Duration of Untreated Disorder and Cannabis Use: An Observational Study on a Cohort of Young Italian Patients Experiencing Psychotic Experiences and Dissociative Symptoms
Valerio Ricci, Giovanni Martinotti, Franca Ceci, Stefania Chiappini, Francesco di Carlo, Julius Burkauskas, Ottavia Susini, Debora Luciani, Diego Quattrone, Domenico de Berardis, Mauro Pettorruso, Giuseppe Maina, Massimo Di Giannantonio
International Journal of Environmental Research and Public Health November 30, 2021 DOI: 10.3390/ijerph182312632 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Peer reviewed |
|---|---|
| Sample size | 62 |
| Population | First-episode psychosis patients with and without cannabis use disorder recruited from Italian psychiatric hospitals |
| Duration | Assessed at beginning of antipsychotic treatment and after 3 and 6 months |
| Measures | Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF) scale, Dissociative Experiences Scale (DES-II) |
| Topics | Cannabis |
| Citations | 33 |
| Key findings | Longer duration of untreated psychosis was associated with worse symptoms, while cannabis use did not appear to affect DUP. Both longer DUP and cannabis use were related to more dissociative symptoms at onset and over time. The authors suggest cannabis use may be a predictor of first-episode psychosis and disease outcome, though several factors may influence the relationship between cannabis use and DUP. |
Abstract
Background: The Duration of Untreated Psychosis (DUP) is the time between the first-episode psychosis (FEP) and the initiation of antipsychotic treatment. It is an important predictor of several disease-related outcomes in psychotic disorders. The aim of this manuscript is investigating the influence of cannabis on the DUP and its clinical correlates.
Methods: During years 2014-2019, sixty-two FEP patients with and without cannabis use disorder (CUD) were recruited from several Italian psychiatric hospitals. The subjects were then divided into two groups based on the duration of the DUP and assessed at the beginning of the antipsychotic treatment and after 3 and 6 months, using the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale, and the Dissociative Experiences Scale (DES-II).
Results: As expected, a longer DUP was associated with worse symptoms and cannabis use did not seem to affect the DUP, but both were related with more dissociative symptoms at onset and over time.
Discussion: According to our study, cannabis use can be a predictor of FEP and DUP, and of disease outcome. However, several factors might influence the relationship between cannabis use and DUP. Preventing cannabis use and early diagnosis of psychotic disorders might impact the disease by reducing the persistence of symptoms and limiting dissociative experiences.
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 9
- Association between cannabis use and symptom dimensions in schizophrenia spectrum disorders: an individual participant data meta-analysis on 3053 individuals EClinicalMedicine September 8, 2023
- Development and initial validation of the cannabis-related psychosis risk literacy scale (CPRL): a multinational psychometric study BMC Psychiatry April 19, 2024
- Alexithymia and psychopathological dimensions in First-Episode Psychosis: Comparative patterns in natural cannabis versus synthetic cannabinoid users Journal of Psychiatric Research June 19, 2025
- Phenomenology of Hallucinations in Endogenous and Substance-Related Exogenous Psychoses. Psychopathology 2026
- Functional recovery trajectories in cannabis-induced first-episode psychosis: The role of dissociative symptoms in the discrepancy between symptomatic improvement and functional outcomes. Psychiatry Research May 25, 2026
and 4 more in the library
Cites 13
- 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
- Substance-related exogenous psychosis: a postmodern syndrome CNS Spectrums June 25, 2020
- The Bridge Between Classical and “Synthetic”/Chemical Psychoses: Towards a Clinical, Psychopathological, and Therapeutic Perspective Frontiers in Psychiatry November 20, 2019
- Cannabis use disorder and dissociation: A report from a prospective first-episode psychosis study. Drug and Alcohol Dependence October 1, 2021
and 8 more in the library