Marijuana and Madness: Psychiatry and Neurobiology

Cover......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Dedication......Page 7
Contents......Page 9
Contributors......Page 11
Foreword......Page 15
Preface......Page 17
Cannabis and mental illness......Page 19
Understanding cannabinoid chemistry......Page 21
Cannabidiol......Page 23
The endocannabinoids......Page 24
Anandamide......Page 25
Additional endocannabinoids......Page 26
Biosynthesis and inactivation of the endocannabinoids......Page 27
Synthetic cannabinoids......Page 29
Quo vadimus?......Page 30
REFERENCES......Page 31
Cannabinoid receptors......Page 37
Neuroanatomical distribution of CB1 receptors in brain......Page 38
Inhibition of neurotransmitter release......Page 39
Endogenous cannabinoids act as retrograde signal molecules at synapses......Page 40
Effects of cannabinoids on CNS function and psychomotor control......Page 42
Cannabinoid mechanisms in the hippocampus and effects on memory......Page 44
Cannabinoids and the neocortex......Page 46
Effects of cannabinoids on hypothalamic control of appetite......Page 47
Cannabis intoxication......Page 48
Tolerance and dependence......Page 50
REFERENCES......Page 52
3 Acute and subacute psychomimetic effects of cannabis in humans......Page 59
Surveys of cannabis users......Page 60
Human experiments on psychomimetic effects of cannabis......Page 61
Euphoria and laughter......Page 62
Anxiety symptoms with cannabis intoxication......Page 63
Immediate effects on cognition and psychomotor functioning......Page 65
The ‘amotivational’ syndrome......Page 66
Conclusions......Page 68
REFERENCES......Page 69
Introduction......Page 72
Clinical samples......Page 73
Convenience samples......Page 74
Representative samples of the general population......Page 75
What explains the association between cannabis use and depression?......Page 77
Depression causes cannabis use......Page 78
Studies of the effects of cannabis use upon mood......Page 79
Does cannabis use predict later depression?......Page 80
Does depression predict later cannabis use?......Page 82
Summary......Page 83
Measurement of depression......Page 84
The use of genetically informative designs to examine causality......Page 85
Conclusions......Page 86
REFERENCES......Page 87
Psychosis proneness in cannabis users......Page 93
Is there a cross-sectional association between cannabis use and psychosis proneness?......Page 94
Methodological considerations......Page 97
Does cannabis induce the occurrence of psychotic experiences in non-clinical subjects?......Page 98
Is the risk of acute psychotic experiences induced by cannabis increased in subjects with a pre-existing psychosis vulnerability?......Page 100
Is there an interaction between cannabis use and psychosis vulnerability in their effects on increased incidence of psychotic disorder?......Page 101
Conclusions......Page 102
REFERENCES......Page 103
Making causal inferences......Page 107
Case reports......Page 109
Controlled studies of ‘cannabis psychosis’......Page 110
Controlled studies of psychosis in users and non-users of cannabis......Page 111
Time trends in the incidence and prevalence of schizophrenia......Page 113
Conclusions......Page 114
REFERENCES......Page 115
What is a cause?......Page 119
Evidence for association......Page 121
Retrospective studies......Page 123
The Swedish conscript cohort......Page 124
The Dunedin birth cohort......Page 126
Methodological issues......Page 128
Alternative explanations......Page 129
What kind of cause is it?......Page 130
How strong is the causal effect?......Page 131
REFERENCES......Page 134
8 Cannabis abuse and the course of schizophrenia......Page 137
Cross-sectional and retrospective studies......Page 138
Short-term prospective studies......Page 139
Longer-term prospective studies......Page 140
Conclusions......Page 141
ACKNOWLEDGEMENTS......Page 142
REFERENCES......Page 143
The cannabinoid CB1 receptor in the brain......Page 145
Endogenous cannabinoid receptor ligands......Page 148
Perceptual disturbances in patients with schizophrenia, compared to non-psychiatric controls under the influence of cannabis......Page 149
Human CSF studies......Page 150
Postmortem human brain studies......Page 151
CB1 receptor gene polymorphisms in schizophrenia......Page 154
Conclusions......Page 155
REFERENCES......Page 156
10 Cannabinoid ‘model’ psychosis, dopamine—cannabinoid interactions and implications for schizophrenia......Page 160
Review of published studies......Page 161
The current study......Page 162
A cannabinoid ‘model’ psychosis......Page 173
REFERENCES......Page 178
11 Motives that maintain cannabis use among individuals with psychotic disorders......Page 184
Reasons for substance use......Page 185
The self-medication hypothesis......Page 188
Motivational models of substance use......Page 189
Studies supporting a motivational model of cannabis use among individuals with psychotic disorders......Page 193
Motivational models of cannabis use in psychosis......Page 198
REFERENCES......Page 201
Screening......Page 204
Assessment......Page 206
Reasons for use......Page 207
Readiness to change......Page 208
Models of service delivery......Page 209
Treatment approaches......Page 210
Treatment programmes......Page 211
REFERENCES......Page 213
Introduction......Page 216
Short-term residual effects......Page 221
Long-term residual effects......Page 222
Residual effects and lifetime duration of cannabis use......Page 223
Conclusions......Page 224
REFERENCES......Page 225
Index......Page 229