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Schizophrenia and Cannabis

Sheila Caffell and the link between Schizophrenia and Cannabis.

Written by Tazmin Whitefoot - in support of Jeremy Bamber and his ongoing campaign to achieve justice.

In the early hours of August 7th 1985 five people were shot to death at White House Farm. They were Sheila Caffell, her twin six year old boys and her adoptive parents, June and Nevill Bamber. Initially the police believed that Sheila was responsible for the shootings and had then committed suicide. However, in the weeks that followed, that view changed and it was Jeremy Bamber, Sheila’s brother (also adopted, but no blood relation), who was arrested and later convicted. He has since served 25 years in prison for a crime which (in my opinion), he did not commit. The purpose of this article is to explain the link between schizophrenia and cannabis and to show how Sheila’s collapsing mental health had caused her to suffer a psychotic break and murder her family.

Schizophrenia is a mental disorder that is characterised by a disintegration of the process of thought and of emotional responses. Most commonly, the disorder presents as paranoid or bizarre delusions, auditory hallucinations and/or disorganised, incoherent speech and thinking. It is believed that genetics can sometimes play a role in predisposing a person to develop the illness as well as other causal factors, such as a history of mental illness and/or abuse of drugs and alcohol. There is no laboratory test to determine schizophrenia; a diagnosis is made based on the patient’s self reported symptoms and a clinical assessment. It is known that approximately 30-40% of diagnosed schizophrenics attempt suicide at some point during their lifetime and 1 in 10 eventually will eventually commit suicide. It is also known that people between the ages of 16-30 are more vulnerable to developing a psychosis. It is also between this age-range that people are more likely to use cannabis.

In recent years much research has been conducted into schizophrenia to try and establish the link between the illness and the effects of taking cannabis and other drugs. Over 30 different clinical studies have taken place over the past 20 years alone, mostly in the UK, Sweden and Australia. It is now widely believed that using cannabis can prolong the symptoms of mental illness and impede a patient’s chances of recovering from a psychotic episode. If a patient has already developed schizophrenic symptoms then the continuing use of cannabis and other substances, such as alcohol or amphetamines, is thought to have a detrimental effect on the course of their illness. Set out below are details of 2 case studies to give an example of the kind of research that has been so far conducted.

A recent study published in the American Journal of Psychiatry (May 2010) reports some very interesting findings. The authors of the study set out to examine the relationship between patients diagnosed with schizophrenia and the use of cannabis. The study was conducted over a 10 year period, during the initial first period of psychiatric hospitalisation and then at 6 months and 2, 4 and 10 years later. At each assessment patients were rated on their psychiatric symptoms and cannabis use. The conclusion reached is that cannabis use is associated with an adverse course of psychoticsymptoms in schizophrenia sufferers.

Another study took place at the Zucker Hillside Hospital in New York. The researchers used a special kind of MRI called diffusion tensor imaging to compare the brains of several groups of adolescents, both with and without schizophrenia and both users and non-users of cannabis. The imagining measures the motion of water molecules in the brain which can indicate microscopic abnormalities. The MRI imaging revealed that heavy users of cannabis were found to have the type of abnormalities found in certain areas of the brain as in the brains of subjects with schizophrenia. These abnormalities were most pronounced in subjects with schizophrenia who were regular users of cannabis. The abnormalities occur in a pathway of the brain which is related to auditory and language functions which is still under development during adolescence. Thus the research suggests that if an adolescent person is genetically predisposed to develop schizophrenia then using cannabis can cause the same type of damage to the brain’s pathway that the schizophrenia would cause. Or put more simply, regular and prolonged use of cannabis use could bring on the schizophrenia where it might otherwise have not developed, and cause an earlier onset of the illness and/or cause the condition to worsen.



Sheila Caffell was referred for psychiatric treatment to Dr Ferguson in 1983, although she had been suffering from depression for some 18 months or so previously. She was diagnosed as suffering from paranoid schizophrenia. She was a known user of cannabis and was reported to use other recreational drugs, on occasions, such as cocaine. She had become divorced from her husband Colin Caffell 12 months earlier and was reputed to have acquired substantial debts in support of her drug addiction.

Sheila was admitted as an in-patient to St. Andrews Hospital, Northampton in August 1983 following an acute breakdown. During the course of her treatment she was observed to display a number of classic, text book delusions associated with paranoid schizophrenia. These included religious delusions about being given the responsibility of ridding the world of evil and delusions about her children being ‘the devil’s children‘, and having incestual sex with them.

Sheila was discharged one month later, after only having made a partial recovery. The drugs she was prescribed at this time were:

Stelazine. .... an anti-psychotic drug, typically the first line of defencein the treatment of schizophrenia. People with schizophrenia are found to have unusually high levels of dopamine activity. Stelazine works by blocking dopamine receptors in the brain, thus alleviating or minimising schizophrenic symptoms of delusions, hallucinations and disorganised thought and speech. Common side effects are nausea, headaches, dizziness, menstrual irregularities and agitation. Major side effects are lowered life span, dyskinisia and akathisia



In March 1985 Sheila was again admitted to St Andrews hospital following a severe mental breakdown. She had suffered violent outbursts, one of which was witnessed by a friend, who was left traumatised by the event. During her subsequent stay Sheila admitted to having used cocaine quite frequently that year. She was released after having stayed just over 3 weeks. Her release letter raised concerns over the idea that Sheila was capable of murdering her children and had mentioned her having suicidal thoughts. In addition to her current medication of Anafranil she was also prescribed Haloperidol and Procyclidine.

Anafranil ...... a tricyclic anti-depressant (it is named after its chemical structure, which contains 4 rings of atoms). It is contra-indicated for persons suffering with severe anxiety. Caution is indicated with emotionally unstable or suicidal patients. Side effects include confusion, agitation, insomnia, nightmares.

Procyclidine ...... used to counteract the effects of anti-psychotic medications. Known side effects include agitation, confusion and insomnia.

Haloperidol .... a very strong anti-psychotic drug with sedative qualities. It is noted as being the most common neuroleptic ( having tranquilising properties) associated with extra pyramidal symptoms. Extra pyramidal symptoms occur as a result of taking dopamine antagonists, usually anti-psychotic drugs and include tardive dyskinesia, dystonia, akathisia and pseudo-parkinsons. Depression severe enough to result in suicide is also a common side effect in long term, high dose treatment. Clinical trials have shown that taking a medium to high dose of Haloperidol for a 2 week period dramatically increased the dopamine activity up to 98%. Long term effect is not known, but severe dyskinesia is indicated.

In July of 1985, Sheila requested that her dose of Haliperidol be reduced. Her GP, Dr Angeloglou , contacted Dr Ferguson to confirm this. The reason is not known, but could have been due to Sheila experiencing some of the aforementioned side effects. Her dose of 200mg was thus reduced to 100 mg. A sudden reduction in such a potent medication is potentially very dangerous as it may cause severe withdrawal symptoms or a return of the original condition.

On the night of the murders at a family dinner, the subject was raised of having Sheila’s twin boys fostered out. Her psychiatrist later stated that the effect of this news would have been ‘catastrophic’ to Sheila and may have been the trigger that induced a psychotic episode. Her post mortem results showed no trace of the Anafranil, but cannabis and Haliperidol were found. It is reasonable to make the conjecture that failure to take some of her medication plus a reduction of the Haliperidol and ingestion of cannabis could have caused her already fragile mental health to crumble completely.

In 1985 the public and the police were reluctant to believe that a young mother could brutally murder her family. Today reports of women committing violent crime, including murdering their children before attempting/ committing suicide are all well documented through the media. Had Jeremy Bamber’s trial taken place today and had the jury been made aware of all the research and links established between cannabis and schizophrenia, then an entirely different conclusion would surely have been reached. If the advances made with understanding schizophrenia and its treatment had been available to Sheila Caffell back in 1985 it is possible that she would be alive today. She is, after all, as much a victim as Jeremy Bamber.

Did Jeremy Bamber receive a fair trial? Has an innocent man spent 25 years of his life in prison for a crime that he did not commit?

Glossary of MedicalTerms.

Akathisia – characterised by sensation of ‘inner restlessness’ or inability to remain motionless or to sit still.

Dystonia – characterised by contraction of muscle groups that cause repetitive or twisting movements or abnormal postures.

Tardive Dyskinesia –characterised by repetitive, involuntary movements of the body, commonly associated with anti-psychotic drugs such as Haloperidol. (tardive meaning slow or late onset).

Psuedo – Parkinsons – characterised by the symptoms of Parkinsons disease.

Bibliography

The American Journal of Psychiatry - http://ajp.psychiatryonline.org/

New Scientist – www.newscientist.com

About. Com – www.about.com.

The British Journal of Psychiatry - http://ajp.psychiatryonline.org/

The Cochrane Collaboration - http://www2.cochrane.org/reviews/

PubMed. Gov. - http://www.ncbi.nlm.nih.gov/pubmed/

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