The independent and combined effects of cannabis use and systemic inflammation during the early stages of psychosis: exploring the two-hit hypothesis.
Psychological Medicine December 1, 2022 Fabiana Corsi-Zuelli, Leonardo Marques, Daiane Leite Da Roza et al.
Cannabis consumption is not associated with increased inflammation in first-episode psychosis patients or controls, indicating that inflammation does not mediate the cannabis-psychosis link. However, daily cannabis use and onset of use before age 17 interact with a composite measure of systemic inflammation to raise the odds of psychosis beyond the individual effects of either factor alone, and this association appears only among individuals with medium-to-high inflammatory scores. The authors propose that immune dysregulation may modify the cannabis-psychosis relationship, consistent with a two-hit hypothesis, and that immune dysregulation could be part of psychosis pathophysiology independent of cannabis use or other confounders.