Cannabis use among patients presenting to the emergency department for psychosis: Associations with restraint use, medication administration, psychiatric hospitalization, and repeat visits.

B. Gouse; Elijah E. Boliver; Rachel Oblath; Luísa Camacho; Hannah E. Brown

doi:10.1016/j.psychres.2023.115151

Cannabis use among patients presenting to the emergency department for psychosis: Associations with restraint use, medication administration, psychiatric hospitalization, and repeat visits.

B. Gouse, Elijah E. Boliver, Rachel Oblath, Luísa Camacho, Hannah E. Brown

Psychiatry Research March 17, 2023 DOI: 10.1016/j.psychres.2023.115151 (opens in new tab)

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Study at a glance

AI-extracted from the abstract

Characteristics	Retrospective observational study Peer reviewed
Sample size	2,134
Population	Emergency department visits for acute psychosis between March 1, 2019 and February 28, 2021
Duration	90-day follow-up for recurrent ED visits
Topics	Cannabis
Key findings	Emergency department visits for acute psychosis with a positive urinary THC screen had significantly greater risk of physical restraint and parenteral antipsychotic or benzodiazepine administration than visits with a negative or no THC screen. Positive THC screen was not associated with inpatient psychiatric hospitalization or recurrent ED visits for psychosis within 90 days.

Abstract

Cannabis use is associated with increased severity of psychotic symptoms and the risk of acute agitation and aggressive behavior in inpatient (IP) and outpatient settings. Whether or not cannabis use is associated with increased acuity of psychosis-related ED presentations and risk of repeat ED visits for psychosis is unclear. In this retrospective study of 2,134 ED visits for acute psychosis, we investigated the risk of physical restraint, parenteral medication administration, psychiatric hospitalization, and recurrent ED visits. We examined ED visits between March 1, 2019 and February 28, 2021 based on urinary Tetrahydrocannabinol (THC) screen status (positive vs negative vs no screen). The risk of physical restraint, parenteral antipsychotic, and benzodiazepine administration was significantly greater in ED visits with a positive THC screen compared to those with a negative or no THC screen. We did not find an association between a positive urinary THC screen and IP hospitalization or the risk of recurrent ED presentation for psychosis within 90 days. These findings suggest that positive urinary THC may predict acute agitation or acuity of symptoms in ED settings and underscores the importance of screening for THC during ED presentations for psychosis.

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

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