The Relation of Cannabis and Alcohol Use with Cortisol and Symptom Severity in Youth At- Risk for Psychosis Open Access

Abstract

Abstract
The Relation of Cannabis and Alcohol Use with Cortisol and Symptom Severity in Youth At-
Risk for Psychosis
By Sara M. Feldman
Approximately half of the patients suffering from schizophrenia have a lifetime comorbid
substance use disorder (SUD) diagnosis. Substance use among psychotic patients is twice the
rate of use among healthy controls in the general population. SUDs in schizophrenic patients are
associated with poorer clinical outcomes. Research shows that 25 to 45% of individuals who
meet criteria for the prodrome to schizophrenia convert to a full-blown psychotic disorder within
2 to 5 years. Further, individuals who meet prodromal criteria are increasingly likely to convert
to a psychotic disorder if they use cannabis. Experimental studies where Delta-9-THC was
administered show acute increases in cortisol levels. The present study examined the relation of
alcohol (AU) and cannabis use (CU) with cortisol levels and symptoms in 33 healthy controls, 56
prodromal patients, and 40 psychiatric controls. The current study hypothesized that prodromal
subjects who report CU will show elevated cortisol levels, as well as more severe positive
symptoms. The present study indicated no relation of AU with cortisol levels, symptoms, or
conversion to psychosis. Further, the findings indicated that CU was not associated with
symptom severity or progression. However, CU was linked with reduced cortisol levels. The
results are interpreted in light of past findings indicating that youth with lower baseline cortisol
levels are more likely to become cannabis users in the future, and that longer term CU is linked
with reduced cortisol levels. Thus, although CU results in an acute increase in cortisol and
positive symptoms, initial CU and prolonged CU appears to be associated with lower cortisol
levels.

Table of Contents

Table of Contents
Introduction......................................................................................................................................1
Method...........................................................................................................................................19
Results............................................................................................................................................24
Discussion......................................................................................................................................32
References......................................................................................................................................41
Tables.............................................................................................................................................49
Figures............................................................................................................................................56

About this Honors Thesis

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School	Emory College
Department	Psychology
Degree	BA
Submission	Honors Thesis
Language	English
Research Field	Psychology, General
Keyword	cannabis alcohol prodromal symptom severity
Committee Chair / Thesis Advisor	Walker, Elaine, Emory University
Committee Members	Scott, Tracy L, Emory University Nowicki Jr., Stephen, Emory University

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