The association between cannabis use and facial emotion recognition in schizophrenia, siblings, and healthy controls: Results from the EUGEI study

Fusar-Poli, Laura
Pries, Lotta-Katrin
van Os, Jim
Radhakrishnan, Rajiv
Pençe, Ayşegül Yay
Erzin, Gamze
Delespaul, Philippe
Kenis, Gunter
Luykx, Jurjen J
Lin, Bochao D
Akdede, Berna
Binbay, Tolga
Altınyazar, Vesile
Yalınçetin, Berna
Gümüş-Akay, Güvem
Cihan, Burçin
Soygür, Haldun
Ulaş, Halis
Cankurtaran, Eylem Şahin
Kaymak, Semra Ulusoy
Mihaljevic, Marina M
Andric-Petrovic, Sanja
Mirjanic, Tijana
Bernardo, Miguel
Mezquida, Gisela
Amoretti, Silvia
Bobes, Julio
Saiz, Pilar A
García-Portilla, Maria Paz
Sanjuan, Julio
Aguilar, Eduardo J
Santos, José Luis
Jiménez-López, Estela
Arrojo, Manuel
Carracedo, Angel
López, Gonzalo
González-Peñas, Javier
Parellada, Mara
Maric, Nadja P
Atbaşoğlu, Cem
Üçok, Alp
Alptekin, Köksal
Saka, Meram Can
Aguglia, Eugenio
Arango, Celso
Rutten, Bart PF
Guloksuz, Sinan
Schizophrenia is frequently accompanied with social cognitive disturbances. Cannabis represents one established environmental factor associated with the onset and progression of schizophrenia. The present cross-sectional study aimed to investigate the association of facial emotion recognition (FER) performance with cannabis use in 2039 patients with schizophrenia, 2141 siblings, and 2049 healthy controls (HC). FER performance was measured using the Degraded Facial Affect Recognition Task (DFAR). Better FER performance as indicated by higher DFAR-total scores was associated with lifetime regular cannabis use in schizophrenia (B = 1.36, 95% CI 0.02 to 2.69), siblings (B = 2.17, 95% CI 0.79 to 3.56), and HC (B = 3.10, 95% CI 1.14 to 5.06). No associations were found between DFAR-total and current cannabis use. Patients with schizophrenia who started to use cannabis after the age of 16 showed better FER performance than patients who started earlier (B = 2.50, 95% CI 0.15 to 4.84) and non-users (B = 3.72, 95 CI 1.96 to 5.49). Better FER performance was found also in siblings who started to use cannabis after 16 compared to non-users (B = 2.37, 95% CI 0.58 to 4.16), while HC using cannabis performed better than non-users at DFAR-total regardless of the age at onset. Our findings suggest that lifetime regular cannabis use may be associated with better FER regardless of the psychosis risk, but that FER might be moderated by age at first use in people with higher genetic risk. Longitudinal studies may clarify whether there is a cause-and-effect relationship between cannabis use and FER performance in psychotic and non-psychotic samples.
European Neuropsychopharmacology


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Citation Formats
L. Fusar-Poli et al., “The association between cannabis use and facial emotion recognition in schizophrenia, siblings, and healthy controls: Results from the EUGEI study,” European Neuropsychopharmacology, vol. 63, pp. 47–59, 2022, Accessed: 00, 2023. [Online]. Available: