Background
Methods
Patients and methods
Assessments
Cannabis use category | DSM-IV abuse or dependence | Addiction Severity Index (ASI) score |
---|---|---|
Dependence | Meet minimal or more DSM-IV criteria for cannabis dependence | 8–9: extreme problem, treatment absolutely necessary |
Abuse | Meet ≥1 criteria for cannabis abuse | 4–5: moderate problem, some treatment indicated |
6–7: considerable problem, treatment necessary | ||
Use | Meet abuse criteria but do not meet temporal criteria (at least 12 months) or use for 12 months but not fulfilling any criteria of DSM-IV abuse | 2–3: slight problem, substance abuse treatment probably not necessary |
No use | No significant symptoms | 0–1: no real problem |
Patient classification
Statistical analyses
Results
Baseline characteristics
Variable | Total sample (N = 98) | Bad adherence (n = 73) | Good adherence (n = 25) |
p value |
---|---|---|---|---|
Gender, n (%) | Chi2 = 0.003 (p = 0.954) | |||
Male | 71 (72.4) | 53 (72.6) | 18 (72.0) | |
Female | 27 (27.6) | 20 (27.4) | 7 (28.0) | |
Age | 29.8 ± 10.7 | 29.9 ± 10.2 | 30.7 ± 12.2 |
U = 762.5 (p = 0.858) |
Civil status, n (%) | Chi2 = 2.910 (p = 0.233) | |||
Single | 74 (75.5) | 57 (78.1) | 17 (68.0) | |
Married | 17 (17.3) | 10 (13.7) | 7 (28.0) | |
Other | 7 (7.2) | 6 (8.2) | 1 (4.0) | |
Family history, n (%) | Chi2 = 6.036 (p = 0.014) | |||
No | 16 (16.3) | 8 (10.9) | 8 (32.0) | |
Yes | 82 (83.7) | 65 (89.1) | 17 (68.0) | |
Diagnosis, n (%) | Chi2 = 0.601 (p = 0.740) | |||
Bipolar disorder & affective | 33 (33.7) | 23 (31.5) | 10 (40.0) | |
Schizophrenia | 39 (39.8) | 30 (41.1) | 9 (36.0) | |
Other | 26 (26.5) | 20 (27.4) | 6 (24.0) | |
PANSS basal positivea
| 24.8 ± 6.9 | 25.0 ± 6.7 | 24.4 ± 8.0 |
U = 636.0 (p = 0.640) |
PANSS basal negativea
| 18.9 ± 9.4 | 18.3 ± 9.1 | 20.5 ± 9.7 |
U = 598.0 (p = 0.395) |
PANSS basal generala
| 42.2 ± 11.4 | 40.6 ± 10.4 | 47.7 ± 13.1 |
U = 598.0 (p = 0.395) |
GAF basalb
| 55.5 ± 17.9 | 58.5 ± 16.2 | 69.2 ± 14.8 |
U = 152.5 (p = 0.019) |
YMRS basal | 25.4 ± 12.1 | 26.8 ± 12.4 | 21.6 ± 11.8 |
U = 494.5 (p = 0.059) |
HDRS-21 basal | 17.9 ± 8.4 | 16.4 ± 7.0 | 22.6 ± 10.9 |
U = 446.0 (p = 0.017) |
Phillips total basalc
| 5.6 ± 3.0 | 5.9 ± 2.9 | 5.2 ± 3.5 |
U = 587.5 (p = 0.337) |
Strauss total basalb
| 12.8 ± 3.9 | 12.5 ± 3.7 | 13.1 ± 4.5 |
U = 281.5 (p = 0.830) |
Aggressiveness, n % yes [vs. no] | 73 (74.5) | 57 (78.1) | 16 (64.0) | Chi2 = 1.943 (p = 0.163) |
Tobacco use, n (%) yes [vs. no] | 79 (80.6) | 61 (83.6) | 18 (72.0) | Chi2 = 1.593 (p = 0.207) |
Alcohol use, n (%) yes [vs. no] | 94 (95.9) | 72 (98.6) | 22 (88.0) | Chi2 = 5.375 (p = 0.020) |
Cannabis use, n (%) yes [vs. no] | 51 (52.0) | 40 (54.8) | 11 (44.0) | Chi2 = 0.869 (p = 0.351) |
Other drugs use, n (%) yes [vs. no] | 33 (33.7) | 25 (34.2) | 8 (32.0) | Chi2 = 0.042 (p = 0.837) |
Voluntary admission, n (%) | Chi2 = 44.749 (p < 0.001) | |||
No | 56 (57.1) | 56 (76.7) | 0 (0) | |
Yes | 42 (42.9) | 17 (23.3) | 25 (100) |
8-Year data
- Adherence (basal and at 8 years) and clinical and functional variables at 8 years
Variable | Total sample (N = 92) | Bad adherence (n = 45) | Good adherence (n = 47) |
p value |
---|---|---|---|---|
PANSS positive | 24.8 ± 6.9 | 25.2 ± 7.8 | 24.4 ± 6.4 | U = 607.0 (p = 0.413) |
PANSS negative | 18.9 ± 9.4 | 18.9 ± 9.4 | 20.0 ± 9.8 | U = 652.5 (p = 0.745) |
PANSS general | 42.2 ± 11.4 | 44.0 ± 10.7 | 42.5 ± 11.9 | U = 617.0 (p = 0.478) |
YMRS 8 years | 8.0 ± 9.2 | 12.0 ± 10.8 | 5.5 ± 7.2 | U = 304.00 ( p = 0.013)
|
Phillips 8 years | 6.3 ± 2.9 | 6.9 ± 2.5 | 5.6 ± 3.0 | U = 354.50 (p = 0.510) |
GAF 8 years | 61.3 ± 16.8 | 56.2 ±16.1 | 68.1 ± 15.9 | U = 192.00 (p = 0.007)
|
Strauss 8 year total | 12.8 ± 3.4 | 12.2 ± 4.6 | 15.2 ± 4.7 | U = 189.5 (p = 0.010) |
Strauss hospitalization, n (%) yes [vs. no] | 35 (37.7) | 25 (53.8) | 10 (19.2) | Chi2 = 11.461 (p = 0.001) |
Strauss work, n (%) | Chi2 = 9.809 (p = 0.007) | |||
No | 41 (44.6) | 24 (53.3) | 17 (36.2) | |
Partial | 14 (15.2) | 10 (22.2) | 4 (8.5) | |
Total | 37 (40.2) | 11 (24.5) | 26 (55.3) | |
Strauss social activity, n (%) | Chi2 = 1.595 (p = 0.450) | |||
No | 14 (15.2) | 7 (15.6) | 7 (14.9) | |
Little contact | 7 (7.6) | 5 (11.1) | 2 (4.2) | |
Frequently | 71 (77.2) | 33 (73.3) | 38 (80.9) | |
Strauss symptoms, n (%) | Chi2 = 25.641 (p < 0.001) | |||
Severe | 14 (15.2) | 8 (17.8) | 6 (12.8) | |
Moderate | 20 (21.7) | 18 (40.0) | 2 (4.2) | |
Light | 32 (34.8) | 15 (33.3) | 17 (36.2) | |
None | 26 (28.3) | 4 (8.9) | 22 (46.8) | |
Strauss global functioning, n (%) | Chi2 = 22.561 (p < 0.001) | |||
Continued & severe | 2 (2.2) | 2 (4.4) | 0 (0) | |
Important | 11 (12.0) | 6 (13.3) | 5 (10.6) | |
Moderate | 27 (29.3) | 21 (46.7) | 6 (12.8) | |
Light | 30 (32.6) | 13 (28.9) | 17 (36.2) | |
No disorder | 22 (23.9) | 3 (6.7) | 19 (40.4) | |
Alcohol use, n (%) yes [vs. no] | 52 (56.5) | 31 (68.9) | 21 (44.7) | Chi2 = 5.482 (p = 0.019) |
Cannabis use, n (%) yes [vs. no] | 27 (29.3) | 21 (46.7) | 6 (12.8) | Chi2 = 12.742 (p < 0.001) |
Other drugs use, n (%) yes [vs. no] | 15 (16.3) | 15 (33.3) | 0 (0) | Chi2 = 18.719 (p < 0.001) |
Evolution of cannabis use, n (%) | Chi2 = 11.436 (p = 0.003) | |||
Stop use | 25 (27.2) | 9 (20.0) | 16 (34.0) | |
Continue use | 26 (28.3) | 20 (44.4) | 6 (12.8) | |
Never use | 41 (44.5) | 16 (35.6) | 25 (53.2) |
- Associations between adherence at 8 years and substance use
- Change in adherence over 8 years: associations with type of hospitalization and cannabis use
Variable | Total sample (N = 92) | Adherence pattern over 8 years of follow-up | Chi2value (p value) | |||
---|---|---|---|---|---|---|
Always bad (n = 40) | Always good (n = 24) | Improved from bad to good (n = 23) | Worsened from good to bad (n = 5) | |||
Voluntary admission at baseline, n (%)a
| 54.289 (p < 0.001) | |||||
No | 50 (54.3) | 28 (70.0) | 0 (0.0) | 22 (95.7) | 0 (0.0) | |
Yes | 42 (45.7) | 12 (30.0) | 24 (100.0) | 1 (4.3) | 5 (100.0) | |
Evolution of cannabis use, n (%) | 24.036 (p = 0.001) | |||||
Stop use | 23 (25.3) | 4 (11.8) | 6 (27.8) | 9 (38.9) | 4 (75.0) | |
Continue use | 27 (29.1) | 20 (50.0) | 4 (11.1) | 3 (11.1) | 0 (0.0) | |
Never use | 42 (45.6) | 16 (38.2) | 14 (61.1) | 11 (50.0) | 1 (25.0) | |
GAF at 8 years | 55.5 ± 17.9 | 56.5 ± 16.0 | 73.4 ± 10.7 | 62.1 ± 17.0 | 53.7 ± 19.6 | 10.245 (p = 0.036) |