Capopus - Intervention Study For Cannabis Use Disorder In Psychosis

Presentation First Author: 
Carsten Hjorthøj

Context: Cannabis abuse is highly prevalent in psychotic patients. Previous psychosocial interventions have shown little efficacy for reducing cannabis use, possibly owing to low sample size and risk of bias. Design Centrally randomised, observer-blinded, parallel-group clinical trial. Patients A referred sample of 103 patients with ICD-10 psychosis and cannabis-use disorder. Interventions Patients were randomised to six months of TAU (n=51) or TAU plus CapOpus (n=52), the latter consisting mainly of motivational interviewing and cognitive behaviour therapy. TAU was targeted primarily at the psychotic disorder and not provided by trial staff. Main outcome measure The a-priori defined main outcome measure was self-reported days with cannabis use in the preceding month. Results Pre-randomisation cannabis-frequency was 14.9 (95 % CI 12.7 to 17.1) days/month. Post-treatment, the ratio of days/month with cannabis use in CapOpus versus TAU was 0.76 (0.38 to 1.50) (p=0.42), and 0.80 (0.21 to 3.10) (p=0.75) at follow up. From 46.4 (36.4 to 56.3) monthly joints pre-randomisation, post-treatment monthly joints were 27.3 (12.6 to 41.9) in CapOpus and 48.2 (31.8 to 64.6) in TAU (p=0.06). Follow-up amounts were 28.4 (13.5 to 43.2) and 41.6 (25.2 to 58.0) joints (p=0.23). Importantly, younger patients had better efficac, indicating that early psychosis may be an important intervention target. Conclusions CapOpus did not reduce frequency, but possibly amount, of cannabis use. Young patients may be at a vulnerable period in which treatment for cannabis use disorders is vital.

Conference Name: 
Presentation Date: 
January, 2013
Additional Authors: 
Carsten Hjorthøj, Allan Fohlmann, Anne-Mette Larsen, Christian Gluud, Mikkel Arendt, Merete Nordentoft
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