TY - JOUR
T1 - Bidirectional relationships between cannabis use, anxiety and depressive symptoms in the mediation of the association with psychotic experience
T2 - further support for an affective pathway to psychosis
AU - Radhakrishnan, Rajiv
AU - Pries, Lotta-Katrin
AU - Erzin, Gamze
AU - Ten Have, Margreet
AU - de Graaf, Ron
AU - van Dorsselaer, Saskia
AU - Gunther, Nicole
AU - Bak, Maarten
AU - Rutten, Bart P F
AU - van Os, Jim
AU - Guloksuz, Sinan
N1 - Funding Information:
Rajiv Radhakrishnan, Sinan Guloksuz, Lotta-Katrin Pries, Saskia van Dorsselaer, Margreet ten Have, Ron de Graaf, Jim van Os, and Maarten Bak do not have any conflicts of interest and have received no funding or compensation from companies. Rajiv Radhakrishnan is supported by Dana Foundation David Mahoney program, NIMH (grants R21 MH115316-02 and R21 MH123870-01A1), CTSA Grant Number UL1 TR001863 from the National Center for Advancing Translational Science, components of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official view of NIH.
Funding Information:
This work was supported by the Ministry of Health, Welfare and Sport (Grant Number 310253), with supplement support from the Netherlands Organization for Health Research and Development (ZonMw) and the Genetic Risk and Outcome of Psychosis investigators. Lotta Pries is supported by the Kootstra Talent Fellowship of Maastricht University. Jim van Os and Sinan Guloksuz are supported by the Ophelia research project, ZonMw grant number: 636340001. Bart Rutten is supported by a VIDI award, grant number 91718336 from the Netherlands Scientific Organisation.
Publisher Copyright:
© The Author(s), 2022. Published by Cambridge University Press.
PY - 2023/9/12
Y1 - 2023/9/12
N2 - 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.
AB - 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.
KW - Affective dysregulation
KW - bidirectional relationship
KW - cannabis
KW - environment
KW - longitudinal cohort
KW - mediation analysis
KW - population survey
KW - psychosis
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=85159789962&partnerID=8YFLogxK
U2 - 10.1017/S0033291722002756
DO - 10.1017/S0033291722002756
M3 - Article
C2 - 36093677
SN - 0033-2917
VL - 53
SP - 5551
EP - 5557
JO - Psychological medicine
JF - Psychological medicine
IS - 12
ER -