First vs. multiple cannabis-induced psychotic episodes: Is inpatient treatment any different?
F. Andrade, V. Covelo, A.S. Machado
European Psychiatry November 17, 2023 DOI: 10.1192/j.eurpsy.2021.1436 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective observational study Peer reviewed |
|---|---|
| Sample size | 61 |
| Population | Inpatients with a discharge diagnosis of cannabis-induced psychosis at a psychiatry service between January 1, 2018 and December 31, 2019 |
| Topics | Cannabis |
| Keywords | Cannabis psychosis Schizophrénia Fep |
| Key findings | Among inpatients with cannabis-induced psychosis, those with multiple episodes had 10.0 higher odds of discharge to compulsory outpatient treatment, 6.0 higher odds of long-acting injectable antipsychotic prescription, and 4.85 higher odds of future psychiatric readmission compared with first-episode patients. The authors argue that integrative treatment programs are needed to address the specificities and chronicity risk of this group. |
Abstract
Introduction: Recent studies reported very high cumulative risk for a patient who had cannabis-induced psychosis to be diagnosed with a schizophrenia spectrum disorder.
Objectives: We aim to compare sociodemographic and clinical characteristics, treatment and discharge plan in cannabis-induced first psychosis episode (CI-FEP) vs. multiple cannabis-induced psychotic episodes (CI-MEP) inpatients.
Methods: Retrospective observational study of inpatient episodes with a discharge diagnosis of cannabis-induced psychosis between January 1st, 2018 and December 31st, 2019 in the Psychiatry Service of CHUSJ. Descriptive analysis of the results was performed using the SPSS software, version 26.0.
Results: Our sample included 61 inpatients, 19 (31.1%) with CI-FEP and 42 (68.9%) with CI-MEP. CI-MEP group had a median of 1±0,234 previous hospital admissions. CI-MEP group has 10,0 higher odds of being discharged in outpatient compulsory treatment (CI 95% 1,21-82,50, p=0,013) and 6.0 odds of being treated with long-acting injectable antipsychotics (LAIAP) (CI 95% 1,79-20,31, p=0,002) when compared to CI-FEP group. Having multiple cannabis-induced psychotic episodes was associated with future admissions to psychiatry unit (OR 4,85 (95% CI 1,23-19,15, p=0,018). We found no statistically significant differences regarding the sociodemographic and clinical characteristics, use habits and discharge plan between the two groups.
Conclusions: Patients with multiple psychotic episodes due to cannabis use are more likely to have a LAIAP prescription, be discharged in compulsory outpatient regimen and be readmitted in to psychiatric inpatient unit. Considering the prevalence of CI-MEP and the risk of chronicity, we need integrative treatment programs to address the specificities of these patients.
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 |