kcl.ac.uk.2Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK.3Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK.4Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK.5Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK.6Department of Psychiatry, University of Cambridge, Cambridge, UK; Psylife Group, Division of Psychiatry, University College London, London, UK.7Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy.8Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy.9INSERM U955, Equipe 15, Institut National de la Santé et de la Recherche Médicale, Créteil, Paris, France.10Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), Madrid, Spain.11Etablissement Public de Santé Maison Blanche, Paris, France.12Department of Psychiatry, Early Psychosis Section, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands.13Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital clinic, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.14Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.15Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil.16Rivierduinen Institute for Mental Health Care, Leiden, Netherlands.17Department of Psychiatry, University of Cambridge, Cambridge, UK; CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK.18Psylife Group, Division of Psychiatry, University College London, London, UK.19Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, Netherlands.20Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK; Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.21Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK; Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands.22Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, UK.23Department of Addiction, Institute of Psychiatry, King’s College London, London, UK.24Institute of Psychiatry, Psychology and Neuroscience and Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK; South London and Maudsley NHS Mental Health Foundation Trust, London, UK.AbstractBACKGROUND:

Cannabis use is associated with increased risk of later psychotic disorder but whether it affects incidence of the disorder remains unclear. We aimed to identify patterns of cannabis use with the strongest effect on odds of psychotic disorder across Europe and explore whether differences in such patterns contribute to variations in the incidence rates of psychotic disorder.

METHODS:

We included patients aged 18-64 years who presented to psychiatric services in 11 sites across Europe and Brazil with first-episode psychosis and recruited controls representative of the local populations. We applied adjusted logistic regression models to the data to estimate which patterns of cannabis use carried the highest odds for psychotic disorder. Using Europe-wide and national data on the expected concentration of Δ9-tetrahydrocannabinol (THC) in the different types of cannabis available across the sites, we divided the types of cannabis used by participants into two categories: low potency (THC <10%) and high potency (THC View the Original article

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