Cannabis use disorder and dissociation: A report from a prospective first-episode psychosis study.
Valerio Ricci, F. Ceci, Francesco di Carlo, A. Lalli, Laura Ciavoni, Alessio Mosca, G. Sepede, A. Salone, Diego Quattrone, Silvia Fraticelli, Giuseppe Maina, Giovanni Martinotti
Drug and Alcohol Dependence October 1, 2021 DOI: 10.1016/j.drugalcdep.2021.109118 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 70 |
| Population | First-episode psychotic patients (FEPp) with and without cannabis use disorder, recruited in psychiatric inpatient facilities in Lazio and Piemonte, Italy |
| Duration | 8-month follow-up |
| Topics | Cannabis |
| Key findings | First-episode psychosis patients using cannabis had higher levels of positive symptoms, dissociative experiences, and worse functioning than non-users, with functioning worsening over eight months in users while improving in non-users. |
Abstract
Background: Cannabis is the most used recreational drug worldwide. Its use can increase the risk of developing psychotic disorders and exacerbate their course. However, the relationship between cannabis use and dissociative symptoms has been scarcely investigated.
Aims: To examine differences in psychotic and dissociative symptoms, and in functioning in first-episode psychotic patients (FEPp) using cannabis compared with those not using cannabis.
Methods: Between January 2014 and December 2019, seventy FEPp with cannabis use disorder (N = 35) and without it (N = 35) were recruited in psychiatric inpatient facilities in the Italian regions of Lazio and Piemonte. All subjects were assessed at FEP, after 4 and 8 months, using the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Dissociative Experiences Scale - II (DES-II). Detailed information on the pattern of cannabis and other substance use were collected.
Results: FEP using cannabis showed higher levels of positive symptomatology, dissociative experiences and worse functioning than their non-user counterpart, despite a comparable antipsychotic treatment. At an eight-month prospective evaluation, FEP using cannabis still showed higher levels of positive symptomatology and dissociation. Moreover, global functioning worsened over time in FEPp using cannabis, whereas it improved those not using it.
Discussion: Our findings suggest that a greater degree of dissociation and positive symptoms at FEPp and their persistence over time may characterise cannabis-associated psychosis. Both these factors might explain the overall functioning worsening over time that we observed in the cannabis-user group compared to the functioning improvement in the non-user group.