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Schizophrenia Bulletin Advance Access published online on June 23, 2005
Schizophrenia Bulletin, doi:10.1093/schbul/sbi027
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© The Author 2005. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oupjournals.org.

Article

The Environment and Schizophrenia: The Role of Cannabis Use

Cécile Henquet 1, Robin Murray 2, Don Linszen 3, and Jim van Os 4*
1 Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, European Graduate School of Neuroscience, Maastricht University, Maastricht, the Netherlands
2 Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London
3 Department of Psychiatry, University Medical Hospital, Amsterdam
4 Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, European Graduate School of Neuroscience, Maastricht University, Maastricht, the Netherlands; Division of Psychological Medicine, Institute of Psychiatry, De Crespigny Park, London

* To whom correspondence should be addressed.
Jim van Os, E-mail: j.vanos{at}sp.unimaas.nl


  Abstract

Cannabis use is associated with poor outcome in existing schizophrenia and may precipitate psychosis in individuals with preexisting liability. To investigate the overall effect size and consistency of the association between cannabis and psychosis, a meta-analysis from prospective studies was carried out. The pooled odds ratio was 2.1 (95% CI: 1.7-2.5) and could not be explained by confounding or reverse causality. Evidence suggests that cannabis is a component cause in the development and prognosis of psychosis, in which mechanisms of gene-environment interaction are most likely to explain this association. Potential new methods to directly link genetic liability to the effects of cannabis are discussed.

Keywords: psychosis; gene-environment interaction; environment; genetics.
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