Bidirectional relationships between cannabis use, anxiety and depressive symptoms in the mediation of the association with psychotic experience: further support for an affective pathway to psychosis.

Autor:	Radhakrishnan R; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA., Pries LK; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands., Erzin G; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.; Department of Psychiatry, Ankara Diskapi Training and Research Hospital, Ankara, Turkey., Ten Have M; Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands., de Graaf R; Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands., van Dorsselaer S; Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands., Gunther N; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands., Bak M; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands., Rutten BPF; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands., van Os J; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.; Department of Psychiatry, UMC Utrecht Brain Centre, University Medical Centre Utrecht, Utrecht, the Netherlands.; Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, UK., Guloksuz S; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, the Netherlands.
Jazyk:	angličtina
Zdroj:	Psychological medicine [Psychol Med] 2023 Sep; Vol. 53 (12), pp. 5551-5557. Date of Electronic Publication: 2022 Sep 12.
DOI:	10.1017/S0033291722002756
Abstrakt:	Background: Empirical evidence suggests that people use cannabis to ameliorate anxiety and depressive symptoms, yet cannabis also acutely worsens psychosis and affective symptoms. However, the temporal relationship between cannabis use, anxiety and depressive symptoms and psychotic experiences (PE) in longitudinal studies is unclear. This may be informed by examination of mutually mediating roles of cannabis, anxiety and depressive symptoms in the emergence of PE. Methods: Data were derived from the second longitudinal Netherlands Mental Health Survey and Incidence Study. Mediation analysis was performed to examine the relationship between cannabis use, anxiety/depressive symptoms and PE, using KHB logit in STATA while adjusting for age, sex and education status. Results: Cannabis use was found to mediate the relationship between preceding anxiety, depressive symptoms and later PE incidence, but the indirect contribution of cannabis use was small (for anxiety: % of total effect attributable to cannabis use = 1.00%; for depression: % of total effect attributable to cannabis use = 1.4%). Interestingly, anxiety and depressive symptoms were found to mediate the relationship between preceding cannabis use and later PE incidence to a greater degree (% of total effect attributable to anxiety = 17%; % of total effect attributable to depression = 37%). Conclusion: This first longitudinal cohort study examining the mediational relationship between cannabis use, anxiety/depressive symptoms and PE, shows that there is a bidirectional relationship between cannabis use, anxiety/depressive symptoms and PE. However, the contribution of anxiety/depressive symptoms as a mediator was greater than that of cannabis.
Databáze:	MEDLINE
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