Adversity, cannabis use and psychotic experiences: evidence of cumulative and synergistic effects

• Published in: British journal of psychiatry Vol. 204; no. 5; pp. 346 - 353
• Main Authors: Morgan, Craig, Reininghaus, Ulrich, Reichenberg, Abraham, Frissa, Souci, Hotopf, Matthew, Hatch, Stephani L.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.05.2014; Maney; Royal College of Psychiatrists
• Subjects: Abuse; Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Adult Survivors of Child Abuse - psychology; Adversity; Biological and medical sciences; Cannabis; Child abuse & neglect; Childhood factors; Children; Community health; Drug abuse; Drug addiction; Effects; Female; Humans; Life Change Events; Life events; Male; Marijuana; Marijuana Abuse - complications; Marijuana Abuse - psychology; Marijuana Smoking - adverse effects; Marijuana Smoking - psychology; Medical sciences; Middle Aged; Other psychotic disorders; Population studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Psychosis; Psychotic Disorders - etiology; Psychotic Disorders - psychology; Risk factors; Stress; Surveys and Questionnaires; Vulnerability; Young Adult; United Kingdom; Europe; Consumption; Social environment; Human; Mental health; Cannabidaceae; Victimology; Psychosis; Cannabis; Child abuse; Life events; Dicotyledones; Population-based survey; Angiospermae; Risk factor; Early traumatism; Spermatophyta; Drug of abuse; Public health; Recreational drug
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.bp.113.134452

There is robust evidence that childhood adversity is associated with an increased risk of psychosis. There is, however, little research on intervening factors that might increase or decrease risk following childhood adversity. To investigate main effects of, and synergy between, childhood abuse and life events and cannabis use on odds of psychotic experiences. Data on psychotic experiences and childhood abuse, life events and cannabis use were collected from 1680 individuals as part of the South East London Community Health Study (SELCoH), a population-based household survey. There was strong evidence that childhood abuse and number of life events combined synergistically to increase odds of psychotic experiences beyond the effects of each individually. There was similar, but weaker, evidence for cannabis use (past year). Our findings are consistent with the hypothesis that childhood abuse creates an enduring vulnerability to psychosis that is realised in the event of exposure to further stressors and risk factors.