Impulsivity and sensation seeking in cannabis abusing patients with schizophrenia
Available from: Michael Davis
- "Broadly, impulsivity refers to a predisposition toward unplanned reactions without consideration of consequences (Moeller et al, 2001) and can include risky decision making, self-reported high-risk attitudes, poor response inhibition, and rapid decision making (Courtney et al, 2012). It is also associated with poor clinical outcomes in patients with bipolar and schizophrenia including substance abuse (Dervaux et al, 2010; Gut-Fayand et al, 2001), suicidal acts (Gut-Fayand et al, 2001), and aggression (Perroud et al, 2011). However, the role that impulsivity has in bipolar disorder and schizophrenia are poorly understood. "
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ABSTRACT: Impulsive risk-taking contributes to deleterious outcomes among clinical populations. Indeed, pathological impulsivity and risk-taking are common in patients with serious mental illness, and have severe clinical repercussions including novelty seeking, response disinhibition, aggression, and substance abuse. Thus, the current study seeks to examine self-reported impulsivity (Barratt Impulsivity Scale, BIS-11) and performance-based behavioral risk-taking (Balloon Analogue Risk Task, BART) in bipolar disorder and schizophrenia. Participants included 68 individuals with bipolar disorder, 38 with schizophrenia, and 36 healthy controls. Self-reported impulsivity was elevated in the bipolar group compared with schizophrenia patients and healthy controls, who did not differ from each other. On the risk-taking task, schizophrenia patients were significantly more risk-averse than the bipolar patients and controls. Aside from the diagnostic group differences, there was a significant effect of antipsychotic (AP) medication within the bipolar group: bipolar patients taking AP medications were more risk-averse than those not taking AP medications. This difference in risk-taking due to AP medications was not explained by history of psychosis. Similarly, the differences in risk-taking between schizophrenia and bipolar disorder were not fully explained by AP effects. Implications for clinical practice and future research are discussed.Neuropsychopharmacology accepted article preview online, 21 August 2013. doi:10.1038/npp.2013.218.
Available from: Alain Dervaux
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ABSTRACT: Several prospective studies in the general population [1–5] and meta-analyses [6–7] have consistently found that cannabis use is associated with an increased risk of psychotic disorders, in particular schizo-phrenia. Continued cannabis use over time increases the risk of psychosis in a dose–response fashion [3–5]. A higher risk of schizophrenia is predicted by an earlier age of cannabis use [1,6–7]. Several hypotheses have been suggested to explain the association between canna-bis use and schizophrenia, including the following [6,8]: Cannabis use is a causal factor for schizophrenia; Cannabis use precipitates psychosis in vulnerable people; Cannabis use exacerbates symptoms of schizophrenia; Patients with schizophrenia are more liable to become regular cannabis users, including during the prodromal phase. Ferdinand et al. investigated the role of pre-existing self-reported psychotic symp-toms and found a bidirectional association between cannabis and psychotic symptoms in a 14-year follow-up study in the general population . They showed that cannabis use in individuals who did not have psy-chotic symptoms before they began using cannabis predicted later psychotic symp-toms and that the reverse was also true, in that psychotic symptoms in those who had never used cannabis before the onset of psychotic symptoms also predicted future cannabis use. However, in a recent 10-year follow-up study, Kuepper et al. clarified the tempo-ral association between cannabis use and psychotic experiences by systematically For reprint orders, please contact: firstname.lastname@example.org
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