Do cannabis and urbanicity co-participate in causing psychosis? Evidence from a 10-year follow-up cohort study.

Abstract:

BACKGROUND:Cannabis use is considered a component cause of psychotic illness, interacting with genetic and other environmental risk factors. Little is known, however, about these putative interactions. The present study investigated whether an urban environment plays a role in moderating the effects of adolescent cannabis use on psychosis risk. METHOD:Prospective data (n=1923, aged 14-24 years at baseline) from the longitudinal population-based German Early Developmental Stages of Psychopathology cohort study were analysed. Urbanicity was assessed at baseline and defined as living in the city of Munich (1562 persons per km2; 4061 individuals per square mile) or in the rural surroundings (213 persons per km2; 553 individuals per square mile). Cannabis use and psychotic symptoms were assessed three times over a 10-year follow-up period using the Munich version of the Composite International Diagnostic Interview. RESULTS:Analyses revealed a significant interaction between cannabis and urbanicity [10.9% adjusted difference in risk, 95% confidence interval (CI) 3.2-18.6, p=0.005]. The effect of cannabis use on follow-up incident psychotic symptoms was much stronger in individuals who grew up in an urban environment (adjusted risk difference 6.8%, 95% CI 1.0-12.5, p=0.021) compared with individuals from rural surroundings (adjusted risk difference -4.1%, 95% CI -9.8 to 1.6, p=0.159). The statistical interaction was compatible with substantial underlying biological synergism. CONCLUSIONS:Exposure to environmental influences associated with urban upbringing may increase vulnerability to the psychotomimetic effects of cannabis use later in life.

journal_name

Psychol Med

journal_title

Psychological medicine

authors

Kuepper R,van Os J,Lieb R,Wittchen HU,Henquet C

doi

10.1017/S0033291711000511

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

2121-9

issue

10

eissn

0033-2917

issn

1469-8978

pii

S0033291711000511

journal_volume

41

pub_type

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