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Cannabis use in first episode psychosis in Tunisia

E. Bergaoui, R. Lansari, O. Chehaider, W. Ben Flah, A. Larnaout, W. Melki

European Psychiatry April 1, 2024 DOI: 10.1192/j.eurpsy.2024.630 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Observational cross-sectional study Peer reviewed
Sample size 50
Population Patients hospitalized for a first episode of psychosis
Measures Cannabis Abuse Screening Test (CAST), Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF)
Topics Cannabis
Key findings About 60% of patients with first-episode psychosis used cannabis, and 81% of users had a high risk of dependence. Longer duration of untreated psychosis correlated with more negative symptoms (r=0.420), higher total PANSS scores (r=0.424), and lower GAF functioning (r=-0.420). Cannabis screening scores correlated with positive symptoms (r=0.432) but not with age of onset or GAF. The authors argue cannabis is neither necessary nor sufficient to cause psychosis but may affect prognosis.

Abstract

IntroductionThe use of cannabis is associated with developing psychotic disorders, especially for those with a pre-existing vulnerability and elevated familial risk for psychosis.ObjectivesTo assess cannabis use during first episode psychosis and its relationship with patients’ clinical symptoms and functioning.MethodsWe assessed 50 patients hospitalized for first episode psychosis using three scales: CAST test (Cannabis Abuse Screening Test), Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF).ResultsThe sex ratio of our population was 4 men to 1 woman. The average age was 25.6±6.16 years. About 60% of the patients used cannabis. The average duration of untreated psychosis was 10 months, with extremes ranging from one week to 24 months. Forty-four patients were antipsychotic-naïve (88%). For patients who used cannabis, the mean score of CAST test was 11.3±4.16, with extremes between 4 and 18. The risk of dependence was high in 81% of cannabis users. The PANSS total scale showed a mean score of 58.29±12.90 with extremes between 35 and 91. The average score at GAF scale was 30 with extremes between 20 and 70. Duration of untreated psychosis was significantly correlated to negative scale of PANSS (p=0,012 ; r=0,420), PANSS total score (p=0,011 ; r=0,424) and GAF levels (p=0,012 ; r=-0,420).There was no association between age of onset of psychosis and cannabis use (p=0,181) nor CAST scores (p=0,747). There was no correlation between CAST and GAF scores (p=0,641).However, there was a significant and positive correlation between CAST scores and positive scale of PANSS (p=0,04 ; r=0,432).ConclusionsCannabis use is neither necessary nor sufficient to cause psychosis on its own. However, it has an influence on the prognosis. Early intervention programs should address cannabis and substance use problems early in the course of illness.Disclosure of InterestNone Declared

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