Medication adherence mediates the impact of sustained cannabis use on symptom levels in first-episode psychosis
Schizophrenia Research, 08/21/2012
Faridi K et al. – First episode psychosis (FEP) patients with an active cannabis use disorder may make a choice of either stopping cannabis and not taking medications or continuing cannabis but becoming more adherent to medications, adherence to medication appears to help both groups but continuous users remain at higher risk of poor symptom outcome even while on medication.Methods
- From a consecutive patient cohort (N=192) with a DSM-IV diagnosis of a FEP, 62 patients who met DSM-IV criteria for a currently active cannabis abuse disorder were followed up for one year.
- Complete data on repeated measures of medication adherence, symptoms, and cannabis use were available for 48 of the 62 patients.
- Twenty-eight patients (58.7%) continued while 20 (41.2%) stopped cannabis use after entering treatment.
- While both groups were relatively non-adherent at six months, 25/28 (92%) of the former group became adherent compared to 8/20 (40%) of those who stopped cannabis use (p<.01).
- While there was no overall effect of continued cannabis use on symptom levels at 12months, after controlling for medication adherence patients with continuous cannabis use had significantly higher level of symptoms (F(1,30)=2.74, p=0.03).