Poster #M178: White matter integrity in treatment-refractory schizophrenia: a diffusion tensor imaging study
Poster #M178: White matter integrity in treatment-refractory schizophrenia: a diffusion tensor imaging study
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海报
DOI：
10.1038/npjschz.2016.8
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Stefan Leucht
中科院分区：
文献类型：
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作者：
Maximilian Huhn;Claudia Leucht;Markus Dold;Philipp Rothe;Stefan Heres;Stefan Leucht
背景几项研究报道，使用大麻的精神病患者比未使用大麻的患者有更好的认知表现（Rabin et al. 2011）。在之前的一项研究中，我们发现在一生中吸食大麻的精神病患者中有更高的病前智商和更好的智商，我们的研究结果与这种关联是由于更好的病前功能而不是大麻使用对认知表现的改善作用的想法一致（Ferraro等人，2013年）。许多作者假设，消费大麻的精神病患者构成了一个分化的患者亚组，其具有比不使用大麻的患者更好的认知和社交技能，这是从事非法药物消费所必需的（Compton等人，2011; Løberg等人，2014; Arnold等人，2015年）。考虑到大麻使用的流行率和模式是由文化驱动的，我们想检验来自不同欧洲国家的首次发作精神病（FEP）大麻使用和不使用患者的发病前功能更好的假设。（英国、意大利、西班牙、法国、荷兰）作为EUGEI研究的一部分。（746例; 999例对照）完成了智商（WAIS简易版）、病前适应量表（PAS）和大麻使用（CEQ修订版）的评估。首先，我们对PAS成分进行了因素分析，获得了两个主要因素：“病前社会适应”（PSA）和“病前学业适应”（PAA）。因此，我们进行了线性混合模型与智商，PSA和PAA作为因变量和大麻的寿命（是/否），受试者的状态（病例/对照），性别和年龄作为自变量。ResultsAcross all countries，智商较高的患者谁吸烟大麻在他们的一生相比，那些没有（P= 0.027）。这种智商差异仅为3分，病例组和健康对照组相同（P= 0.949）。同样，一生中吸食大麻的患者比非使用者表现出更好的PSA评分（P= 0.009）。大麻使用者和非使用者之间PSA评分的差异在病例中显著大于对照组（P= 0.038）。相反，在所有国家中，PAA在终生吸食大麻的患者中的结果最差（Po 0. 001)在5个不同的欧洲国家，我们的大麻使用FEP的患者比非使用者患者具有更高的智商、更好的PSA和更低的PAA。从这些初步结果开始，我们可以得出结论，更好的PSA与FEP患者使用大麻显著相关。然而，在探索性分析中，更好的IQ与更好的PAA相关（o 0. 001)但与PSA无关（P= 0.260）;因此表明智商和PSA与大麻使用之间存在独立关系。需要进一步的分析，以模拟这些多元关系。
BackgroundSeveral studies report that patients with psychosis who used cannabis have a better cognitive performance than those whodid not (Rabin et al. 2011). In a previous study we found out a higher premorbid IQ, and a better IQ in psychotic patients who smoked cannabis in their lifetime, and our findings were consistent with the idea that this association is due to a better premorbid functioning rather than to an ameliorative effect of cannabis use on cognitive performance (Ferraro et al., 2013). 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 in illegal drug consumption, than non-using patients (Compton et al., 2011; Løberg et al., 2014; Arnold et al., 2015). Given that the prevalence, and patterns, of cannabis use are culturally driven, we wanted to test the hypothesis of a better premorbid functioning in First Episode Psychosis (FEP) cannabis-using and non-using patients coming from different European countries (England, Italy, Spain, France, the Netherlands) as part of the EUGEI-STUDY.Methods1.745 people (746 cases; 999 controls) completed the assessment for Intellectual Quotient (IQ)(WAIS-brief version) premorbid adjustment (Premorbid Adjustment Scale–PAS) and cannabis use (CEQ-Revised). We first performed a factor analysis on PAS components, by obtaining two main factors:“Premorbid Social Adjustment”(PSA) and “Premorbid Academic Adjustment”(PAA). We therefore performed linear mixed models with IQ, PSA, and PAA as dependent variables and cannabis lifetime (Yes/No), subject status (Cases/Controls), gender and age as independent variables.ResultsAcross all countries, IQ was higher in those patients who smoked cannabis in their lifetime compared to those who did not (P= 0.027). This IQ difference was only 3 points and was the same for cases and healthy controls (P= 0.949). Similarly, patients who had smoked cannabis in their lifetime showed better PSA scores than non users (P= 0.009). The difference in PSA score between cannabis-users and non-users was significantly greater in cases than controls (P= 0.038). Conversely, across all countries, PAA resulted worst in patients who smoked cannabis lifetime than patients who did not (Po0. 001) and this PAA score difference was the same for cases and controls (P= 0.693).DiscussionOur cannabis-using FEP patients have higher IQ, better PSA and lower PAA than non user patients across 5 different European countries. Starting from these preliminary results, we can conclude that a better PSA is significantly associated with cannabis use in FEP patients. Nevertheless, in an exploratory analysis, a better IQ resulted related to a better PAA (o0. 001) but not to PSA (P= 0.260); thus indicating an independent relationship of IQ and PSA with cannabis use. Further analysis are required in order to model these multivariate relationships.