Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-06-09T03:24:21.370Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive functioning associated with stimulant use in patients with non-affective psychosis, their unaffected siblings and healthy controls

Published online by Cambridge University Press:  22 November 2013

F. J. van der Meer ,
J. H. Meijer ,
C. J. Meijer ,
W. van den Brink  and
E. Velthorst
F. J. van der Meer
Affiliation:
Department of Early Psychosis, Academic Medical Center, Amsterdam, The Netherlands
J. H. Meijer
Affiliation:
Department of Early Psychosis, Academic Medical Center, Amsterdam, The Netherlands
C. J. Meijer
Affiliation:
Department of Early Psychosis, Academic Medical Center, Amsterdam, The Netherlands
W. van den Brink
Affiliation:
Department of Early Psychosis, Academic Medical Center, Amsterdam, The Netherlands
E. Velthorst
Affiliation:
Department of Early Psychosis, Academic Medical Center, Amsterdam, The Netherlands
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Little is known about the effect of stimulant use (amphetamines, cocaine, ecstasy) on cognitive functioning in schizophrenia patients. The current study examined (1) whether recency and frequency of stimulant use is associated with cognitive functioning and (2) whether these associations differ between psychotic patients, their unaffected siblings and controls.

Method

Participants completed a comprehensive cognitive test battery. Stimulant use was assessed by urinalysis and by the Composite International Diagnostic Interview (CIDI). Using random effects regression models, the main effects of Stimulant Use and the interaction with Diagnostic Status on cognitive functioning were assessed.

Results

The interaction term between Stimulant Use and Diagnostic Status was not significant for any of the cognitive outcome variables, indicating similar effects of stimulant use in all three groups. Recent stimulant users showed more errors deficit in verbal learning in comparison to never users (Cohen's d = −0.60, p < 0.005). Lifetime frequent stimulant use was significantly associated with worse immediate and delayed verbal recall, working memory and acquired knowledge (Cohen's d = −0.22 to −0.29, p < 0.005). Lifetime infrequent stimulant use was not associated with significant cognitive alterations in comparison to never use.

Conclusions

The presence of cognitive deficits associated with lifetime stimulant use is dependent on the frequency of use, with no observed deficits in infrequent users and modest negative effects in frequent users.

Keywords

Amphetaminescocainecognitionecstasyfamily studiesschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 9 , July 2014 , pp. 1901 - 1911
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, NC, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615–623.Google Scholar
APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR). American Psychiatric Association: Washington, DC.Google Scholar
Barch, DM, Carter, CS (2005). Amphetamine improves cognitive function in medicated individuals with schizophrenia and in healthy volunteers. Schizophrenia Research 77, 43–58.Google Scholar
Barnett, JH, Werners, U, Secher, SM, Hill, KE, Brazil, R, Masson, K, Pernet, DE, Kirkbride, JB, Murray, GK, Bullmore, ET, Jones, PB (2007). Substance use in a population-based clinic sample of people with first-episode psychosis. British Journal of Psychiatry 190, 515–520.CrossRefGoogle Scholar
Benton, AL, Sivan, AB, Hamsher, K, Varney, NR, Spreen, O (1983). Benton's Test of Facial Recognition. Oxford University Press: New York, NY.Google Scholar
Block, RI, Erwin, WJ, Ghoneim, MM (2002). Chronic drug use and cognitive impairments. Pharmacology, Biochemistry, and Behavior 73, 491–504.Google Scholar
Bolla, KI, Rothman, R, Cadet, JL (1999). Dose-related neurobehavioral effects of chronic cocaine use. Journal of Neuropsychiatry and Clinical Neurosciences 11, 361–369.Google Scholar
Brand, N, Jolles, J (1985). Learning and retrieval rate of words presented auditorily and visually. Journal of General Psychology 112, 201–210.Google Scholar
Buckley, PF (1998). Substance abuse in schizophrenia: a review. Journal of Clinical Psychiatry 59 (Suppl. 3), 26–30.Google Scholar
Chambers, RA, Krystal, JH, Self, DW (2001). A neurobiological basis for substance abuse comorbidity in schizophrenia. Biological Psychiatry 50, 71–83.Google Scholar
Charach, A, Yeung, E, Climans, T, Lillie, E (2011). Childhood attention-deficit/hyperactivity disorder and future substance use disorders: comparative meta-analyses. Journal of the American Academy of Child and Adolescent Psychiatry 50, 9–21.Google Scholar
Cooper, L, Liberman, D, Tucker, D, Nuechterlein, KH, Tsuang, J, Barnett, HL (1999). Neurocognitive deficits in the dually diagnosed with schizophrenia and cocaine abuse. Psychiatric Rehabilitation Skills 3, 231–245.Google Scholar
Copersino, ML, Serper, MR, Vadhan, N, Goldberg, BR, Richarme, D, Chou, JC, Stitzer, M, Cancro, R (2004). Cocaine craving and attentional bias in cocaine-dependent schizophrenic patients. Psychiatry Research 128, 209–218.Google Scholar
Coulston, CM, Perdices, M, Tennant, CC (2007). The neuropsychology of cannabis and other substance use in schizophrenia: review of the literature and critical evaluation of methodological issues. Australian and New Zealand Journal of Psychiatry 41, 869–884.Google Scholar
Coyle, JT (2006). Substance use disorders and schizophrenia: a question of shared glutamatergic mechanisms. Neurotoxicity Research 10, 221–233.Google Scholar
Center for Substance Abuse Treatment (1999). Treatment Improvement Protocol (TIP) Series, No. 32 Rockville (MD): Substance Abuse and Mental Health Services Administration (US).Google Scholar
Curran, C, Byrappa, N, McBride, A (2004). Stimulant psychosis: systematic review. British Journal of Psychiatry 185, 196–204.Google Scholar
D'Souza, DC, Abi-Saab, WM, Madonick, S, Forselius-Bielen, K, Doersch, A, Braley, G, Gueorguieva, R, Cooper, TB, Krystal, JH (2005). Delta-9-tetrahydrocannabinol effects in schizophrenia: implications for cognition, psychosis, and addiction. Biological Psychiatry 57, 594–608.Google Scholar
Estroff, TW, Gold, MS (1985). Medical and psychiatric complications of cocaine abuse with possible points of pharmacological treatment. Advances in Alcohol and Substance Abuse 5, 61–76.CrossRefGoogle ScholarPubMed
Fernandez-Serrano, MJ, Perez-Garcia, M, Verdejo-Garcia, A (2011). What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance? Neuroscience and Biobehavioral Reviews 35, 377–406.Google Scholar
Fowler, IL, Carr, VJ, Carter, NT, Lewin, TJ (1998). Patterns of current and lifetime substance use in schizophrenia. Schizophrenia Bulletin 24, 443–455.Google Scholar
Gillen, RW, Kranzler, HR, Bauer, LO, Burleson, JA, Samarel, D, Morrison, DJ (1998). Neuropsychologic findings in cocaine-dependent outpatients. Progress in Neuro-Psychopharmacology and Biological Psychiatry 22, 1061–1076.Google Scholar
Goldberg, TE, Bigelow, LB, Weinberger, DR, Daniel, DG, Kleinman, JE (1991). Cognitive and behavioral effects of the coadministration of dextroamphetamine and haloperidol in schizophrenia. American Journal of Psychiatry 148, 78–84.Google Scholar
Green, B, Young, R, Kavanagh, D (2005). Cannabis use and misuse prevalence among people with psychosis. British Journal of Psychiatry 187, 306–313.Google Scholar
Henquet, C, Rosa, A, Krabbendam, L, Papiol, S, Fananas, L, Drukker, M, Ramaekers, JG, van Os, J (2006). An experimental study of catechol-O-methyltransferase Val158Met moderation of delta-9-tetrahydrocannabinol-induced effects on psychosis and cognition. Neuropsychopharmacology 31, 2748–2757.Google Scholar
Henquet, C, van Os, J, Kuepper, R, Delespaul, P, Smits, M, Campo, JA, Myin-Germeys, I (2010). Psychosis reactivity to cannabis use in daily life: an experience sampling study. British Journal of Psychiatry 196, 447–453.CrossRefGoogle ScholarPubMed
Janowsky, DS, Davis, JM (1976). Methylphenidate, dextroamphetamine, and levamfetamine. Effects on schizophrenic symptoms. Archives of General Psychiatry 33, 304–308.Google Scholar
Janowsky, DS, el-Yousel, MK, Davis, JM, Sekerke, HJ (1973). Provocation of schizophrenic symptoms by intravenous administration of methylphenidate. Archives of General Psychiatry 28, 185–191.Google Scholar
Joyal, CC, Halle, P, Lapierre, D, Hodgins, S (2003). Drug abuse and/or dependence and better neuropsychological performance in patients with schizophrenia. Schizophrenia Research 63, 297–299.Google Scholar
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.Google Scholar
Korver, N, Quee, PJ, Boos, HB, Simons, CJ, de Haan, L; GROUP Investigators (2012). Genetic Risk and Outcome of Psychosis (GROUP), a multi-site longitudinal cohort study focused on gene-environment interaction: objectives, sample characteristics, recruitment and assessment methods. International Journal of Methods in Psychiatric Research 21, 205–221.Google Scholar
Kraemer, T, Maurer, HH (2002). Toxicokinetics of amphetamines: metabolism and toxicokinetic data of designer drugs, amphetamine, methamphetamine, and their N-alkyl derivatives. Therapeutic Drug Monitoring 24, 277–289.CrossRefGoogle ScholarPubMed
Landabaso, MA, Iraurgi, I, Jimenez-Lerma, JM, Calle, R, Sanz, J, Gutierrez-Fraile, M (2002). Ecstasy-induced psychotic disorder: six-month follow-up study. European Addiction Research 8, 133–140.Google Scholar
Landry, MJ (2002). MDMA: a review of epidemiologic data. Journal of Psychoactive Drugs 34, 163–169.CrossRefGoogle ScholarPubMed
Linszen, DH, Dingemans, PM, Lenior, ME (1994). Cannabis abuse and the course of recent-onset schizophrenic disorders. Archives of General Psychiatry 51, 273–279.Google Scholar
Loberg, EM, Hugdahl, K (2009). Cannabis use and cognition in schizophrenia. Frontiers in Human Neuroscience 3, 53.Google Scholar
Meijer, J, Simons, CJ, Quee, PJ, Verweij, K; GROUP Investigators (2012). Cognitive alterations in patients with non-affective psychotic disorder and their unaffected siblings and parents. Acta Psychiatrica Scandinavica 125, 66–76.CrossRefGoogle ScholarPubMed
Mittenberg, W, Motta, S (1993). Effects of chronic cocaine abuse on memory and learning. Archives of Clinical Neuropsychology 8, 477–483.Google Scholar
Moore, TH, Zammit, S, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370, 319–328.CrossRefGoogle ScholarPubMed
Murray, RM, O'Callaghan, E, Castle, DJ, Lewis, SW (1992). A neurodevelopmental approach to the classification of schizophrenia. Schizophrenia Bulletin 18, 319–332.Google Scholar
Nolan, KA, Bilder, RM, Lachman, HM, Volavka, J (2004). Catechol O-methyltransferase Val158Met polymorphism in schizophrenia: differential effects of Val and Met alleles on cognitive stability and flexibility. American Journal of Psychiatry 161, 359–361.Google Scholar
Nuechterlein, KH, Dawson, ME (1984). Information processing and attentional functioning in the developmental course of schizophrenic disorders. Schizophrenia Bulletin 10, 160–203.Google Scholar
Pencer, A, Addington, J (2003). Substance use and cognition in early psychosis. Journal of Psychiatry and Neuroscience 28, 48–54.Google Scholar
Potvin, S, Briand, C, Prouteau, A, Bouchard, RH, Lipp, O, Lalonde, P, Nicole, L, Lesage, A, Stip, E (2005). CANTAB explicit memory is less impaired in addicted schizophrenia patients. Brain and Cognition 59, 38–42.Google Scholar
Potvin, S, Joyal, CC, Pelletier, J, Stip, E (2008). Contradictory cognitive capacities among substance-abusing patients with schizophrenia: a meta-analysis. Schizophrenia Research 100, 242–251.Google Scholar
Rabin, RA, Zakzanis, KK, Daskalakis, ZJ, George, TP (2013). Effects of cannabis use status on cognitive function, in males with schizophrenia. Psychiatry Research 206, 158–165.Google Scholar
Rabin, RA, Zakzanis, KK, George, TP (2011). The effects of cannabis use on neurocognition in schizophrenia: a meta-analysis. Schizophrenia Research 128, 111–116.Google Scholar
Richard, ML, Liskow, BI, Perry, PJ (1985). Recent psychostimulant use in hospitalized schizophrenics. Journal of Clinical Psychiatry 46, 79–83.Google Scholar
Schnell, T, Kleiman, A, Gouzoulis-Mayfrank, E, Daumann, J, Becker, B (2012). Increased gray matter density in patients with schizophrenia and cannabis use: a voxel-based morphometric study using DARTEL. Schizophrenia Research 138, 183–187.Google Scholar
Serper, MR, Copersino, ML, Richarme, D, Vadhan, N, Cancro, R (2000). Neurocognitive functioning in recently abstinent, cocaine-abusing schizophrenic patients. Journal of Substance Abuse 11, 205–213.Google Scholar
Sevy, S, Kay, SR, Opler, LA, van Praag, HM (1990). Significance of cocaine history in schizophrenia. Journal of Nervous and Mental Disease 178, 642–648.Google Scholar
Shaner, A, Khalsa, ME, Roberts, L, Wilkins, J, Anglin, D, Hsieh, SC (1993). Unrecognized cocaine use among schizophrenic patients. American Journal of Psychiatry 150, 758–762.Google Scholar
Smelson, DA, Davis, CW, Di Pano, R, Johnson, V, Losonczy, MF, Ziedonis, D (2002). Executive and motor skill functioning among cocaine-dependent schizophrenics and non-drug-abusing schizophrenics. Journal of Nervous and Mental Disease 190, 200–202.Google Scholar
Smelson, DA, Davis, CW, Eisenstein, N, Engelhart, C, Williams, J, Losonczy, MF, Ziedonis, D (2003). Cognitive disparity in schizophrenics with and without cocaine dependency. Journal of Substance Abuse Treatment 24, 75–79.CrossRefGoogle ScholarPubMed
Smith, MJ, Barch, DM, Wolf, TJ, Mamah, D, Csernansky, JG (2008). Elevated rates of substance use disorders in non-psychotic siblings of individuals with schizophrenia. Schizophrenia Research 106, 294–299.Google Scholar
Staack, RF, Maurer, HH (2005). Metabolism of designer drugs of abuse. Current Drug Metabolism 6, 259–274.Google Scholar
Stefanis, NC, Hanssen, M, Smirnis, NK, Avramopoulos, DA, Evdokimidis, IK, Stefanis, CN, Verdoux, H, van Os, J (2002). Evidence that three dimensions of psychosis have a distribution in the general population. Psychological Medicine 32, 347–358.Google Scholar
Swofford, CD, Scheller-Gilkey, G, Miller, AH, Woolwine, B, Mance, R (2000). Double jeopardy: schizophrenia and substance use. American Journal of Drug and Alcohol Abuse 26, 343–353.Google Scholar
Toomey, R, Lyons, MJ, Eisen, SA, Xian, H, Chantarujikapong, S, Seidman, LJ, Faraone, SV, Tsuang, MT (2003). A twin study of the neuropsychological consequences of stimulant abuse. Archives of General Psychiatry 60, 303–310.Google Scholar
van Dijk, D, Koeter, MW, Hijman, R, Kahn, RS, van den Brink, W (2012). Effect of cannabis use on the course of schizophrenia in male patients: a prospective cohort study. Schizophrenia Research 137, 50–57.Google Scholar
van Holst, RJ, Schilt, T (2011). Drug-related decrease in neuropsychological functions of abstinent drug users. Current Drug Abuse Reviews 4, 42–56.Google Scholar
van Os, J, Kenis, G, Rutten, BP (2010). The environment and schizophrenia. Nature 468, 203–212.Google Scholar
van 't Wout, M, Aleman, A, Kessels, RP, Laroi, F, Kahn, RS (2004). Emotional processing in a non-clinical psychosis-prone sample. Schizophrenia Research 68, 271–281.Google Scholar
Varma, SL, Sharma, I (1993). Psychiatric morbidity in the first-degree relatives of schizophrenic patients. British Journal of Psychiatry 162, 672–678.Google Scholar
Versmissen, D, Janssen, I, Myin-Germeys, I, Mengelers, R, Campo, JA, van Os, J, Krabbendam, L (2008). Evidence for a relationship between mentalising deficits and paranoia over the psychosis continuum. Schizophrenia Research 99, 103–110.Google Scholar
Wechsler, D (1997). Wechsler Adult Intelligence Scale – Third Edition (WAIS-III). Psychological Corporation: San Antonio, TX.Google Scholar
WHO (1990). Composite International Diagnostic Interview (CIDI): (a) Version 1.0, (b) User Manual, (c) Training Manual, (d) Computer Programs. World Health Organization: Geneva.Google Scholar
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D, Sartorius, N (1990). SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry 47, 589–593.Google Scholar
Yucel, M, Bora, E, Lubman, DI, Solowij, N, Brewer, WJ, Cotton, SM, Conus, P, Takagi, MJ, Fornito, A, Wood, SJ, McGorry, PD, Pantelis, C (2012). The impact of cannabis use on cognitive functioning in patients with schizophrenia: a meta-analysis of existing findings and new data in a first-episode sample. Schizophrenia Bulletin 38, 316–330.Google Scholar