ArticleThe American journal of psychiatry2009
Association of pre-onset cannabis, alcohol, and tobacco use with age at onset of prodrome and age at onset of psychosis in first-episode patients.
Article in The American journal of psychiatry, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
70 citing papers in PubMed, 3 syntheses or guidelines pooled it, 198 citations in OpenAlex.
- On the proportion of patients who experience a prodrome prior to psychosis onset: A systematic review and meta-analysis.Molecular psychiatry · 2024Pooled it
- Does tobacco use cause psychosis? Systematic review and meta-analysis.The lancet. Psychiatry · 2015Pooled it
- The age at onset of psychosis and tobacco use: a systematic meta-analysis.Social psychiatry and psychiatric epidemiology · 2012Pooled it
- Not a Sip: Effects of Zero Tolerance Laws on Road Traffic Fatalities.Health economics · 2026Article
- Cannabis and tobacco co-use predicts psychosis in clinical high risk cohorts.Nature. Mental health · 2026Article
- Exposotypes in psychotic disorders.Scientific reports · 2025Article
- Influence of cannabis use on incidence of psychosis in people at clinical high risk.Psychiatry and clinical neurosciences · 2023Article
- Subclinical psychotic symptoms in Indian adults: Application of the Community Assessment of Psychic Experiences (CAPE).Asian journal of psychiatry · 2023Article
- Profiles and factors associated with schizophrenia in eastern Ethiopia: A matched case-control study.Frontiers in psychiatry · 2022Article
- A cross-sectional study of substance use in patients with schizophrenia hospitalized for relapse at the Ar-Razi Psychiatric Hospital in Salé, CHU Ibn Sina Rabat, Morocco.The Pan African medical journal · 2022Article
- Lifetime Cannabis Use Is Not Associated With Negative Beliefs About Medication in Patients With First Treatment Psychosis.Frontiers in psychiatry · 2022Article
- Dissecting Molecular Genetic Mechanisms of 1q21.1 CNV in Neuropsychiatric Disorders.International journal of molecular sciences · 2021Review
- Longitudinal association between CRP levels and risk of psychosis: a meta-analysis of population-based cohort studies.NPJ schizophrenia · 2021Review
- Imaging Brain Fatty Acid Amide Hydrolase in Untreated Patients With Psychosis.Biological psychiatry · 2020Article
- Persistent cannabis use among young adults with early psychosis receiving coordinated specialty care in the United States.Schizophrenia research · 2020Article
- A Retrospective Study of the Clinical Characteristics Associated with Alcohol and Cannabis use in Early Phase Psychosis.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2020Article
- Factors Moderating the Association Between Cannabis Use and Psychosis Risk: A Systematic Review.Brain sciences · 2020Review
- Prenatal THC exposure produces a hyperdopaminergic phenotype rescued by pregnenolone.Nature neuroscience · 2019Article
- Factor structure of the Cannabis Experiences Questionnaire in a first-episode psychosis sample.Early intervention in psychiatry · 2019Article
- Nicotine consumption during the prodromal phase of schizophrenia - a review of the literature.Neuropsychiatric disease and treatment · 2019Article
10 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
objectiveSeveral reports suggest that cannabis use is associated with an earlier age at onset of psychosis, although not all studies have operationalized cannabis use as occurring prior to onset of symptoms. This study addressed whether pre-onset cannabis use, alcohol use, and tobacco use are associated with an earlier age at onset of prodromal and psychotic symptoms. Effects of the progression of frequency of use were examined through time-dependent covariates in survival analyses.
methodFirst-episode patients (N=109) hospitalized in three public-sector inpatient psychiatric units underwent in-depth cross-sectional retrospective assessments. Prior substance use and ages at onset of prodromal and psychotic symptoms were determined by standardized methods, and analyses were conducted using Cox regression modeling.
resultsWhereas classifying participants according to maximum frequency of use prior to onset (none, ever, weekly, or daily) revealed no significant effects of cannabis or tobacco use on risk of onset, analysis of change in frequency of use prior to onset indicated that progression to daily cannabis and tobacco use was associated with an increased risk of onset of psychotic symptoms. Similar or even stronger effects were observed when onset of illness or prodromal symptoms was the outcome. A gender-by-daily-cannabis-use interaction was observed; progression to daily use resulted in a much larger increased relative risk of onset of psychosis in females than in males.
conclusionsPre-onset cannabis use may hasten the onset of psychotic as well as prodromal symptoms. Age at onset is a key prognostic factor in schizophrenia, and discovering modifiable predictors of age at onset is crucial.
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