Asian Journal of Psychiatry
July 8, 2026
Valerio Ricci, Domenico de Berardis, Giovanni Martinotti et al.
BACKGROUND Cannabis-induced psychosis presents complex sex-based disparities that challenge traditional epidemiological patterns. While males demonstrate higher cannabis use rates, emerging evidence reveals paradoxical vulnerability patterns where females may show heightened susceptibility to cannabis-related psychotic outcomes despite lower consumption rates. OBJECTIVE To map evidence for...
Psychiatry Research
May 25, 2026
Valerio Ricci, Andrea Paggi, Giovanni Martinotti et al.
Functional recovery in cannabis-induced first-episode psychosis (FEP) remains incompletely understood. Dissociative symptoms, frequently associated with cannabis use, may represent a key but underexplored determinant of functional trajectories. This prospective cohort study followed 72 patients meeting DSM-5 criteria for cannabis-induced psychotic disorder over 24 months. Functional recovery...
The International journal of social psychiatry
April 26, 2026
Valerio Ricci, Giovanni Martinotti, Giuseppe Maina
Distinguishing substance-induced psychotic disorders (SIPD) from primary psychotic disorders with concurrent substance use remains a critical diagnostic challenge for treatment planning and prognostic counseling. To systematically review the clinical phenomenology of SIPD, identify distinguishing symptom patterns, and examine relationships between phenomenology and outcomes. A systematic search...
Schizophrenia Research
March 24, 2026
Valerio Ricci, Stefania Chiappini, Giovanni Martinotti et al.
Substance-induced psychotic disorders (SIPDs) present significant clinical challenges with variable outcomes. While some patients achieve complete remission following substance cessation, others develop persistent symptoms requiring extended intervention. Understanding treatment response predictors is critical for optimizing clinical management and prognostic accuracy. Following PRISMA...
Psychopathology
2026
Valerio Ricci, Massimiliano Aragona, Giuseppe Maina et al.
1 citation
Healthcare professionals encounter challenges in discerning endogenous and exogenous, drug-related, psychopathological phenomena. This study aimed to explore qualitative differences between hallucinations in schizophrenia and two forms of substance-related psychosis. These are substance-induced psychosis (SIP), which has an acute onset and is usually transient, and substance-related persistent...
Healthcare
December 8, 2025
Valerio Ricci, Stefania Chiappini, Giovanni Martinotti et al.
Objective: To scope the available literature on antipsychotic treatment in substance-induced psychotic disorders, summarize evidence across substance categories, and highlight priorities for future research. Methods: This scoping review followed Arksey and O’Malley’s framework and PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, Embase, PsycINFO, and Cochrane Library (January...
The American Journal on Addictions
September 1, 2025
Valerio Ricci, Domenico de Berardis, Giovanni Martinotti et al.
AbstractBackground and ObjectivesCannabis use is associated with psychotic disorder onset and exacerbation. This study examines how continued cannabis use affects depressive symptoms, psychotic symptoms, and suicidal behaviors following cannabis‐induced first‐episode psychosis (FEP).MethodsSixty‐five participants (aged 16–50 years) with FEP were recruited from psychiatric inpatient facilities...
Asian Journal of Psychiatry
July 10, 2025
Valerio Ricci, A. Sarni, Marialuiga Barresi et al.
Cannabis use represents a significant risk factor for both psychotic disorders and suicidal behaviors, with growing evidence suggesting complex interactions between these variables. This systematic review examines the relationship between cannabis use and suicide risk in first-episode psychosis (FEP) patients, and explores underlying mechanisms, moderating factors, and intervention strategies....
Journal of Psychiatric Research
June 19, 2025
Valerio Ricci, Ilenia di Muzio, Mancusi Gianluca et al.
2 citations
AIMS: This study aimed to investigate the differences in psychotic symptomatology, dissociative symptoms, alexithymia, and aberrant salience among three groups: non-cannabis users (NU), natural cannabis users (NC), and synthetic cannabinoid users (SCs). The study also explored the patterns of alexithymia and its associations with other psychopathological dimensions in these populations....
Journal of Personalized Medicine
April 1, 2025
Marco Di, M. Pepe, Giacomo D’andrea et al.
18 citations
Background. Treatment-resistant depression (TRD) is a prevalent, high-burden disorder. Esketamine nasal spray (ESK-NS) has been approved for, T.R.D.; and efficacy has been observed in both clinical trials and real-world studies. However, observations integrating patients’ perspective on this treatment are limited. This multicentric Italian study explored experiences with ESK-NS in TRD patients,...
Psychiatry Research
April 1, 2025
Valerio Ricci, Stefania Chiappini, Giovanni Martinotti et al.
Epidemiological data have provided evidence that psychotic-like experiences (PLEs) occur in the general population without clinical impairment. According to the psychosis continuum hypothesis, PLEs are subject to multiple risk factors. This review synthesizes current research on biological, substance use-related, and environmental risk factors for PLEs in non-clinical populations....
Rivista di psichiatria
March 1, 2025
A. Sarni, Giovanni Martinotti, Giuseppe Maina et al.
The increasing prevalence of Novel Psychoactive Substances (NPS) presents a significant challenge for both diagnosis and treatment, particularly due to the complex psychotic states they can induce. This paper explores the concept of lysergic psychoma, rooted in Bonhoeffer's exogenous psychosis model, and its relevance to modern substance-induced psychoses. Lysergic psychoma, characterized by...
Frontiers in Psychiatry
January 30, 2025
Valerio Ricci, Alessandro Sarni, Giuseppe Maina
The relationship between substance use and the onset of psychosis has been a subject of clinical and academic debate for centuries. The potential for cannabis to trigger psychosis was first suggested by Grose in 1772, who documented issues related to cannabis use in India (1). Karl Jaspers later explored this connection in his Allgemeine Psychopathologie (1959), describing toxic intoxications...
Journal of Psychoactive Drugs
January 8, 2025
Valerio Ricci, Domenico de Berardis, Sheikh Shoib et al.
4 citations
This study explores the psychotic-like experiences (PLEs) associated with recreational ketamine use among young adults. Ketamine, initially introduced as an anesthetic, is now widely used recreationally for its dissociative effects, raising concerns about its impact on mental health. Ten participants aged 18-24, who used ketamine recreationally multiple times a week, were assessed using the...
Current Neuropharmacology
2025
Gianluca Rosso, Giacomo d'Andrea, Stefano Barlati et al.
23 citations
Data on long-term treatment with Esketamine Nasal Spray (ESKNS) in real-world patients with treatment resistant depression (TRD) is scarce. The primary aim of the study is to evaluate the effectiveness and tolerability of ESK-NS treatment at 6 and 12-month follow-ups. This is part of an observational, retrospective, multicentric Italian study (REAL-ESK study). Subjects for the present study...
Frontiers in Psychiatry
2025
Valerio Ricci, Maria Celeste Ciavarella, Carlotta Marrangone et al.
7 citations
Substance use and the emergence of Novel Psychoactive Substances (NPS) present a significant public health challenge and diagnostic dilemma, particularly in the context of psychosis. The increasing availability of psychoactive substances among youth has led to a rise in Substance Use Disorders (SUDs), with profound implications for mental health. This paper explores the psychopathological...
Frontiers in Psychiatry
2025
Valerio Ricci, Domenico de Berardis, Giovanni Martinotti et al.
Cannabis use represents a significant environmental risk factor for psychotic disorders, with emerging evidence suggesting complex interactions between cannabinoid exposure, dissociative experiences, and fundamental disturbances of self-experience (self-disorders) in early psychosis. This systematic review examines the phenomenological and neurobiological relationships among dissociation,...
Rivista di psichiatria
November 1, 2024
Valerio Ricci, Domenico de Berardis, Giovanni Martinotti et al.
2 citations
BACKGROUND: Cannabis is the most used recreational drug worldwide. Its use can increase the risk of developing psychotic disorders and exacerbate their course. However, little is known about the relationship between psychosis and withdrawal and the literature is still scarce. CASE PRESENTATION: In this study, based on an analysis of 4 patients referred to our mental health department and...
Psychiatry International
October 15, 2024
Valerio Ricci, Giovanni Martinotti, Giuseppe Maina
9 citations
Substance-induced psychosis (SIP) is an increasingly prevalent and complex condition that presents significant diagnostic and therapeutic challenges. With the rising use of novel psychoactive substances (NPSs) and potent traditional compounds like cannabis and cocaine, particularly among adolescents and young adults, understanding the mechanisms and clinical manifestations of SIP has become...
The Journal of Nervous and Mental Disease
September 1, 2024
Valerio Ricci, Giuseppe Maina, Gilberto Di Petta et al.
The psychopathological manifestations associated with substance use, including induced psychotic experiences, are increasingly relevant but not well-understood within the medical community. Novel psychoactive substances and potentiated old compounds like cannabis and cocaine have emerged as a global concern, especially among adolescents and young adults. Transition rates from substance-induced...
Current Topics in Medicinal Chemistry
August 1, 2024
Valerio Ricci, Domenico De Berardis, Giovanni Martinotti et al.
Background: Cannabis is the most widely used illicit substance. Numerous scientific evidence confirm the strong association between cannabis and psychosis. Exposure to cannabis can induce the development of psychosis and schizophrenia in vulnerable individuals. However, the neurobiological processes underlying this relationship are unknown. Neurotrophins are a class of proteins that serve as...
Healthcare (Basel, Switzerland)
January 29, 2024
Valerio Ricci, Domenico de Berardis, Giuseppe Maina
16 citations
This narrative review explores the efficacy and tolerability of third-generation antipsychotics (TGAs)-aripiprazole, cariprazine, brexpiprazole, and lurasidone-for the management of substance-induced psychosis (SIP). SIP is a psychiatric condition triggered by substance misuse or withdrawal, characterized by unique features distinct from those of primary psychotic disorders. These distinctive...
Frontiers in Psychiatry
January 8, 2024
Valerio Ricci, Ilenia di Muzio, F. Ceci et al.
Background Natural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk and exacerbate the course of psychotic disorders. These could be influenced by the Aberrant Salience (AS) construct. It refers to an excess of attribution of meaning to stimuli that are otherwise regarded as neutral, thereby transform them into adverse, dangerous, or mysterious entities. This leads the...
Psychopathology
2024
Valerio Ricci, Giuseppe Maina, Giovanni Martinotti
11 citations
The term "dissociation" encompasses a wide array of symptoms and phenomena, all sharing the common characteristic of involving altered states of consciousness where an individual temporarily loses the sense of continuity of their own identity. In the context of addiction pathology, however, the dissociative paradigm remains a topic of ongoing debate. It fluctuates between the description of...
Psychopathology
2024
Valerio Ricci, Giuseppe Maina, Giovanni Martinotti
8 citations
The state of twilight consciousness is marked by a focused narrowing of awareness, maintaining vigilance and attention while simultaneously experiencing perceptual shifts in the surrounding environment. It is crucial to recognize that this twilight state represents not just a contraction but also an expansion of conscious experience. Substances of abuse, particularly new psychoactive...