Differential effects of childhood trauma and cannabis use disorders in ă patients suffering from schizophrenia
Résumé
Background: Childhood trauma (CT) and cannabis use are both ă environmental and modifier risk factors for schizophrenia. However, ă little is known about how they interact in schizophrenia. We examined ă the main effect of each of these two environmental factors on the ă clinical expression of the disease using a large set of variables, and ă we tested whether and how cannabis and CT interact to influence the ă course and the presentation of the illness. ă Methods: A sample of 366 patients who met the DSM-IV-TR criteria for ă schizophrenia was recruited through the FACE-SCZ (Fondamental Advanced ă Centre of Expertise - Schizophrenia) network. Patients completed a large ă standardized clinical evaluation including Structured Clinical Interview ă for DSM Disorders-I (SCID-I), Positive and Negative Symptoms Scale ă (PANSS), Columbia-Suicide Severity Rating Scale (C-SSRS), Global ă Assessment of Functioning (GAF), Short-Quality of Life-18 (S-QoL-18), ă and Medication Adherence Rating Scale (MARS). We assessed CT with the ă Childhood Trauma Questionnaire and cannabis status with SCID-I. ă Results: CT significantly predicted the number of hospitalizations, GAF, ă and S-QoL-18 scores, as well as the PANSS total, positive, excitement, ă and emotional distress scores. Cannabis use disorders significantly ă predicted age of onset, and MARS. There was no significant interaction ă between CT and cannabis use disorders. However, we found evidence of a ă correlation between these two risk factors. ă Conclusions: CT and cannabis both have differential deleterious effects ă on clinical and functional outcomes in patients with schizophrenia. Our ă results highlight the need to systematically assess the presence of ă these risk factors and adopt suitable therapeutic interventions. (C) ă 2016 Elsevier B.V. All rights reserved.