A systematic evidence map of the association between cannabis use and psychosis-related outcomes across the psychosis continuum: An umbrella review of systematic reviews and meta-analyses.
J. Groening, Emma Denton, Rimsha Parvaiz, David Losada Brunet, Aisha von Daniken, Yiling Shi, P. Bhattacharyya
Psychiatry Research November 1, 2023 DOI: 10.1016/j.psychres.2023.115626 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Umbrella review of systematic reviews and meta-analyses Peer reviewed |
|---|---|
| Sample size | 32 |
| Population | Healthy, high-risk, and clinical populations |
| Topics | Cannabis |
| Key findings | Cannabis use is associated with subclinical psychosis states and traits in healthy populations and with earlier onset and relapse of psychosis in patients, but not with clinical-high-risk states or transition to psychosis. |
Abstract
While the legal status and public perception of cannabis are currently changing in many countries, one of the important considerations from a public health viewpoint is its potential association with adverse health outcomes such as the development of psychosis. We conducted an umbrella review of systematic reviews and meta-analyses using the AMSTAR-2 to assess the quality of included reviews. We further created an evidence map to visualize and facilitate the overview of the published evidence synthesis on the association between cannabis use and all psychosis-related outcomes and risk moderators in healthy, high-risk, and clinical populations. Overall, we found 32 systematic reviews and meta-analyses. Based on a synthesis of current evidence, cannabis use is associated with subclinical psychosis states (psychotic-like experiences) and traits (schizotypal personality) in the healthy population, as well as earlier onset and development of psychosis. An association with the clinical-high-risk state for psychosis, attenuated psychosis symptoms and transition to psychosis in this population could not be confirmed. An association between cannabis use and psychosis outcomes in patients with psychotic disorder could solely be confirmed regarding relapse. Whether causal effects underlie those associations has not sufficiently been addressed in the evidence synthesis to date.
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
Cited by 8
- Randomized Laboratory Study of Single-Dose Cannabis, Dronabinol, and Placebo in Patients With Schizophrenia and Cannabis Use Disorder Schizophrenia Bulletin June 20, 2024
- The Relationship Between Cannabis Use and Schizophrenia As a Risk Factor or For Its Therapeutic Potential: A Systematic Review of Evidence Cureus September 20, 2025
- Adolescent-onset regular cannabis use is associated with altered neural and behavioural responses during anticipation and feedback of monetary reward and loss Psychopharmacology October 17, 2026
- Personality, not cognition, distinguishes chronic ayahuasca and cannabis users from non-users European Neuropsychopharmacology February 12, 2026
- Cannabis Use and Age-Related Acceleration of Psychosis Onset: A Meta-Analysis. Biological Psychiatry August 1, 2026
and 3 more in the library
Cites 14
- Effects of cannabis use on outcomes of psychotic disorders: systematic review The British Journal of Psychiatry October 31, 2008
- Risk-thresholds for the association between frequency of cannabis use and the development of psychosis: a systematic review and meta-analysis Psychological Medicine March 24, 2022
- Cannabis induced psychosis: a systematic review on the role of genetic polymorphisms. Pharmacological Research May 1, 2022
- Early onset psychosis and cannabis use: Prevalence, clinical presentation and influence of daily use. Asian Journal of Psychiatry May 27, 2021
- Cannabis use in Adolescence and Risk of Psychosis: Are there Factors that Moderate this Relationship? A Systematic Review and Meta-Analysis Substance Abuse February 22, 2021
and 9 more in the library