Substance Misuse and Cognitive Functioning in People with Psychosis

Substance misuse has been proven to have many negative academic, behavioral, and emotional effects. Individuals who are addicted to alcohol, opiates, cocaine, or cannabis have been studied at length in an effort to demonstrate the deleterious consequences of substance use on users, family members, friends, employers, and society at large. But less is known about how substance use affects cognitive abilities of individuals with psychotic disorders. This is a critical area of research, as substance use rates are particularly high in individuals with psychosis, especially people with schizophrenia. Kim Donoghue of the Division of Psychiatry at the University of Nottingham in England recently conducted a meta-analysis of existing research on substance and poly-substance use among individuals diagnosed with psychosis.

Donoghue reviewed numerous studies that included people with psychosis who had a history of substance use, misuse, and dependency related to alcohol, cannabis, and cocaine. The literature also included participants with psychosis who had no history of substance use. Donoghue analyzed how each level of use and each particular substance affected cognitive functioning and found that in contrast to what was expected, individuals with psychosis who used drugs performed better on some cognitive tests than those who did not use drugs. Specifically, cocaine users had better psychomotor processing speed and attention than nonusers, but had deficits in memory and verbal ability. Individuals with psychosis who used cannabis had better overall functioning than those who did not use cannabis.

The findings revealed here should be considered with caution. First, Donoghue acknowledges that the effect sizes in her study were small. The limited number of studies focusing on unique substance use with psychosis limited the scope of the results. Also, Donoghue points out that the differentiation between use, misuse, and dependency varied between studies. One explanation for the finding related to cannabis is that it is theorized that these individuals may be higher-functioning individuals. If they are able to seek out and acquire drugs, despite the limitations of their psychosis, they may have higher functional competence and more neurological capacity than their nonusing peers. However, this finding should not be considered advocacy for drug use. Donoghue added, “Longitudinal studies with a more extensive follow-up period will enable an in-depth assessment of the extent of impairment resulting from long-term substance misuse.”

Reference:
Donoghue, Kim, and Gillian A. Doody. Effect of illegal substance use on cognitive function in individuals with a psychotic disorder, a review and meta-analysis. Neuropsychology 26.6 (2012): 785-801. Print.

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  • mark

    mark

    November 23rd, 2012 at 5:20 PM

    interesting to see some of these drugs actually seem to have helped..but I see what you mean when it says this shouldn’t been taken as an advocacy for usage,but medicinal uses need to be explored,they have really not been due to the prohibition,what’s wrong in research?

  • Marley

    Marley

    November 24th, 2012 at 5:24 AM

    Shouldn’t be used as advocacy for drug use? Well you know that this is exactly the way that it is going to be used by people who are always looking for ways to validate how they feel about using drugs and seeking ways to legitimize the use of them.

  • Natasha

    Natasha

    November 24th, 2012 at 1:45 PM

    We need to look at long term effects too.Because something that can cause problems to all people but gives some benefits in the short term may not be that beneficial after all.And moreover, administering substances to those with psychosis may always produce an unpredictable result.Better to be safe than sorry,even in test conditions!

  • 000

    000

    November 24th, 2012 at 4:55 PM

    it maybe helping by showing that there is a way out of that traumatic realty of psychosis

  • Raegan

    Raegan

    November 25th, 2012 at 4:23 PM

    SO cannabis helps in better overall functioning yet they do not want to acknowledge it.It has so many proven medical benefits and yet the Federal government thinks it is deadly.We see this fear and paranoia spread everyday.Just why is the Federal government afraid of letting free research on cannabis continue?Is the truth so hard to digest?!

  • BENNY

    BENNY

    November 26th, 2012 at 12:15 AM

    “However, this finding should not be considered advocacy for drug use.”

    That sounds right.But wouldn’t it be great if we could replicate the reactions happening and thus produce good results MINUS the drugs involved?

  • Jenn

    Jenn

    November 26th, 2012 at 3:59 AM

    Well, this really does back up the claim that a lot of college students are making that they study better and retain information better when they are “substance impaired”. Not sure that I buy into all of this as it is still a small sample; however I do believe that there are some people for whom this allows them to relax and get past the anxiety that the material could be causing, and therefore allows them to be a little more open to ingesting and retaining the right information.

  • easton

    easton

    November 26th, 2012 at 3:52 PM

    @Jenn:I’ve never heard of this!If true this is not a good thing at all.These drugs are never a good thing and to consider they help retain whatever you’re studying just seems to be a desperate attempt to legitimize its use.I don’t think anybody has gained any super abilities while under the influence of any drug.The instances of people doing crazy things that land them in a soup?There are many of those!

  • Reuben M

    Reuben M

    November 27th, 2012 at 1:17 PM

    Are these drugs really helping these people with their condition? Or have they become so dependent due to their condition that the consumption actually makes them better?!

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