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If cannabis caused schizophrenia - how many cannabis users may need to be prevented in order to prevent one case of schizophrenia? England and Wales calculations

Hickman, Matt, Vickerman, Peter, Macleod, John, Lewis, Glyn, Zammit, Stanley, Kirkbride, James and Jones, Peter 2009. If cannabis caused schizophrenia - how many cannabis users may need to be prevented in order to prevent one case of schizophrenia? England and Wales calculations. Addiction 104 (11) , pp. 1856-1861. 10.1111/j.1360-0443.2009.02736.x

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Abstract

Background We consider how many cannabis users may need to be prevented in order to prevent one case of schizophrenia or psychosis [defined as number needed to prevent (NNP)]. Method Calculation for England and Wales using best available estimates of: incidence of schizophrenia; rates of heavy and light cannabis use; and risk that cannabis causes schizophrenia. Results In men the annual mean NNP for heavy cannabis and schizophrenia ranged from 2800 [90% confidence interval (CI) 2018–4530] in those aged 20–24 years to 4700 (90% CI 3114–8416) in those aged 35–39. In women, mean NNP for heavy cannabis use and schizophrenia ranged from 5470 (90% CI 3640–9839) in those aged 25–29 to 10 870 (90% CI 6786–22 732) in 35–39-year-olds. Equivalent mean NNP for heavy cannabis use and psychosis were lower, from 1360 (90% CI 1007–2124) in men aged 20–24 and 2480 (90% CI 1408–3518) in women aged 16–19. The mean and median number of light cannabis users that would need to be prevented in order to prevent one case of schizophrenia or psychosis per year are four to five times greater than among heavy users. Conclusions The number of young people who need to be exposed to an intervention to generate NNP and prevent one case of schizophrenia will be even larger. The public health importance of preventing cannabis to reduce schizophrenia or psychosis remains uncertain. More attention should be given to testing the hypothesis that cannabis is related causally to psychotic outcomes, and to considering what strategies will be the most effective in reducing heavy cannabis use among young people.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Uncontrolled Keywords: Cannabis; models; number needed to prevent; prevention; psychosis; schizophrenia
Publisher: Wiley-Blackwell
ISSN: 0965-2140
Last Modified: 04 Jun 2017 03:56
URI: http://orca.cf.ac.uk/id/eprint/29225

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