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Original journal article (apparently not linked to in the Bloomberg piece): Association between cannabis use disorder and schizophrenia stronger in young males

Original journal article (apparently not linked to in the Bloomberg piece): Association between cannabis use disorder and schizophrenia stronger in young males than in females (May 4 2023) https://www.cambridge.org/core/journals/psychological-medicine/article/association-between-cannabis-use-disorder-and-schizophrenia-stronger-in-young-males-than-in-females/E1F8F0E09C6541CB8529A326C3641A68 https://www.cambridge.org/core/journals/psychological-medici... Interestingly, the journal article doesn't bother to mention how cannabis use disorder (CUD) is defined; however, Bloomberg's description "frequent use despite negative consequences" is essentially that of the DSM, and so is presumably what they're using. That is - not based any particular rate of consumption (which is of course difficult to measure reliably, especially in prohibitionist countries like Denmark). But "continued use despite negative consequences". And that seems to be the crux of the matter: what the article is saying, basically, is that "people who continue to use despite negative consequences ... continue to suffer negative consequences." Which is rather different from: "Heavy use, by itself, brings these consequences."

sosodev 3y ago
Oh that's interesting. I thought the linked review study was what they were referencing. Why would they reference a study as the basis for the entire article without linking to it? .-. This really seems like bad journalism for the sake of clickbait.
- autoexec 3y ago
  It feels like I see this a lot more recently and not just with science articles. Someone will write an entire article about a subject and never provide enough information for anyone to reach any informed opinion about it at all. It might be an article about a controversial statement someone made, but they'll never quote or link to what was actually said and instead only talk about the drama surrounding it. When the article is about the text of a proposed law, the law is rarely linked to and is often not even named. It feels like I see way more links to random people's tweets from news sources than links to actual sources. I guess commentary gets more clicks than content, but I the content is what actually matters and is usually what I'm interested in.
  - Hxfso-1 3y ago
    Interesting observation!
vitehozonage 3y ago
Indeed. Shameful level of journalism. Every time I see reporting relating to health science I expect this and it is generally the case, it is so disappointing.
- zoiksmeboiks 3y ago
  Capitalist journalism will seek to preserve capitalism, which demands sober workers to exploit.
vanjajaja1 3y ago
How is 'negative consequences' defined? I think its interesting that young males experience it more than young females, but it does make me wonder if 'negative consequences' is a boundary defined by society that these young males are choosing to ignore and thereby self selecting into another hazily defined illness.
notacoward 3y ago
> "people who continue to use despite negative consequences ... continue to suffer negative consequences." That's an inaccurate paraphrase. What they're saying is that people who continue to use despite negative consequences are more likely to suffer this particular negative consequence. Not as strong a statement as the headline, perhaps, but also not as weak as your misparaphrase.
bjourne 3y ago
> Interestingly, the journal article doesn't bother to mention how cannabis use disorder (CUD) is defined; however, Bloomberg's description "frequent use despite negative consequences" is essentially that of the DSM, and so is presumably what they're using. Yes, it does: "CUD was identified in the same registers and supplemented with the somatic part of the National Patient Register, defined as ICD-8 code 304.5 and ICD-10 code F12.X." 304.5 is the diagnostic code for CUD. We can infer that a person with CUD themselves have considered their cannabis use to be problematic. Otherwise they wouldn't have been diagnosed.
- lisasays 3y ago
  Good catch. I scanned for it but missed it.
gwern 3y ago
I'll save everyone a click: yes, this is a case of 'correlation != causation'. We know extremely well, for a fact, that at least a good chunk of the SCZ/marijuana use relationship is confounded/reverse causation. The authors do little to improve over the known-wrong simple correlation strategy. This is especially lame when they have access to the Danish population registry with its rich metadata and very large _n_, and could so easily control for a lot of confounds, by doing within-family comparisons. (Spoilers: the correlations would shrink a lot if you compare siblings or better yet, twins. Tip to the authors if you're reading this: 'controlling for parental history of schizophrenia', for something as rare as schizophrenia where so few are diagnosed but will still be carrying heavy liability, doesn't control for genetic factors.) They could have done some actual science, and contributed some knowledge; instead, all they did was waste everyone's time by contributing yet another meaningless highly-confounded piece of research to add to the pile of other equally useless correlates on SCZ/marijuana, a pile which did not need increasing. What a waste.
- lisasays 3y ago
  I'll save everyone a click: yes, this is a case of 'correlation != causation'. The authors (whose freshman stats classes were presumably as good as yours) were evidently well aware of this distinction - which is why they took the trouble to say 'association' rather than 'causation' in the title. So the pedantry here seems rather misplaced.
  - gwern 3y ago
    No, my pedantry is not misplaced. Let me again repeat: we know the correlate is confounded. This isn't a hypothetical. It is a known fact established from many different methods triangulating the same result: the naive SCZ/marijuana correlation is confounded, and quite substantially so. Their entire analysis is predicated on an assumption which is substantially false. And I agree they know what they're doing, which is why it makes me so angry to read their paper and I am criticizing them personally and not simply raising a technical point: they know they are peddling bullshit, and at best, they want to believe, and at worst, they are cynically manufacturing scary media-friendly results they know will be cited more than the results they should have published, 'the SCZ/marijuana relationship was attenuated by over half when we ran the standard within-family analysis on the population register like we should have, yet again demonstrating how confounded it is and how hard it will be to infer any causality, sad to say for those looking for a quick hit of scary controversy and reason to ban marijuana'. The authors themselves cover up and ignore the many past results demonstrating confounding, fail to do better when they so easily could have, and then have the sheer unmitigated chutzpah, the incredible gal, to just say "assuming causality" right in the abstract to immediately start advertising huge inflammatory claims like "one-fifth of cases of schizophrenia among young males might be prevented by averting CUD." (again, from the abstract, and repeated throughout). Yes, and 'assuming the moon is made of cheese', we could save a ton on moon base supplies and might avert one-fifth of moon base costs by mining the cheese... But I don't advise going to the media about your exciting new research about how NASA could trim its budgets. I don't blame the people reporting on this for getting it wrong, when the authors spin it so hard that a CD would explode.

sosodev 3y ago

Oh that's interesting. I thought the linked review study was what they were referencing. Why would they reference a study as the basis for the entire article without linking to it? .-. This really seems like bad journalism for the sake of clickbait.

autoexec 3y ago
It feels like I see this a lot more recently and not just with science articles. Someone will write an entire article about a subject and never provide enough information for anyone to reach any informed opinion about it at all. It might be an article about a controversial statement someone made, but they'll never quote or link to what was actually said and instead only talk about the drama surrounding it. When the article is about the text of a proposed law, the law is rarely linked to and is often not even named. It feels like I see way more links to random people's tweets from news sources than links to actual sources. I guess commentary gets more clicks than content, but I the content is what actually matters and is usually what I'm interested in.
- Hxfso-1 3y ago
  Interesting observation!

vitehozonage 3y ago

Indeed. Shameful level of journalism. Every time I see reporting relating to health science I expect this and it is generally the case, it is so disappointing.

zoiksmeboiks 3y ago
Capitalist journalism will seek to preserve capitalism, which demands sober workers to exploit.

vanjajaja1 3y ago

How is 'negative consequences' defined? I think its interesting that young males experience it more than young females, but it does make me wonder if 'negative consequences' is a boundary defined by society that these young males are choosing to ignore and thereby self selecting into another hazily defined illness.

notacoward 3y ago

> "people who continue to use despite negative consequences ... continue to suffer negative consequences." That's an inaccurate paraphrase. What they're saying is that people who continue to use despite negative consequences are more likely to suffer this particular negative consequence. Not as strong a statement as the headline, perhaps, but also not as weak as your misparaphrase.

bjourne 3y ago

> Interestingly, the journal article doesn't bother to mention how cannabis use disorder (CUD) is defined; however, Bloomberg's description "frequent use despite negative consequences" is essentially that of the DSM, and so is presumably what they're using. Yes, it does: "CUD was identified in the same registers and supplemented with the somatic part of the National Patient Register, defined as ICD-8 code 304.5 and ICD-10 code F12.X." 304.5 is the diagnostic code for CUD. We can infer that a person with CUD themselves have considered their cannabis use to be problematic. Otherwise they wouldn't have been diagnosed.

lisasays 3y ago
Good catch. I scanned for it but missed it.

gwern 3y ago

I'll save everyone a click: yes, this is a case of 'correlation != causation'. We know extremely well, for a fact, that at least a good chunk of the SCZ/marijuana use relationship is confounded/reverse causation. The authors do little to improve over the known-wrong simple correlation strategy. This is especially lame when they have access to the Danish population registry with its rich metadata and very large _n_, and could so easily control for a lot of confounds, by doing within-family comparisons. (Spoilers: the correlations would shrink a lot if you compare siblings or better yet, twins. Tip to the authors if you're reading this: 'controlling for parental history of schizophrenia', for something as rare as schizophrenia where so few are diagnosed but will still be carrying heavy liability, doesn't control for genetic factors.) They could have done some actual science, and contributed some knowledge; instead, all they did was waste everyone's time by contributing yet another meaningless highly-confounded piece of research to add to the pile of other equally useless correlates on SCZ/marijuana, a pile which did not need increasing. What a waste.

lisasays 3y ago
I'll save everyone a click: yes, this is a case of 'correlation != causation'. The authors (whose freshman stats classes were presumably as good as yours) were evidently well aware of this distinction - which is why they took the trouble to say 'association' rather than 'causation' in the title. So the pedantry here seems rather misplaced.
- gwern 3y ago
  No, my pedantry is not misplaced. Let me again repeat: we know the correlate is confounded. This isn't a hypothetical. It is a known fact established from many different methods triangulating the same result: the naive SCZ/marijuana correlation is confounded, and quite substantially so. Their entire analysis is predicated on an assumption which is substantially false. And I agree they know what they're doing, which is why it makes me so angry to read their paper and I am criticizing them personally and not simply raising a technical point: they know they are peddling bullshit, and at best, they want to believe, and at worst, they are cynically manufacturing scary media-friendly results they know will be cited more than the results they should have published, 'the SCZ/marijuana relationship was attenuated by over half when we ran the standard within-family analysis on the population register like we should have, yet again demonstrating how confounded it is and how hard it will be to infer any causality, sad to say for those looking for a quick hit of scary controversy and reason to ban marijuana'. The authors themselves cover up and ignore the many past results demonstrating confounding, fail to do better when they so easily could have, and then have the sheer unmitigated chutzpah, the incredible gal, to just say "assuming causality" right in the abstract to immediately start advertising huge inflammatory claims like "one-fifth of cases of schizophrenia among young males might be prevented by averting CUD." (again, from the abstract, and repeated throughout). Yes, and 'assuming the moon is made of cheese', we could save a ton on moon base supplies and might avert one-fifth of moon base costs by mining the cheese... But I don't advise going to the media about your exciting new research about how NASA could trim its budgets. I don't blame the people reporting on this for getting it wrong, when the authors spin it so hard that a CD would explode.