Cannabis use disorder and dissociation: A report from a prospective first-episode psychosis study.
Valerio Ricci, Franca Ceci, Francesco di Carlo, A. Lalli, Laura Ciavoni, Alessio Mosca, G. Sepede, Anatolia 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.
Comparable studies
Other observational and cohort studies on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| High-potency cannabis and the risk of psychosis People with first episode of psychosis and healthy controls from the local population | 2009 | Case-control study | n = 454 |
| Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada Rural aboriginal population | 2013 | Observational study | |
| Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people | 2000 | Observational | |
| Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study Individuals from the general population in Germany aged 14-24 at baseline | 2011 | Observational cohort | n = 1,923 |
| Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases Patients treated for cannabis-induced psychotic symptoms in Denmark between 1994 and... | 2005 | Observational cohort | n = 535 |
Citations in the library
Cited by 22
- Duration of Untreated Disorder and Cannabis Use: An Observational Study on a Cohort of Young Italian Patients Experiencing Psychotic Experiences and Dissociative Symptoms International Journal of Environmental Research and Public Health November 30, 2021
- Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals EClinicalMedicine September 8, 2023
- Third-Generation Antipsychotics and Lurasidone in the Treatment of Substance-Induced Psychoses: A Narrative Review. Healthcare January 29, 2024
- Dissociation and Temporality in Substance Abuse: A Clinical Phenomenological Overview. Psychopathology 2024
- Substance-Induced Psychosis: Diagnostic Challenges and Phenomenological Insights Psychiatry International October 15, 2024
and 17 more in the library
Cites 26
- High-potency cannabis and the risk of psychosis The British Journal of Psychiatry November 30, 2009
- Traditional marijuana, high‐potency cannabis and synthetic cannabinoids: increasing risk for psychosis World Psychiatry September 22, 2016
- Poor medication adherence and risk of relapse associated with continued cannabis use in patients with first-episode psychosis: a prospective analysis The Lancet Psychiatry July 10, 2017
- Association Between Continued Cannabis Use and Risk of Relapse in First-Episode Psychosis JAMA Psychiatry September 28, 2016
- Substance-related exogenous psychosis: a postmodern syndrome CNS Spectrums June 25, 2020
and 21 more in the library