Cannabis
link to mental illness strengthened.
The link between regular cannabis use and later depression and schizophrenia
has been significantly strengthened by three new studies.
The
studies provide "little support" for an alternative explanation
- that people with mental illnesses self-medicate with marijuana - according
to Joseph Rey and Christopher Tennant of the University of Sydney, who
have written an editorial on the papers in the British Medical Journal.
One
of the key conclusions of the research is that people who start smoking
cannabis as adolescents are at the greatest risk of later developing
mental health problems. Another team calculates that eliminating cannabis
use in the UK population could reduce cases of schizophrenia by 13 per
cent.
Until
now, say Rey and Tennant, there was "a dearth of reliable evidence"
to support the idea that cannabis use could cause schizophrenia or depression.
That lack of good evidence "has handicapped the development of
rational public health policies," according to one of the research
groups, led by George Patton at the Murdoch Children's Research Institute
in Melbourne, Australia.
The
works also highlights potential risks associated with using cannabis
as a medicine to ease the symptoms of muscular sclerosis, for example.
Pharmacological
effect
Patton's
team followed over 1600 Australian school pupils aged 14 to 15 for seven
years. Daily cannabis use was associated with a five-fold increased
risk of depression at the age of 20. Weekly use was linked to a two-fold
increase. The regular users were no more likely to have suffered from
depression or anxiety at the start of the study.
The
reason for the link is unclear. Social consequences of frequent cannabis
use include educational failure and unemployment, which could increase
the risk of depression. "However, because the risk seems confined
largely to daily users, the question about a direct pharmacological
effect remains," says Patton.
In
separate research, a team led by Stanley Zammit at the University of
Cardiff, UK, evaluated data on over 50,000 men who had been Swedish
military conscripts in 1969 and1970. This group represents 97 per cent
of men aged 18 to 20 in the population at that time.
The
new analysis revealed a dose-dependant relationship between the frequency
of cannabis use and schizophrenia. This held true in men with no psychotic
symptoms before they started using cannabis, suggesting they were not
self-medicating.
Genetic
factors
Finally,
researchers led by Terrie Moffitt at King's College London, UK, analysed
comprehensive data on over 1000 people born in Dunedin, New Zealand
in 1972 and 1973.
They
found that people who used cannabis by age 15 were four times as likely
to have a diagnosis of schizophreniform disorder (a milder version of
schizophrenia) at age 26 than non-users.
But
when the number of psychotic symptoms at age 11 was controlled for,
this increased risk dropped to become non-significant. This suggests
that people already at greater risk of later developing mental health
problems are also more likely to smoke cannabis.
The
total number of high quality studies on cannabis use and mental health
disorders remains small, stress Rey and Tennant. And it is still not
clear whether cannabis can cause these conditions in people not predisposed
by genetic factors, for example, to develop them.
"The
overall weight of evidence is that occasional use of cannabis has few
harmful effects overall," Zammit's team writes. "Nevertheless,
our results indicate a potentially serious risk to the mental health
of people who use cannabis. Such risks need to be considered in the
current move to liberalise and possibly legalise the use of cannabis
in the UK and other countries."
Journal
references: British Medical Journal (vol 325, p1195, p1199, p1212, p1183)
Emma
Young