Cannabis Use in First-Episode Psychosis: Associations with Symptom Dimensions and Sociodemographic Factors
Azizi Mohammad
Journal of Pakistan Psychiatric Society March 30, 2026 DOI: 10.63050/jpps.23.01.1178 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Cross-sectional study Peer reviewed |
|---|---|
| Sample size | 104 |
| Population | Inpatients with first-episode psychosis and no prior antipsychotic exposure admitted to a tertiary care psychiatric unit in Peshawar, Pakistan |
| Measures | Positive and Negative Syndrome Scale (PANSS) |
| Topics | Cannabis |
| Key findings | Cannabis use was reported exclusively among male patients (28.4%). Unemployment and lower socioeconomic status predicted cannabis use, while employment, student status, and satisfactory socioeconomic status were associated with lower odds of use; moderate manic symptoms and higher PANSS activation scores were also linked with lower likelihood of use. The authors argue that social determinants, rather than symptom severity, strongly influence cannabis use in first-episode psychosis. |
Abstract
Abstract Objective:To determine sociodemographic and clinical predictors of cannabis use among patients with first-episode psychosis (FEP) admitted to a tertiary care psychiatric unit in Pakistan. Methods:This cross-sectional study was conducted at the Psychiatry Unit, Khyber Teaching Hospital, Peshawar, from January 2021 to December 2024. Consecutive inpatients with FEP and no prior antipsychotic exposure were assessed using a structured proforma for sociodemographic and clinical data. Symptom severity was measured with the Positive and Negative Syndrome Scale (PANSS). Binary logistic regression was applied to identify predictors of cannabis use. Results:Among 104 participants (77.9% male; mean age 23.4 ± 8.4 years), cannabis use was reported exclusively among males (28.4%). Unemployment and lower socioeconomic status significantly predicted cannabis use. Being employed (OR = 0.017, 95% CI [0.001–0.367]) or a student (OR = 0.064, 95% CI [0.006–0.693]) was associated with markedly lower odds of cannabis use compared with unemployment. Satisfactory socioeconomic status was also protective (OR = 0.074, 95% CI [0.010–0.522]). Clinically, moderate manic symptoms and higher PANSS activation scores were linked with lower likelihood of cannabis use (p < 0.05). Conclusion:Cannabis use in first-episode psychosis is strongly influenced by social determinants such as occupation and socioeconomic status rather than symptom severity. Culturally informed, gender-sensitive prevention strategies are needed to address substance use risk in psychosis within South Asian contexts.
Comparable studies
Other cross-sectional and survey studies on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Cannabis use before age 15 and subsequent executive functioning 104 chronic cannabis users (49 early-onset before age 15, 55 late-onset after age 15)... | 2011 | Observational cross-sectional study | n = 148 |
| Patterns of simultaneous polysubstance use in drug using university students Drug-using university students | 2006 | Cross-sectional survey | n = 149 |
| Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey Online survey respondents | 2020 | Cross-sectional survey | |
| User perceptions of the benefits and harms of hallucinogenic drug use: A web-based questionnaire study Users of hallucinogenic drugs who completed a web-based questionnaire | 2010 | Cross-sectional survey | n = 600 |
| Illicit Use of LSD or Psilocybin, but not MDMA or Nonpsychedelic Drugs, is Associated with Mystical Experiences in a Dose-Dependent Manner Adults recruited from the MAPS website and newsletter, most reporting use of various... | 2012 | Cross-sectional survey | n = 337 |