Could cannabis use moderate the association between insight and depression: a prospective study

Poster A17, Thursday, October 20, 11:30 am - 1:00 pm, Le Baron

Julien Elowe1, Philippe Golay, Philipp Baumann, Alessandra Solida-Tozzi, Philippe Conus; 1CHUV, University of Lausanne, Lausanne, Switzerland

Introduction : While insight can have a positive impact on FEP in terms of medication adherence and functional outcome, it seems to be associated with increased depression level and suicidal behavior. Surprisingly, no study has questioned the role of cannabis use as a potential mediator in this relationship. Methods : 214 FEP patients were followed over a period of three years in a specialized early psychosis program. A series of multivariate regression models were estimated. Insight, medication adherence and cannabis use were entered as independent variables while the PANSS positive score, PANSS negative score, the MADRS score and the GAF score were alternately selected as the dependent variable. Two-way and three way interaction terms between insight, medication adherence and cannabis use were also entered as predictors. Results : The three-way interaction term between cannabis use, insight and treatment adherence was significant ( = .405, p = .020) revealing a complex relationship between these three variables and depression. While a high level of insight tends to be significantly associated to higher MADRS scores in patients with high treatment adherence and high cannabis use, depression decreases significantly in patients with high treatment adherence and low cannabis use when insight was present. Discussion : Interestingly, our study supports the general idea that cannabis use enhances the likelihood of depression in FEP patients presenting with high insight. As expected and in line with other work , we found that the level of insight always predicted global functioning throughout the program .

Topic Area: Diagnosis and Phenomenology

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