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Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people

BMJ 2004; 330 doi: https://doi.org/10.1136/bmj.38267.664086.63 (Published 30 December 2004) Cite this as: BMJ 2004;330:11

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Some remarks on the excellent paper...

Dear Sir/Madam,

We would like to make some observations on this article in the light of our extensive clinical experience (approximately fifty five thousand acute psychiatric patients, in the course of thirty five years). Our work was first carried out on a psychiatric ward (70 beds) between 1959 and 1992. From 1959 to 1963, we worked with patients who had exclusively consumed cannabis, and since 1968 our cases have been politox users. After Weitbrecht’s contribution (1957, 1959), we became especially interested in this syndrome and have isolated (Natural History of cannabis patient evolution) some particular syndromes which seem to us to be more interesting than mere symptoms:

• Cannabic Ivresse
• Amotivational Syndrome
• Psychological Addiction
• Somatic Dependence (abstinence syndrome)
• Verbal Hallucinatory cases (uncriticised Acoustic Hallucinations in the grammatical 2nd person singular)
• Verbal Hallucinosis (partial criticism with phonemic Hallucinations in the 3rd grammatical person)
• Revindicative delusion on ‘Weltanschauung Problems’ (Janzarik)
• Defectual situation.

We would also like to comment on language disturbance in cannabis users. These patients have a perturbation of language “sur mesure” (syntactic construction, categorical conceptions) and their language is degraded to a protopathic level. We attribute academic failure at school to this language/thinking disturbance. (Wittgenstein)

Finally, we wish to point out that in Psychiatry the symptomatic and syndromic expression is never specific, but only typical. (Weitbrecht)

Prof. Dr. Antonio López Zanón.
Emeritus Profesor, Universidad Complutense de Madrid, Spain.
Honorary Profesor, Universidad Autónoma, Santo Domingo, R.D.

Mary G. Allport
Associate Lecturer, Universidad Pontificia Comillas, Madrid, Spain.
Associate Lecturer, The Open University, United Kingdom.

Bibliography: Sobre las drogas y los drogadictos (a través de su ejemplo – tipo: los consumidores de cannabis) A. López Zanón, I. López San Roman, P. Blanco. Edipo, S.A., 2004.

Competing interests: None declared

Competing interests: No competing interests

25 January 2005
Antonio lopez zanon
psychiatric clinic
Mary G. Alport
Madrid. 28003. Spain