DOCSLIB.ORG

Correlations and Agreement Between Delta9tetrahydrocannabinol (THC

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Correlations and Agreement Between Delta9tetrahydrocannabinol (THC bs_bs_banner RESEARCH REPORT doi:10.1111/j.1360-0443.2011.03757.x Correlations and agreement between delta-9-tetrahydrocannabinol (THC) in blood plasma and timeline follow-back (TLFB)-assisted self-reported use of cannabis of patients with cannabis use disorder and psychotic illness attending the CapOpus randomized clinical trialadd_3757 1123..1131 Carsten Rygaard Hjorthøj1, Allan Fohlmann1, Anne-Mette Larsen1, Mikkel Arendt2 & Merete Nordentoft1 Mental Health Centre Copenhagen and Faculty of Health Sciences, University of Copenhagen, Copenhagen NV, Denmark1 and Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark2 ABSTRACT Aims To assess correlations and agreement between timeline follow-back (TLFB)-assisted self-report and blood samples for cannabis use. Design Secondary analysis of a randomized trial. Setting Copenhagen, Denmark. Participants One hundred and three patients from the CapOpus trial with cannabis use disorder and psychosis, providing 239 self-reports of cannabis use and 88 valid blood samples. Measurements Delta-9-tetrahydrocannabinol (THC), 11-hydroxy-delta-9-tetrahydrocannabinol (11-OH-THC) and 11-nor-delta-9-tetrahydrocannabinol-9- carboxylic acid (THC-COOH) detected in plasma using high-performance liquid chromatography with tandem mass spectrometry detection. Self-report of cannabis-use last month by TLFB. Pearson’s r, sensitivity and specificity calcu- lated as measures of correlation or agreement. Findings Correlations were strong; r = 0.75 for number of days and r = 0.83 for number of standard joints in the preceding month when excluding outliers. Including outliers, coefficients were moderate to strong (r = 0.49). There were differences in subgroups, mainly inconsistent, depending on inclusion or exclusion of outliers. Sensitivity and specificity for TLFB detecting the presence or absence of cannabis use were 95.7% [95% confidence interval (CI) 88.0–99.1%) and 72.2% (95% CI 46.5–90.3%), respectively. Using 19 days as cut-off on TLFB, they were 94.3% (95% CI 86.0–98.4%) and 94.4% (95% CI 72.2–99.9%), respectively.Area under the receiver operating characteristic (ROC) curve was 0.96. Conclusions Timeline follow-back (TLFB)-assisted self-report of cannabis use correlates highly with plasma-delta-9-tetrahydrocannabinol in patients with comorbid cannabis use disorder and psychosis. Sensitivity and specificity of timeline follow-back appear to be optimized with 19 days as the cut-off point. As such, timeline follow-back may be superior to analysis of blood when going beyond 19 days of recall. Keywords Agreement, cannabis, correlation, dual diagnosis, psychosis, THC, timeline follow-back, validity. Correspondence to: Carsten Rygaard Hjorthøj, Mental Health Centre Copenhagen and Faculty of Health Sciences, University of Copenhagen, Bispebjerg Bakke 23, Building 13A, 2400 Copenhagen NV, Denmark. E-mail: [email protected] Submitted 12 August 2011; initial review completed 21 September 2011; final version accepted 6 December 2011 INTRODUCTION disorders [2]. Cannabis use in psychotic populations is associated with poorer prognosis and treatment outcome Cannabis is the most widely used illicit substance in the [3–7]. As such, both determination and quantification of world [1], and its use and abuse are especially prevalent the substance is of high importance to practitioners and in psychiatric populations, e.g. patients with psychotic researchers. Two common ways to assess cannabis use © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction Addiction, 107, 1123–1131 1124 Carsten Rygaard Hjorthøj et al. are retrospective self-report and biological matrices such self-reported use of cannabis. The TLFB (and other as blood or urine. Instruments and techniques exist that assessment instruments) was administered by a trained aim to improve reliability of self-reported cannabis use. interviewer. One such instrument is the manual-based timeline Other information was collected at these three inter- follow-back (TLFB), which uses a visual calendar to views, and in the present investigation these are used to enhance recall [8]. In a systematic review and meta- conduct subgroup analyses. This included measures of analysis we showed that TLFB validly assesses illicit sub- psychopathology (Positive and Negative Syndrome Scale stance use compared to biological samples [9]. However, for Schizophrenia—PANSS) [18], Manchester Short particularly for cannabis, some studies reported sub- Assessment of Quality of Life (MANSA) [19], the World optimal agreement between TLFB and urine [10,11]. In Health Organization’s Disability Assessment Schedules addition, most of the validation in the review was based (WHODAS-II) [20] and cognitive tests including the on determination rather than quantification of cannabis Hopkins Verbal Learning Test (HVLT) [21] and Trail use, and no studies used blood for validation, even though Making Tests A and B [22]. blood holds advantages over both urine and hair for this purpose [12]. Finally, the meta-analysis showed slightly Self-reported cannabis use lower agreement rates in the presence of psychiatric By means of the TLFB instrument, self-reported cannabis comorbidity. use was assessed for the past 30 days. This length of time Training raters to use a manual-based instrument was appropriate in terms of the randomized trial, in such as TLFB is cheaper than using blood. Blood samples which the primary aim was to reduce cannabis use. For require the use of a laboratory, and often storage facilities that purpose, a longer retrospective period would not such as freezers. Also, cannabis is detectable even in have been of interest. Patients were asked to provide blood for a limited time, varying from hours to at least a information on events such as birthdays, parties, out- week post-abstinence in chronic users [13,14]. Similarly, patient treatment visits, visits to the dealer, visits to or 11-nor-delta-9-tetrahydrocannabinol-9-carboxylic acid from friends, etc. This information was entered into the (THC-COOH) detection times have been reported as TLFB calendar and used to enhance recall by use of ques- ranging in one study from 3.5 to 74.3 hours [15] to 25 tions along the lines of: ‘on the day you visited your days in a case study of a chronic cannabis user [12]. mother two weeks ago, did you use any cannabis that Conversely, self-report is limited only by respondents’ day? And how about the days before and after, do you memory,which may allow for longer retrospective assess- remember?’. Information on cannabis use was sought to ment. Finally, even though formulas have been developed be specific regarding amount (e.g. number of joints) and to establish the quantities and frequencies of cannabis type (e.g. cannabis resin, sinsemilla). Only as a last resort use from blood [12,16], such information would be were typical amounts, frequencies or guesses used. From readily available from TLFB. this information, it was possible to establish number of The aim of the present study was to assess the corre- days with cannabis use in the preceding month and total lations and agreement between TLFB and blood samples amount of cannabis used. For the latter, amounts were for cannabis use in patients with comorbid cannabis use converted into ‘standard joints’, defined as 0.5 g of can- disorders and psychosis [17]. nabis resin. For more potent types of cannabis, e.g. sin- semilla, a factor of 1.5 was applied—this was the case for METHODS 13 subjects at baseline, three post-treatment and four at follow up. Subjects comprised the 103 participants in the CapOpus trial, full details of which regarding design and overall Blood samples results are reported elsewhere [17]. These patients provided 239 self-reports of cannabis use and 88 valid Each blood sample was obtained with a Vacuette® blood blood samples. Briefly, CapOpus was a randomized trial collection set into a 9-ml Vacuette® tube containing of a psychosocial intervention to treat cannabis abuse in potassium (K3) ethylenediamine tetraacetic acid (EDTA). people with both cannabis use disorder and psychosis Each sample was put immediately into a centrifuge to (the F2 section of ICD-10). Patients were randomized to isolate plasma, which was stored subsequently in a -80°C either treatment as usual (TAU) or CapOpus plus TAU freezer. Samples were analysed at Odense University Hos- for 6 months. Patients were interviewed at baseline, pital for delta-9-tetrahydrocannabinol (THC) and the post-treatment and at 4-month follow-up. Assessments metabolites 11-hydroxy-delta-9-tetrahydrocannabinol included a detailed TLFB of self-reported cannabis use (11-OH-THC) and THC-COOH using high-performance in the past 30 days. Patients were also asked (but liquid chromatography with tandem mass spectrometry not required) to provide a blood sample to validate detection (LC/MS/MS) [23–25]. Values were rounded to © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction Addiction, 107, 1123–1131 TLFB versus THC in plasma 1125 the nearest integer, except for THC and 11-OH-THC false negatives (FN: negative TLFB, positive blood), true values below 0.5 ng/ml; as the detection limit reported by negatives (TN: both TLFB and blood negative), false posi- the laboratory was 0.2 ng/ml, values of these molecules tives (FP: positive TLFB, negative blood) and true positives below 0.2 ng/ml were rounded to 0 ng/ml, and between (TP: both TLFB and blood positive). From these propor- 0.2 ng/ml and 0.5 ng/ml were kept unchanged. We also TP tions we also calculated sensitivity (), specificity calculated the cannabis influence factor (CIF) [12], which TP+ FN is used in Germany to interpret acute effects in cases of TN TP driving while intoxicated, and with higher CIF indicating (), positive predictive value ()and nega- FP+ TN TP+ FP THC[] ng/ ml11−− OH THC[] ng/ ml TN + tive predictive value ()of TLFB. Exact binomial recent use: CIF = 314. 5 330.
Load more

Recommended publications
  • Outcome Measurements in Economic Evaluations of Drug Misuse Interventions
    Outcome Measurements in Economic Evaluations of Drug Misuse Interventions Ching-Wen Chang A thesis submitted as fulfilment for the degree of Doctor of Philosophy Department of Health Sciences University of York September 2010 To my grandfather 2 Abstract This thesis critically evaluates the measurement of outcomes in economic evaluations of drug misuse interventions. Three different aspects of measuring outcomes are examined: one focusing on non-monetary outcomes at the individual patient level; one focusing on monetary outcomes within studies using individual patient level data; and one focusing on long-term outcomes, both monetary and non-monetary. The many limitations of measuring these outcomes in existing economic evaluations of drug misuse interventions are exposed and the problems with conducting such studies are identified. The importance of this thesis is thus in providing an overview and methodological critique of the extant economic evaluations of drug misuse interventions. In addition a decision analytic model for a drug testing in schools programme is developed to illustrate how the limitations highlighted in the methodological critique might be addressed by future research. The findings of the thesis reveal the problems with using EQ-5D as a generic outcome measure for economic evaluations of drug misuse interventions, as is recommended by NICE in the UK. The nature of drug misuse problems requires that a wide range of different measures, including drug misuse specific measures, must be taken into account when evaluating drug misuse interventions. Similarly, the limitations with existing studies that attempt to estimate the monetary outcome of drug misuse interventions are exposed, as many studies fail to take into account all of the costs that will determine the monetary impact of an intervention for society.
    [Show full text]
  • Cannabis and Psychosis: a Critical Overview of the Relationship
    Curr Psychiatry Rep (2016) 18:12 DOI 10.1007/s11920-015-0657-y SUBSTANCE USE AND RELATED DISORDERS (F LEVIN AND E DAKWAR, SECTION EDITORS) Cannabis and Psychosis: a Critical Overview of the Relationship 1 2,3,4,5 Charles Ksir & Carl L. Hart # Springer Science+Business Media New York 2016 Abstract Interest in the relationship between cannabis use examination, along with a variety of other problem behaviors and psychosis has increased dramatically in recent years, in (e.g., early or heavy use of cigarettes or alcohol and poor part because of concerns related to the growing availability of school performance). Future research studies that focus exclu- cannabis and potential risks to health and human functioning. sively on the cannabis-psychosis association will therefore be There now exists a plethora of scientific articles addressing of little value in our quest to better understand psychosis and this issue, but few provide a clear verdict about the causal how and why it occurs. nature of the cannabis-psychosis association. Here, we review recent research reports on cannabis and psychosis, giving par- Keywords Marijuana . Schizophrenia . Mental illness . ticular attention to how each report provides evidence relating Cognition . THC . Psychotic disorder to two hypotheses: (1) cannabis as a contributing cause and (2) shared vulnerability. Two primary kinds of data are brought to bear on this issue: studies done with schizophrenic patients Introduction and studies of first-episode psychosis. Evidence reviewed here suggests that cannabis does not in itself cause a psychosis There has been a recent explosion of interest in the relationship disorder. Rather, the evidence leads us to conclude that both between cannabis use and psychosis, with over 100 papers ad- early use and heavy use of cannabis are more likely in indi- dressing this topic each year since 2012, compared to fewer than viduals with a vulnerability to psychosis.
    [Show full text]
  • Ling Af Mennesker Med Skizofreni Og Komplekse Behand- Lingsforløb Vedvarende Symptomer, Mis- Brug Eller Mangelfuld Behand- Lingstilknytning
    National Klinisk Ret- ningslinje for behand- ling af mennesker med skizofreni og komplekse behand- lingsforløb Vedvarende symptomer, mis- brug eller mangelfuld behand- lingstilknytning Titel National Klinisk Retningslinje for behandling af mennesker med skizofreni - vedva- rende symptomer, misbrug eller mangelfuld behandlingstilknytning © Sundhedsstyrelsen, år. Publikationen kan frit refereres med tydelig kildeangivelse. Sundhedsstyrelsen Axel Heides Gade 1 2300 København S URL: http://www.sst.dk Sprog: Dansk Kategori: Faglig rådgivning. Høringsversion: 23. februar 2015. Format: PDF 2 / 131 Indhold 1 Indledning 8 1.1 Formål 8 1.2 Afgrænsning af patientgruppe 8 1.3 Målgruppe/brugere 8 1.4 Emneafgrænsning 8 1.5 Patientperspektivet 10 1.6 Juridiske forhold 10 2 Farmakologisk behandling 11 2.1 Reduktion af clozapin-dosis ved plasmakoncentration over den øvre grænse i det orienterende terapeutiske interval (fokuseret spørgsmål 1) 11 2.1.1 Anbefaling 11 2.1.2 Praktiske råd og særlige patientovervejelser 11 2.1.3 Baggrund for valg af spørgsmål 11 2.1.4 Litteratur 12 2.1.5 Gennemgang af evidensen 12 2.1.6 Arbejdsgruppens overvejelser 12 2.1.7 Rationale for anbefaling 13 2.2 Depotbehandling med antipsykotika (fokuseret spørgsmål 2) 14 2.2.1 Anbefaling 14 2.2.2 Praktiske råd og særlige patientovervejelser 14 2.2.3 Baggrund for valg af spørgsmål 14 2.2.4 Litteratur 15 2.2.5 Gennemgang af evidensen 15 2.2.6 Summary of Findings-tabel 16 2.2.7 Arbejdsgruppens overvejelser 19 2.2.8 Rationale for anbefaling 19 2.3 Tillægsbehandling med SSRI/SNRI (fokuseret
    [Show full text]
  • This Is the Author's Version of a Work That Was Submitted
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Queensland University of Technology ePrints Archive This is the author’s version of a work that was submitted/accepted for pub- lication in the following source: Rebgetz, Shane, Kavanagh, David J.,& Hides, Leanne (2016) Changes in cannabis use among psychotic clients without specialised sub- stance use treatment. Schizophrenia Research, 175(1-3), pp. 136-141. This file was downloaded from: https://eprints.qut.edu.au/94460/ c Crown Copyright c 2016 Published by Elsevier B.V. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 Notice: Changes introduced as a result of publishing processes such as copy-editing and formatting may not be reflected in this document. For a definitive version of this work, please refer to the published source: https://doi.org/10.1016/j.schres.2016.03.030 1 This is the preprint version of the journal article accepted for publication. Please cite as: Rebgetz, S., Kavanagh, D. J. Hides, L. Changes in cannabis use among psychotic clients without specialised substance use treatment, Schizophrenia Research, doi: 10.1016/j.schres.2016.03.030. 2 Corresponding Author: Mr Shane Rebgetz Locked Mail Bag 3 Caboolture Queensland Australia 4510 T: +61 7 5316 3100 (Australia) F: +61 7 5499 3171 (Australia) E-Mail: [email protected] Original article Changes in cannabis use among psychotic clients without specialised substance use treatment Shane Rebgetz1,2, David J Kavanagh1, Leanne Hides1 Authors: 1 Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
    [Show full text]
  • 3Rd Schizophrenia International Research Society Conference Schizophrenia: the Globalization of Research
    3rd Schizophrenia International Research Society Conference Schizophrenia: The Globalization of Research FLORENCE, ITALY 14 - 18 APRIL 2012 This meeting is jointly sponsored by the Vanderbilt University School of Medicine and the Schizophrenia International Research Society 3rd Schizophrenia International Research Society Conference Schizophrenia: The Globalization of Research Opening letter Dear Attendees, It is our great pleasure to welcome you to the 3rd Biennial Schizophrenia International Research Society (SIRS) Conference. SIRS is a non-profit organization dedicated to promoting research and communication about schizophrenia among research scientists internationally. We sincerely appreciate your interest in the Society and in our conference. The second congress in 2010 was a major success for the field attracting more than 1500 attendees from 53 countries. We anticipate an even higher attendance at this congress with most of the best investigators in the world in attendance. SIRS was founded in 2005 with the goal of bringing together scientists from around the world to exchange the latest advances in biological and psychosocial research in schizophrenia. The Society strives to facilitate international collaboration to discover the causes of, and better treatments for, schizophrenia and related disorders. Part of the mission of the Society is to promote educational programs in order to effectively disseminate new research findings and to expedite the publication of new research on schizophrenia. In addition to the Biennial Congress, the Society hosted the first regional meeting in São Paulo, Brazil in August of 2011. The meeting was a great success with over 150 presenters and 400 attendees. Under the outstanding leadership of Program Committee Chair Jim van Os and Co-Chair Dawn Velligan, we have an exciting scientific program planned for the 3rd Biennial Conference.
    [Show full text]
  • Severe Mental Illness and Substance Misuse (Dual Diagnosis): Community Health and Social Care Services
    Severe mental illness and substance misuse (dual diagnosis): community health and social care services Draft Review 1: The epidemiology, and current configuration of health and social care community services, for people in the UK with a severe mental illness who also misuse substances A systematic review Dr. Odette Megnin-Viggars, Ms Marie Brown, Ms Elena Marcus, Ms Sarah Stockton and Prof. Steve Pilling National Collaborating Centre for Mental Health Draft version v4.0, December 2015 Prepared for the Public Health and Social Care Centre at the National Institute for Health and Care Excellence (NICE) Severe mental illness and substance misuse (dual diagnosis) – community health and social services – Review 1 ACKNOWLEDGEMENTS The authors are also grateful for the helpful comments and support received from the project team (Lakshmi Murthy, Chris Carmona, Paul Levay, Caroline Mulvihill) at NICE. Page 2 of 301 Severe mental illness and substance misuse (dual diagnosis) – community health and social services – Draft Review 1 Table of Contents Acknowledgements ...................................................................................................................... 2 Glossary and abbreviations ....................................................................................................... 5 Executive summary ...................................................................................................................... 8 Introduction ................................................................................................................................
    [Show full text]
  • The Impact of Cannabis Use on Clinical Outcomes in Recent Onset Psychosis
    Schizophrenia Bulletin vol. 41 no. 2 pp. 382–390, 2015 doi:10.1093/schbul/sbu095 Advance Access publication July 9, 2014 The Impact of Cannabis Use on Clinical Outcomes in Recent Onset Psychosis Christine Barrowclough*,1, Lynsey Gregg1, Fiona Lobban2, Sandra Bucci1, and Richard Emsley3 1 2 School of Psychological Sciences, University of Manchester, Manchester, UK; Spectrum Centre, University of Lancaster, Lancaster, Downloaded from https://academic.oup.com/schizophreniabulletin/article/41/2/382/2526090 by guest on 28 September 2021 UK; 3Institute of Population Health, University of Manchester, Manchester, UK *To whom correspondence should be addressed; School of Psychological Sciences, University of Manchester, 2nd Floor Zochonis Building, Brunswick Street, Manchester M13 9PL, UK; tel: 0161-275-8485, fax: 0161-306-0406, e-mail: christine.barrowclough@ manchester.ac.uk Background: There are inconsistencies in findings as to detrimental effect of such widespread drug use in this pop- whether cannabis use has a negative impact on clinical out- ulation has been a major focus of research interest. There comes for people with established psychosis. Effects may be is now consistent evidence that cannabis is an independent more evident on patients with recent onset psychosis. Aim: risk factor for the development of psychosis,2 and that To investigate the relationship between cannabis use and cannabis use is associated with earlier onset of psychotic clinical outcome, including whether change in cannabis use illness,3 but the findings as to whether cannabis expo- affects psychotic symptoms, affective symptoms, functioning sure has a negative impact on clinical outcomes for those and psychotic relapse in a sample of people in early psycho- who have already developed a psychosis are less in agree- sis with comorbid cannabis abuse or dependence.
    [Show full text]
  • Université Du Québec À Chicoutimi Mémoire
    UNIVERSITÉ DU QUÉBEC À CHICOUTIMI MÉMOIRE PRÉSENTÉ À L’UNIVERSITÉ DU QUÉBEC À CHICOUTIMI COMME EXIGENCE PARTIELLE DE LA MAÎTRISE EN TRAVAIL SOCIAL PAR ALEXANDRE THÉBERGE LES FACTEURS D’INFLUENCE DANS LE RÉTABLISSEMENT DES PERSONNES ATTEINTES D’UN TROUBLE CONCOMITANT : UNE ÉTUDE EXPLORATOIRE AOÛT 2017 ii Sommaire Les troubles mentaux graves sont à l’origine de grandes souffrances humaines ce qui a pour effet d’altérer le fonctionnement social des individus et entrainer une forte utilisation de soins spécialisés gouvernementaux. Au Québec, le Ministère de la Santé et des Services sociaux (MSSS, 2005) dans son plan d’action en santé mentale affirme que de 2 à 3% de la population adulte souffre d’un trouble mental. Toutefois, on observe rarement la présence d'un seul diagnostic de TMG. En effet, les personnes atteintes d’un trouble mental grave risquent davantage d’avoir une problématique reliée à la consommation de substances et vice-versa (Skinner, O'Grady, Bartha, & Parker, 2004). Le plan d’action en santé mentale du MSSS (2005) a aussi démontré une forte corrélation entre ces deux problématiques. Jusqu’à deux tiers des personnes ayant un trouble mental au Québec auraient aussi une problématique de consommation de substances. Cette concomitance engendre de nombreuses complications dans la prise en charge de ces individus soit : une plus grande fréquence d’hospitalisation (Haywood et al., 1995), plus de rechutes (Landry, Cournoyer, Bergeron, & Brochu, 2001; Schmidt, Hesse, & Lykke, 2011; Swofford, Kasckow, Scheller-Gilkey, & Inderbitzin, 1996; Xie, McHugo, Fox, & Drake, 2005), davantage de probabilités de vivre des conditions de pauvreté (Caton et al., 1994; Drake et al., 1991; McGinty, Baker, Steinwachs, & Daumit, 2013; Schmidt et al., 2011), une satisfaction moins élevée dans les relations familiales (Dixon, McNary, & Lehman, 1995) ainsi que des risques plus élevés dans le domaine des infections transmissibles sexuellement et par le sang tel que l’hépatite C et le VIH/Sida (Rosenberg et al., 2001).
    [Show full text]
  • Exploring Methodological Issues in Mental Health
    FACULTY OF HEALTH S C I E N C E S SOUTHERN DANISH UNIVERSITY PSYCHIATRIC RESEARCH UNIT REGION ZEALAND PhD thesis Lene Halling Hastrup Exploring methodological issues in mental health economic evaluations: illustrated in relation to community mental intervention among persons with first-episode psychosis PhD thesis Exploring methodological issues in mental health economic evaluations: illustrated in relation to community mental health intervention among persons with first-episode psychosis Lene Halling Hastrup 3 Author Lene Halling Hastrup, MSc (Economics) Psychiatric Research Unit, Region Zealand Supervisors Dorte Gyrd-Hansen, Professor, PhD, Institute of Public Health, Southern Danish University & Australian Centre for Health Economic Research on Health, University of Queensland, Merete Nordentoft, Professor, MD, DMSc, Psychiatric Center Copenhagen, Mental Health Services in the Capital Region of Denmark and Faculty of Health Sciences, University of Copenhagen Christian Kronborg, Associate Professor, MSc., PhD, Institute of Public Health, Southern Danish University & Erik Simonsen, Professor, MD, PhD, Dr.h.c., Psychiatric Research Unit, Region Zealand and Faculty of Health Sciences, University of Copenhagen Review committee Chairperson: Professor Jan Sørensen, Southern Danish University Professor Carl Hampus Lyttkens, Lunds Universitet Associate Professor Ulrika Enemark, University of Aarhus Submitted November 2, 2011 Public defense June 1, 2012 4 Foreword This thesis is the result of three years of work at Psychiatric Research Unit, Region Zealand. I was enrolled two years at the University of Copenhagen and the final year at the Institute of Public Health at University of Southern Denmark. Region Zealand financed the Ph.D. project. The idea to the project came up when I was working as Project manager at Storstrøms County evaluating an Assertive Community Treatment (ACT) project, which was carried out at Falster and Southern Zealand.
    [Show full text]
  • First-Episode Psychosis and Co-Occurring Substance Use
    EVIDENCE-BASED RESOURCE GUIDE SERIES First-Episode Psychosis and Co-Occurring Substance Use Disorders Acknowledgments This report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA) under contract number HHSS2832017000651I/HHSS28342001T with SAMHSA, U.S. Department of Health and Human Services (HHS). Thomas Clarke served as contracting officer representative. Disclaimer The views, opinions, and content of this publication are those of the authors and do not necessarily reflect the views, opinions, or policies of SAMHSA. Nothing in this document constitutes a direct or indirect endorsement by SAMHSA of any non-federal entity’s products, services, or policies, and any reference to non-federal entity’s products, services, or policies should not be construed as such. Public Domain Notice All material appearing in this publication is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA. Electronic Access This publication may be downloaded from http://store.samhsa.gov Recommended Citation Substance Abuse and Mental Health Services Administration: First-Episode Psychosis and Co-Occurring Substance Use Disorders. Publication No. PEP19-PL-Guide-3 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2019. Originating Office National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857, Publication No. PEP19-PL-Guide-3. Nondiscrimination Notice SAMHSA complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
    [Show full text]
  • Program Book
    ND Schizophrenia 2 International Research Society Florence Conference 10-14 April, 2010 Dear Attendees, The Schizophrenia International Research Society, a non-profit organization dedicated to promoting research and communication among research scientists internationally about schizophrenia, sincerely appreciates your interest in the Society and our conference. The first congress in 2008 was a major success for the field attracting approximately 1500 attendees from 43 countries. We anticipate an even higher attendance at this congress with more of the best investigators in the field of schizophrenia in attendance. The Schizophrenia International Research Society was founded in 2005 with the goal of bringing together scientists from around the world to exchange the latest advances in biological and psychosocial research in schizophrenia. The Society strives to facilitate international collaboration to discover the causes and better treatments for schizophrenia and related spectrum disorders. Part of the mission of the Society is to promote educational programs in order to effectively disseminate new research findings and to expedite the publication of new and newsworthy research on schizophrenia. It is estimated that 1 in every 100 people in the world live with this disease. The Society and its meetings strive to increase the understanding of the personal, familial and societal impact of schizophrenia. Now more than ever there is a need for increased research funding for schizophrenia research around the world. By attending the 2nd Biennial Conference of the Society you will be exposed to sessions that will assist you to: • Foster communication and advance knowledge about the multiple treatment possibilities for schizophrenia. • Develop the best methods to design new intervention studies.
    [Show full text]
  • Trials Biomed Central
    Trials BioMed Central Study protocol Open Access Design paper: The CapOpus trial: A randomized, parallel-group, observer-blinded clinical trial of specialized addiction treatment versus treatment as usual for young patients with cannabis abuse and psychosis Carsten Hjorthøj*1, Allan Fohlmann1, Anne-Mette Larsen1, Mette TR Madsen1, Lone Vesterager1, Christian Gluud2, Mikkel C Arendt3 and Merete Nordentoft1 Address: 1Psychiatric Center Bispebjerg, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark, 2Center for Clinical Intervention Research, Copenhagen Trial Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark and 3Centre for Psychiatric Research, Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark Email: Carsten Hjorthøj* - [email protected]; Allan Fohlmann - [email protected]; Anne-Mette Larsen - [email protected]; Mette TR Madsen - [email protected]; Lone Vesterager - [email protected]; [email protected]; Mikkel C Arendt - [email protected]; Merete Nordentoft - [email protected] * Corresponding author Published: 11 July 2008 Received: 30 April 2008 Accepted: 11 July 2008 Trials 2008, 9:42 doi:10.1186/1745-6215-9-42 This article is available from: http://www.trialsjournal.com/content/9/1/42 © 2008 Hjorthøj et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: A number of studies indicate a link between cannabis-use and psychosis as well as more severe psychosis in those with existing psychotic disorders. There is currently insufficient evidence to decide the optimal way to treat cannabis abuse among patients with psychosis.
    [Show full text]