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A neuropsychological approach to differentiating cannabis‐induced and primary psychotic disorders

Aim Rates of cannabis use are elevated in early psychosis populations, rendering it difficult to determine if an episode of psychosis is related to cannabis use (e.g., cannabis‐induced psychosis), or if substance use is co‐occurring with a primary psychotic disorder (e.g., schizophrenia). Clinical p...

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Published in:Early intervention in psychiatry 2023-06, Vol.17 (6), p.564-572
Main Authors: Woolridge, Stephanie M., Wood‐Ross, Chelsea, Voleti, Rohit, Harrison, Geoffrey W., Berisha, Visar, Bowie, Christopher R.
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cited_by cdi_FETCH-LOGICAL-c3538-ad5a37606b99e9fde1527509ef4a8be83cea8cd1138981188d119217d5403cef3
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container_issue 6
container_start_page 564
container_title Early intervention in psychiatry
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creator Woolridge, Stephanie M.
Wood‐Ross, Chelsea
Voleti, Rohit
Harrison, Geoffrey W.
Berisha, Visar
Bowie, Christopher R.
description Aim Rates of cannabis use are elevated in early psychosis populations, rendering it difficult to determine if an episode of psychosis is related to cannabis use (e.g., cannabis‐induced psychosis), or if substance use is co‐occurring with a primary psychotic disorder (e.g., schizophrenia). Clinical presentations of these disorders are often indistinguishable, hindering assessment and treatment. Despite substantial research identifying cognitive deficits, eye movement abnormalities and speech impairment associated with primary psychotic disorders, these neuropsychological features have not been explored as targets for diagnostic differentiation in early psychosis. Methods Eighteen participants with cannabis‐induced psychosis (Mage = 21.9, SDage = 4.25, 14 male) and 19 participants with primary psychosis (Mage = 29.2, SDage = 7.65, 17 male) were recruited from early intervention programs. Diagnoses were ascertained by primary treatment teams after a minimum of 6 months in the program. Participants completed tasks assessing cognitive performance, saccadic eye movements and speech. Clinical symptoms, trauma, substance use, premorbid functioning and illness insight were also assessed. Results Relative to individuals with primary psychosis, individuals with cannabis‐induced psychosis demonstrated significantly better performance on the pro‐saccade task, faster RT on pro‐ and anti‐saccade tasks, better premorbid adjustment, and a higher degree of insight into their illness. There were no significant differences between groups on psychiatric symptoms, premorbid intellectual functioning, or problems related to cannabis use. Conclusions In early stages of illness, reliance on traditional diagnostic tools or clinical interviews may be insufficient to distinguish between cannabis‐induced and primary psychosis. Future research should continue to explore neuropsychological differences between these diagnoses to improve diagnostic accuracy.
doi_str_mv 10.1111/eip.13348
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Clinical presentations of these disorders are often indistinguishable, hindering assessment and treatment. Despite substantial research identifying cognitive deficits, eye movement abnormalities and speech impairment associated with primary psychotic disorders, these neuropsychological features have not been explored as targets for diagnostic differentiation in early psychosis. Methods Eighteen participants with cannabis‐induced psychosis (Mage = 21.9, SDage = 4.25, 14 male) and 19 participants with primary psychosis (Mage = 29.2, SDage = 7.65, 17 male) were recruited from early intervention programs. Diagnoses were ascertained by primary treatment teams after a minimum of 6 months in the program. Participants completed tasks assessing cognitive performance, saccadic eye movements and speech. Clinical symptoms, trauma, substance use, premorbid functioning and illness insight were also assessed. Results Relative to individuals with primary psychosis, individuals with cannabis‐induced psychosis demonstrated significantly better performance on the pro‐saccade task, faster RT on pro‐ and anti‐saccade tasks, better premorbid adjustment, and a higher degree of insight into their illness. There were no significant differences between groups on psychiatric symptoms, premorbid intellectual functioning, or problems related to cannabis use. Conclusions In early stages of illness, reliance on traditional diagnostic tools or clinical interviews may be insufficient to distinguish between cannabis‐induced and primary psychosis. Future research should continue to explore neuropsychological differences between these diagnoses to improve diagnostic accuracy.</description><identifier>ISSN: 1751-7885</identifier><identifier>EISSN: 1751-7893</identifier><identifier>DOI: 10.1111/eip.13348</identifier><identifier>PMID: 37280059</identifier><language>eng</language><publisher>Melbourne: Wiley Publishing Asia Pty Ltd</publisher><subject>Abnormalities ; Cannabis ; cannabis‐related disorder ; Cognitive tasks ; differential diagnosis ; Disorders ; Drug use ; early diagnosis ; Eye movements ; Illnesses ; Males ; Marijuana ; Medical diagnosis ; Neuropsychology ; Psychosis ; Saccadic eye movements ; Schizophrenia ; Signs and symptoms ; Speech ; substance‐induced psychoses</subject><ispartof>Early intervention in psychiatry, 2023-06, Vol.17 (6), p.564-572</ispartof><rights>2022 John Wiley &amp; Sons Australia, Ltd.</rights><rights>2023 John Wiley &amp; Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-ad5a37606b99e9fde1527509ef4a8be83cea8cd1138981188d119217d5403cef3</citedby><cites>FETCH-LOGICAL-c3538-ad5a37606b99e9fde1527509ef4a8be83cea8cd1138981188d119217d5403cef3</cites><orcidid>0000-0002-1983-8861 ; 0000-0003-1792-7075</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37280059$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Woolridge, Stephanie M.</creatorcontrib><creatorcontrib>Wood‐Ross, Chelsea</creatorcontrib><creatorcontrib>Voleti, Rohit</creatorcontrib><creatorcontrib>Harrison, Geoffrey W.</creatorcontrib><creatorcontrib>Berisha, Visar</creatorcontrib><creatorcontrib>Bowie, Christopher R.</creatorcontrib><title>A neuropsychological approach to differentiating cannabis‐induced and primary psychotic disorders</title><title>Early intervention in psychiatry</title><addtitle>Early Interv Psychiatry</addtitle><description>Aim Rates of cannabis use are elevated in early psychosis populations, rendering it difficult to determine if an episode of psychosis is related to cannabis use (e.g., cannabis‐induced psychosis), or if substance use is co‐occurring with a primary psychotic disorder (e.g., schizophrenia). Clinical presentations of these disorders are often indistinguishable, hindering assessment and treatment. Despite substantial research identifying cognitive deficits, eye movement abnormalities and speech impairment associated with primary psychotic disorders, these neuropsychological features have not been explored as targets for diagnostic differentiation in early psychosis. Methods Eighteen participants with cannabis‐induced psychosis (Mage = 21.9, SDage = 4.25, 14 male) and 19 participants with primary psychosis (Mage = 29.2, SDage = 7.65, 17 male) were recruited from early intervention programs. Diagnoses were ascertained by primary treatment teams after a minimum of 6 months in the program. Participants completed tasks assessing cognitive performance, saccadic eye movements and speech. Clinical symptoms, trauma, substance use, premorbid functioning and illness insight were also assessed. Results Relative to individuals with primary psychosis, individuals with cannabis‐induced psychosis demonstrated significantly better performance on the pro‐saccade task, faster RT on pro‐ and anti‐saccade tasks, better premorbid adjustment, and a higher degree of insight into their illness. There were no significant differences between groups on psychiatric symptoms, premorbid intellectual functioning, or problems related to cannabis use. Conclusions In early stages of illness, reliance on traditional diagnostic tools or clinical interviews may be insufficient to distinguish between cannabis‐induced and primary psychosis. Future research should continue to explore neuropsychological differences between these diagnoses to improve diagnostic accuracy.</description><subject>Abnormalities</subject><subject>Cannabis</subject><subject>cannabis‐related disorder</subject><subject>Cognitive tasks</subject><subject>differential diagnosis</subject><subject>Disorders</subject><subject>Drug use</subject><subject>early diagnosis</subject><subject>Eye movements</subject><subject>Illnesses</subject><subject>Males</subject><subject>Marijuana</subject><subject>Medical diagnosis</subject><subject>Neuropsychology</subject><subject>Psychosis</subject><subject>Saccadic eye movements</subject><subject>Schizophrenia</subject><subject>Signs and symptoms</subject><subject>Speech</subject><subject>substance‐induced psychoses</subject><issn>1751-7885</issn><issn>1751-7893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp1kM9OAyEQh4nRWK0efAGziRc91C6wFDga458mTfSg5w2F2YrZwgq7Mb35CD6jTyJ1aw8mcpkh8_Fl-CF0gvNLnM4YbHOJKS3EDjrAnOERF5LubnvBBugwxtc8Z3xC8D4aUE5EuskDpK8yB13wTVzpF1_7hdWqzlTTBK_0S9b6zNiqggCutaq1bpFp5Zya2_j18Wmd6TSYTDmTNcEuVVhlvai1Oj2MPhgI8QjtVaqOcLypQ_R8e_N0fT-aPdxNr69mI00ZFSNlmKJ8kk_mUoKsDGBGOMslVIUScxBUgxLaYEyFFBgLkVpJMDesyNOsokN03nvT8m8dxLZc2qihrpUD38WSCEILyUkxSejZH_TVd8Gl7dYUEYwILhJ10VM6-BgDVOXmlyXOy3XyZUq-_Ek-sacbYzdfgtmSv1EnYNwD77aG1f-m8mb62Cu_Ad2ajvc</recordid><startdate>202306</startdate><enddate>202306</enddate><creator>Woolridge, Stephanie M.</creator><creator>Wood‐Ross, Chelsea</creator><creator>Voleti, Rohit</creator><creator>Harrison, Geoffrey W.</creator><creator>Berisha, Visar</creator><creator>Bowie, Christopher R.</creator><general>Wiley Publishing Asia Pty Ltd</general><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1983-8861</orcidid><orcidid>https://orcid.org/0000-0003-1792-7075</orcidid></search><sort><creationdate>202306</creationdate><title>A neuropsychological approach to differentiating cannabis‐induced and primary psychotic disorders</title><author>Woolridge, Stephanie M. ; Wood‐Ross, Chelsea ; Voleti, Rohit ; Harrison, Geoffrey W. ; Berisha, Visar ; Bowie, Christopher R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-ad5a37606b99e9fde1527509ef4a8be83cea8cd1138981188d119217d5403cef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Abnormalities</topic><topic>Cannabis</topic><topic>cannabis‐related disorder</topic><topic>Cognitive tasks</topic><topic>differential diagnosis</topic><topic>Disorders</topic><topic>Drug use</topic><topic>early diagnosis</topic><topic>Eye movements</topic><topic>Illnesses</topic><topic>Males</topic><topic>Marijuana</topic><topic>Medical diagnosis</topic><topic>Neuropsychology</topic><topic>Psychosis</topic><topic>Saccadic eye movements</topic><topic>Schizophrenia</topic><topic>Signs and symptoms</topic><topic>Speech</topic><topic>substance‐induced psychoses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Woolridge, Stephanie M.</creatorcontrib><creatorcontrib>Wood‐Ross, Chelsea</creatorcontrib><creatorcontrib>Voleti, Rohit</creatorcontrib><creatorcontrib>Harrison, Geoffrey W.</creatorcontrib><creatorcontrib>Berisha, Visar</creatorcontrib><creatorcontrib>Bowie, Christopher R.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Early intervention in psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Woolridge, Stephanie M.</au><au>Wood‐Ross, Chelsea</au><au>Voleti, Rohit</au><au>Harrison, Geoffrey W.</au><au>Berisha, Visar</au><au>Bowie, Christopher R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A neuropsychological approach to differentiating cannabis‐induced and primary psychotic disorders</atitle><jtitle>Early intervention in psychiatry</jtitle><addtitle>Early Interv Psychiatry</addtitle><date>2023-06</date><risdate>2023</risdate><volume>17</volume><issue>6</issue><spage>564</spage><epage>572</epage><pages>564-572</pages><issn>1751-7885</issn><eissn>1751-7893</eissn><abstract>Aim Rates of cannabis use are elevated in early psychosis populations, rendering it difficult to determine if an episode of psychosis is related to cannabis use (e.g., cannabis‐induced psychosis), or if substance use is co‐occurring with a primary psychotic disorder (e.g., schizophrenia). Clinical presentations of these disorders are often indistinguishable, hindering assessment and treatment. Despite substantial research identifying cognitive deficits, eye movement abnormalities and speech impairment associated with primary psychotic disorders, these neuropsychological features have not been explored as targets for diagnostic differentiation in early psychosis. Methods Eighteen participants with cannabis‐induced psychosis (Mage = 21.9, SDage = 4.25, 14 male) and 19 participants with primary psychosis (Mage = 29.2, SDage = 7.65, 17 male) were recruited from early intervention programs. Diagnoses were ascertained by primary treatment teams after a minimum of 6 months in the program. Participants completed tasks assessing cognitive performance, saccadic eye movements and speech. Clinical symptoms, trauma, substance use, premorbid functioning and illness insight were also assessed. Results Relative to individuals with primary psychosis, individuals with cannabis‐induced psychosis demonstrated significantly better performance on the pro‐saccade task, faster RT on pro‐ and anti‐saccade tasks, better premorbid adjustment, and a higher degree of insight into their illness. There were no significant differences between groups on psychiatric symptoms, premorbid intellectual functioning, or problems related to cannabis use. Conclusions In early stages of illness, reliance on traditional diagnostic tools or clinical interviews may be insufficient to distinguish between cannabis‐induced and primary psychosis. Future research should continue to explore neuropsychological differences between these diagnoses to improve diagnostic accuracy.</abstract><cop>Melbourne</cop><pub>Wiley Publishing Asia Pty Ltd</pub><pmid>37280059</pmid><doi>10.1111/eip.13348</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1983-8861</orcidid><orcidid>https://orcid.org/0000-0003-1792-7075</orcidid></addata></record>
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subjects Abnormalities
Cannabis
cannabis‐related disorder
Cognitive tasks
differential diagnosis
Disorders
Drug use
early diagnosis
Eye movements
Illnesses
Males
Marijuana
Medical diagnosis
Neuropsychology
Psychosis
Saccadic eye movements
Schizophrenia
Signs and symptoms
Speech
substance‐induced psychoses
title A neuropsychological approach to differentiating cannabis‐induced and primary psychotic disorders
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