Distinguishing between cannabis-induced psychotic disorder and psychotic disorder with concurrent cannabis use: a diagnostic challenge
Cristiana Ţăpoi
Romanian Journal of Psychiatry & Psychotherapy June 30, 2020 DOI: 10.37897/rjpp.2020.2.2 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Patients with first episode of psychosis and history of cannabis use |
| Topics | Cannabis |
| Keywords | Derealization Psychosis Depersonalization Schizophrenia object-oriented programming Hostility Intervention counseling Delusional disorder Clinical psychology Burnout |
| Citations | 1 |
| Key findings | Cannabis-induced psychotic disorder appears to be a distinct clinical entity from primary psychotic disorder with concurrent cannabis use, with differences in clinical presentation and family history, though 25-45% of CIPD patients later develop a chronic psychotic disorder. |
Abstract
Approximately one-third of patients presenting with a first episode of psychosis have a history of cannabis use. Some of these patients meet the criteria for cannabis-induced psychotic disorder (CIPD), which is regarded as a disorder with better outcomes compared to other psychotic disorders. The aim of this paper was to determine whether there are differences in clinical and demographic features between patients with CIPD and patients with a first episode of primary psychotic disorder (PPD) with concurrent cannabis use (CU). A literature search in the PubMed database for papers published in English was conducted. A total of 12 studies published between 2002 and 2019 were selected. Available data support the hypothesis that CIPD is a distinct clinical entity from PPD with CU. Differences were found in clinical presentation, as patients with CIPD tend to have a lower intensity of overall psychotic symptoms, greater insight into psychosis, a higher likelihood of visual hallucinations, depersonalization, and derealization, as well as more intense manic symptoms and hostility than patients with PPD with CU. In terms of family history, patients with CIPD are more likely to have a close relative with a substance use disorder but less likely to have a close relative diagnosed with a psychotic disorder. However, a significant percentage (25-45%) of patients initially treated for CIPD will meet criteria for a chronic psychotic disorder in the following years, and continuous cannabis use is associated with poor prognosis, independent of the initial diagnosis. In these conditions, early intervention is crucial, and substance use treatment should be considered a priority for cannabis users who develop psychotic symptoms.
Comparable studies
Other systematic reviews and meta-analyses on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Effects of cannabis use on outcomes of psychotic disorders: systematic review People with psychotic disorders, as examined in 13 longitudinal studies | 2008 | Systematic review | |
| The Impact of Cannabis Use on Cognitive Functioning in Patients With Schizophrenia: A Meta-analysis of Existing Findings and New Data in a First-Episode Sample Patients with established schizophrenia (meta-analysis: 572) and patients with... | 2010 | Meta-analysis and cross-sectional observational study | n = 700 |
| Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review | 2020 | Systematic review | |
| Neuroimaging in cannabis use: a systematic review of the literature Cannabis users and controls in neuroimaging studies | 2009 | Systematic review | |
| Human Laboratory Studies on Cannabinoids and Psychosis. Healthy human subjects and individuals with schizophrenia | 2016 | Systematic review |
Citations in the library
Cites 9
- Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases The British Journal of Psychiatry November 30, 2005
- The Effect of Cannabis Use and Cognitive Reserve on Age at Onset and Psychosis Outcomes in First-Episode Schizophrenia Schizophrenia Bulletin March 9, 2011
- Pathways from Cannabis to Psychosis: A Review of the Evidence Frontiers in Psychiatry 2013
- Course of cannabis use and clinical outcome in patients with non-affective psychosis: a 3-year follow-up study Psychological Medicine February 5, 2015
- Cannabis use and psychosis: re-visiting the role of childhood trauma. Psychological Medicine November 1, 2011
and 4 more in the library