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Timing of Cannabis Exposure Relative to Prodrome and Psychosis Onset in a Community-Based First Episode Psychosis Sample

E. Kline, M. Ferrara, Fang-Yong Li, D. D'Souza, Matcheri S Keshavan, V. Srihari

Journal of Psychiatric Research 2022 DOI: 10.1016/j.jpsychires.2022.01.039 (opens in new tab)

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AI-extracted from the abstract
Characteristics Observational study of consecutive admissions Peer reviewed
Sample size 246
Population Consecutive admissions to two community-based first-episode psychosis services
Topics Cannabis
Key findings Cannabis exposure (78%) and cannabis use disorders (47%) were highly prevalent at admission, and in 94% of participants cannabis use preceded both attenuated and full-threshold psychosis symptoms by several years. Earlier age at first cannabis exposure was associated with younger age at prodrome and psychosis onset, worse premorbid functioning, and greater severity of cannabis use disorder.

Abstract

Cannabis has been implicated as both a potential cause and adverse prognostic factor in psychotic disorders. Investigating the contributory role of cannabis toward the overall burden of psychotic illnesses may represent an important step toward psychosis prevention and treatment. The current study samples consecutive admissions (N = 246) to two community based first-episode psychosis services to characterize timing of cannabis use relative to psychosis and attenuated symptom onset, differences between those with and without cannabis exposure, and the association of age at first cannabis exposure with clinical and demographic variables. Both cannabis exposure (78%) and cannabis use disorders (47%) were highly prevalent at admission. In 94% of participants, cannabis use preceded the onset of both attenuated and full-threshold psychosis symptoms by several years. Earlier age at first exposure to cannabis was associated with younger age at prodrome and psychosis onset, worse premorbid functioning, and greater severity of cannabis use disorder at admission. The timing of first exposure to cannabis may have individual prognostic as well as public health significance. Documenting the prevalence and impact of cannabis use in early psychosis samples, as well as the overall incidence of psychotic disorders, will be of vital public health significance as the United States enacts cannabis legalization and cannabis products become more widely available.

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

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