of substance use disorders in bipolar type I and II disorder. Substance Abuse Treatment, Prevention, and Policy 2, 29.CrossRefGoogle ScholarPubMed
Coulston, CM, Perdices, M, Tennant, CC (2007 a). The neuropsychological correlates of cannabis use in schizophrenia: lifetime abuse/dependence, frequency of use, and recency of use. Schizophrenia Research 96, 169–184.CrossRefGoogle ScholarPubMed
Coulston, CM, Perdices, M, Tennant, CC (2007 b). The neuropsychology of cannabis and other substance use in schizophrenia: review of the literature and critical evaluation of methodological issues. Australian and New Zealand Journal of Psychiatry 41, 869–884.CrossRefGoogle ScholarPubMed
Craddock, N, O'Donovan, MC, Owen, MJ (2006). Genes for schizophrenia and bipolar disorder? Implications for psychiatric nosology. Schizophrenia Bulletin 32, 9–16.CrossRefGoogle ScholarPubMed
Craddock, N, Owen, MJ (2007). Rethinking psychosis: the disadvantages of a dichotomous classification now outweigh the advantages. World Psychiatry 6, 84–91.Google ScholarPubMed
Crow, TJ (1986). The continuum of psychosis and its implication for the structure of the gene. British Journal of Psychiatry 149, 419–429.CrossRefGoogle ScholarPubMed
Crow, TJ (2008). The ‘big bang’ theory of the origin of psychosis and the faculty of language. Schizophrenia Research 102, 31–52.CrossRefGoogle ScholarPubMed
D'Souza, DC, Abi-Saab, WM, Madonick, S, Forselius-Bielen, K, Doersch, A, Braley, G, Gueorguieva, R, Cooper, TB, Krystal, JH (2005). Δ9-Tetrahydrocannabinol effects in schizophrenia: implications for cognition, psychosis, and addiction. Biological Psychiatry 57, 594–608.CrossRefGoogle ScholarPubMed
Daban, C, Martinez-Aran, A, Torrent, C, Tabares-Seisdedos, R, Balanza-Martinez, V, Salazar-Fraile, J, Selva-Vera, G, Vieta, E (2006). Specificity of cognitive deficits in bipolar disorder versus schizophrenia. A systematic review. Psychotherapy and Psychosomatics 75, 72–84.CrossRefGoogle ScholarPubMed
Delis, D, Kaplan, E, Kramer, JK (2005). The Delis–Kaplan Executive Function System (D-KEFS). Norwegian Manual Supplement. Pearson Assessment: Stockholm.Google Scholar
Delis, D, Kramer, JH, Kaplan, E, Ober, BA (2004). California Verbal Learning Test, 2nd edn (CVLT-II). Norwegian Manual Supplement. Pearson Assessment: Stockholm.Google Scholar
Eysenck, MW, Derakshan, N, Santos, R, Calvo, MG (2007). Anxiety and cognitive performance: attentional control theory. Emotion 7, 336–353.CrossRefGoogle ScholarPubMed
Gottesman, II, Gould, TD (2003). The endophenotype concept in psychiatry: etymology and strategic intentions. American Journal of Psychiatry 160, 636–645.CrossRefGoogle ScholarPubMed
Green, B, Young, R, Kavanagh, D (2005). Cannabis use and misuse prevalence among people with psychosis. British Journal of Psychiatry 187, 306–313.CrossRefGoogle ScholarPubMed
Henquet, C, Krabbendam, L, de Graaf, R, ten Have, M, van Os, J (2006). Cannabis use and expression of mania in the general population. Journal of Affective Disorders 95, 103–110.CrossRefGoogle ScholarPubMed
Herman, M (2004). Neurocognitive functioning and quality of life among dually diagnosed and non-substance abusing schizophrenia inpatients. International Journal of Mental Health Nursing 13, 282–291.CrossRefGoogle ScholarPubMed
Hugdahl, K, Rund, BR, Lund, A, Asbjornsen, A, Egeland, J, Ersland, L, Landro, NI, Roness, A, Stordal, KI, Sundet, K, Thomsen, T (2004). Brain activation measured with fMRI during a mental arithmetic task in schizophrenia and major depression. American Journal of Psychiatry 161, 286–293.CrossRefGoogle ScholarPubMed
Ilan, AB, Smith, ME, Gevins, A (2004). Effects of marijuana on neurophysiological signals of working and episodic memory. Psychopharmacology (Berlin) 176, 214–222.CrossRefGoogle ScholarPubMed
Ivleva, E, Thaker, G, Tamminga, CA (2008). Comparing genes and phenomenology in the major psychoses: schizophrenia and bipolar 1 disorder. Schizophrenia Bulletin 34, 734–742.CrossRefGoogle ScholarPubMed
Joyal, CC, Halle, P, Lapierre, D, Hodgins, S (2003). Drug abuse and/or dependence and better neuropsychological performance in patients with schizophrenia. Schizophrenia Research 63, 297–299.CrossRefGoogle ScholarPubMed
Kavanagh, DJ, Waghorn, G, Jenner, L, Chant, DC, Carr, V, Evans, M, Hemnan, H, Jablensky, A, McGrath, JJ (2004). Demographic and clinical correlates of comorbid substance use disorders in psychosis: multivariate analyses from an epidemiological sample. Schizophrenia Research 66, 115–124.CrossRefGoogle ScholarPubMed
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.CrossRefGoogle ScholarPubMed
Keefe, RS, Bilder, RM, Harvey, PD, Davis, SM, Palmer, BW, Gold, JM, Meltzer, HY, Green, MF, Miller, DD, Canive, JM, Adler, LW, Manschreck, TC, Swartz, M, Rosenheck, R, Perkins, DO, Walker, TM, Stroup, TS, McEvoy, JP, Lieberman, JA (2006). Baseline neurocognitive deficits in the CATIE schizophrenia trial. Neuropsychopharmacology 31, 2033–2046.CrossRefGoogle ScholarPubMed
Larsen, TK, Friis, S, Haahr, U, Johannessen, JO, Melle, I, Opjordsmoen, S, Rund, BR, Simonsen, E, Vaglum, PV, McGlashan, TH (2004). Premorbid adjustment in first-episode non-affective psychosis: distinct patterns of pre-onset course. British Journal of Psychiatry 185, 108–115.CrossRefGoogle ScholarPubMed
Liraud, F, Verdoux, H (2002). Effect of comorbid substance use on neuropsychological performance in subjects with psychotic or mood disorders. Encephale 28, 160–168.Google ScholarPubMed
Martinez-Aran, A, Vieta, E, Torrent, C, Sanchez-Moreno, J, Goikolea, JM, Salamero, M, Malhi, GS, Gonzalez-Pinto, A, Daban, C, Varez-Grandi, S, Fountoulakis, K, Kaprinis, G, Tabares-Seisdedos, R, Yuso-Mateos, JL (2007). Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disorders 9, 103–113.CrossRefGoogle ScholarPubMed
Moore, TH, Zammit, S, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370, 319–328.CrossRefGoogle ScholarPubMed
Morgan, CJ, Curran, HV (2008). Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis. British Journal of Psychiatry 192, 306–307.CrossRefGoogle ScholarPubMed
Murray, RM, Morrison, PD, Henquet, C, Di Forti, M (2007). Cannabis, the mind and society: the hash realities. Nature Reviews. Neuroscience 8, 885–895.Google Scholar
O'Donovan, MC, Craddock, N, Norton, N, Williams, H, Peirce, T, Moskvina, V, Nikolov, I, Hamshere, M, Carroll, L, Georgieva, L, Dwyer, S, Holmans, P, Marchini, JL, Spencer, CCA, Howie, B, Leung, HT, Hartmann, AM, Moller, HJ, Morris, DW, Shi, Y, Feng, G, Hoffmann, P, Propping, P, Vasilescu, C, Maier, W, Rietschel, M, Zammit, S, Schumacher, J, Quinn, EM, Schulze, TG, Williams, NM, Giegling, I, Iwata, N, Ikeda, M, Darvasi, A, Shifman, S, He, L, Duan, J, Sanders, AR, Levinson, DF, Gejman, PV, Cichon, S, Nothen, MM, Gill, M, Corvin, A, Rujescu, D, Kirov, G, Owen, MJ (2008). Identification of loci associated with schizophrenia by genome-wide association and follow-up. Nature Genetics 40, 1053–1055.CrossRefGoogle ScholarPubMed
Pedersen, G, Hagtvet, KA, Karterud, S (2007). Generalizability studies of the Global Assessment of Functioning-Split version. Comprehensive Psychiatry 48, 88–94.CrossRefGoogle ScholarPubMed
Potvin, S, Joyal, CC, Pelletier, J, Stip, E (2008). Contradictory cognitive capacities among substance-abusing patients with schizophrenia: a meta-analysis. Schizophrenia Research 100, 242–251.CrossRefGoogle ScholarPubMed
Ranganathan, M, D'Souza, DC (2006). The acute effects of cannabinoids on memory in humans: a review. Psychopharmacology (Berlin) 188, 425–444.CrossRefGoogle ScholarPubMed
Ringen, PA, Melle, I, Birkenæs, AB, Engh, JA, Færden, A, Jönsdóttir, H, Nesvåg, R, Vaskinn, A, Friis, S, Larsen, F, Opjordsmoen, S, Sundet, K, Andreassen, OA (2007). Illicit drug use in patients with psychotic disorders compared with that in the general population: a cross-sectional study. Acta Psychiatrica Scandinavica 117, 133–138.CrossRefGoogle ScholarPubMed
Sevy, S, Burdick, KE, Visweswaraiah, H, Abdelmessih, S, Lukin, M, Yechiam, E, Bechara, A (2007). Iowa gambling task in schizophrenia: a review and new data in patients with schizophrenia and co-occurring cannabis use disorders. Schizophrenia Research 92, 74–84.CrossRefGoogle ScholarPubMed
Simon, NM, Otto, MW, Wisniewski, SR, Fossey, M, Sagduyu, K, Frank, E, Sachs, GS, Nierenberg, AA, Thase, ME, Pollack, MH (2004). Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). American Journal of Psychiatry 161, 2222–2229.CrossRefGoogle ScholarPubMed
Simonsen, C, Sundet, K, Vaskinn, A, Birkenaes, AB, Engh, JA, Faerden, A, Jonsdottir, H, Ringen, PA, Opjordsmoen, S, Melle, I, Friis, S, Andreassen, OA (2009). Neurocognitive dysfunction in bipolar and schizophrenia spectrum disorders depends on history of psychosis rather than diagnostic group. Schizophrenia Bulletin. Published online: 14 May 2009. doi:10.1093/schbul/sbp034.CrossRefGoogle Scholar
Simonsen, C, Sundet, K, Vaskinn, A, Birkenaes, AB, Engh, JA, Hansen, CF, Jonsdottir, H, Ringen, PA, Opjordsmoen, S, Friis, S, Andreassen, OA (2008). Neurocognitive profiles in bipolar I and bipolar II disorder: differences in pattern and magnitude of dysfunction. Bipolar Disorders 10, 245–255.CrossRefGoogle ScholarPubMed
Snyder, SH (1973). Amphetamine psychosis: a ‘model’ schizophrenia mediated by catecholamines. American Journal of Psychiatry 130, 61–67.CrossRefGoogle Scholar
Thoma, P, Wiebel, B, Daum, I (2007). Response inhibition and cognitive flexibility in schizophrenia with and without comorbid substance use disorder. Schizophrenia Research 92, 168–180.CrossRefGoogle ScholarPubMed
Turner, DC, Clark, L, Pomarol-Clotet, E, McKenna, P, Robbins, TW, Sahakian, BJ (2004). Modafinil improves cognition and attentional set shifting in patients with chronic schizophrenia. Neuropsychopharmacology 29, 1363–1373.CrossRefGoogle ScholarPubMed
van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder. Psychological Medicine 39, 179–195.CrossRefGoogle ScholarPubMed
Vaskinn, A, Sundet, K (2001). Estimating pre-morbid IQ: a Norwegian version of National Adult Reading Test. Journal of the Norwegian Psychological Association 38, 1133–1140.Google Scholar
Ventura, J, Liberman, RP, Green, MF, Shaner, A, Mintz, J (1998). Training and quality assurance with the Structured Clinical Interview for DSM-IV (SCID-I/P). Psychiatry Research 79, 163–173.CrossRefGoogle ScholarPubMed
Wechsler, D (2003). Wechsler Adult Intelligence Scale, 3rd edn (WAIS-III). Norwegian Manual Supplement. Pearson Assessment: Stockholm.Google Scholar
Wechsler, D (2007). Wechsler Abbreviated Scale of Intelligence (WASI), Norwegian Manual Supplement. Pearson Assessment: Stockholm.Google Scholar
Wechsler, D (2008). Wechsler Memory Scale (WMS-III). Norwegian Manual Supplement. Pearson Assessment: Stockholm.Google Scholar
Weiss, RD, Najavits, LM, Greenfield, SF, Soto, JA, Shaw, SR, Wyner, D (1998). Validity of substance use self-reports in dually diagnosed outpatients. American Journal of Psychiatry 155, 127–128.CrossRefGoogle ScholarPubMed
Wobrock, T, Sittinger, H, Behrendt, B, D'Amelio, R, Falkai, P, Caspari, D (2007). Comorbid substance abuse and neurocognitive function in recent-onset schizophrenia. European Archives of Psychiatry and Clinical Neuroscience 257, 203–210.CrossRefGoogle ScholarPubMed