Pathways from Cannabis to Psychosis: A Review of the Evidence
Frontiers in Psychiatry 2013 DOI: 10.3389/fpsyt.2013.00128 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Cannabis |
| Citations | 63 |
| Key findings | Argues that cannabis may lead to psychosis through two distinct pathways: early-initiated lifelong cannabis use, and relatively brief cannabis use by vulnerable individuals just before psychosis onset. The author contends that genetic and developmental vulnerability to schizophrenia-spectrum disorders, and whether cannabis use continues after psychosis onset, also shape the clinical and neurobiological features, course, and outcome of psychosis. |
Abstract
The nature of the relationship between cannabis use (CU) and psychosis is complex and remains unclear. Researchers and clinicians remain divided regarding key issues such as whether or not cannabis is an independent cause of psychosis and schizophrenia. This paper reviews the field in detail, examining questions of causality, the neurobiological basis for such causality and for differential inter-individual risk, the clinical and cognitive features of psychosis in cannabis users, and patterns of course and outcome of psychosis in the context of CU. The author proposes two major pathways from cannabis to psychosis based on a differentiation between early-initiated lifelong CU and a scenario where vulnerable individuals without a lifelong pattern of use consume cannabis over a relatively brief period of time just prior to psychosis onset. Additional key factors determining the clinical and neurobiological manifestation of psychosis as well as course and outcome in cannabis users include: underlying genetic and developmental vulnerability to schizophrenia-spectrum disorders; and whether or not CU ceases or continues after the onset of psychosis. Finally, methodological guidelines are presented for future research aimed at both elucidating the pathways that lead from cannabis to psychosis and clarifying the long-term outcome of the disorder in those who have a history of using cannabis.
Comparable studies
Other narrative reviews on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Causal association between cannabis and psychosis: examination of the evidence | 2004 | Review | |
| Cannabis sativa: A comprehensive ethnopharmacological review of a medicinal plant with a long history. General (historical and pharmacological review) | 2018 | Review | |
| Psychiatric effects of cannabis | 2001 | Review | |
| Beyond THC: The New Generation of Cannabinoid Designer Drugs | 2011 | Review | |
| Cannabidiol, a Cannabis sativa constituent, as an antipsychotic drug | 2006 | Review |
Citations in the library
Cited by 5
- Cannabis and Psychosis: A Review of the Risk Factors Involved American Journal of Plant Sciences 2020
- Distinguishing between cannabis-induced psychotic disorder and psychotic disorder with concurrent cannabis use: a diagnostic challenge Romanian Journal of Psychiatry & Psychotherapy June 30, 2020
- Meta-analysis of neurocognition in young psychosis patients with current cannabis use. Journal of Psychiatric Research April 1, 2018
- The Effects of Cannabinoids on Executive Functions: Evidence from Cannabis and Synthetic Cannabinoids—A Systematic Review Brain Sciences February 27, 2018
- Prenatal cannabis exposure - The "first hit" to the endocannabinoid system. Neurotoxicology and Teratology 2016
Cites 14
- Causal association between cannabis and psychosis: examination of the evidence The British Journal of Psychiatry January 30, 2004
- Effects of cannabis use on outcomes of psychotic disorders: systematic review The British Journal of Psychiatry October 31, 2008
- The Impact of Cannabis Use on Cognitive Functioning in Patients With Schizophrenia: A Meta-analysis of Existing Findings and New Data in a First-Episode Sample Schizophrenia Bulletin July 25, 2010
- Cannabis use and cognition in schizophrenia Frontiers in Human Neuroscience 2009
- Pre-Illness Cannabis Use and the Early Course of Nonaffective Psychotic Disorders: Associations with Premorbid Functioning, the Prodrome, and Mode of Onset of Psychosis Schizophrenia Research October 30, 2010
and 9 more in the library