Cannabinoid use in psychotic patients impacts inflammatory levels and their association with psychosis severity

Psychiatry Res. 2020 Nov:293:113380. doi: 10.1016/j.psychres.2020.113380. Epub 2020 Aug 10.

Abstract

Inflammatory abnormalities are well-documented in individuals with chronic psychotic disorders. Particular attention has focused on interleukin-6 (IL-6) and its correlation with psychotic symptom severity. Cannabis use is associated with an increased risk of psychosis and also has immunomodulating properties. It has been hypothesized that inflammatory disturbances are a common underlying pathology between cannabis use and psychosis. We measured inflammatory markers in individuals admitted to a psychiatric unit with acute psychosis who had toxicology positive for natural and/or synthetic cannabinoids (n = 59) compared to patients with negative cannabinoid toxicology (n = 60). Psychosis severity was assessed using the Positive and Negative Syndrome Scale (PANSS). While PANSS scores were similar between groups, cannabinoid-positive participants were more likely to receive pro re nata (PRN or as-needed) medications for agitation in the psychiatric emergency room, particularly synthetic cannabinoid-positive participants. In unadjusted models, cannabinoid-positive participants had lower interferon-γ (IFN-γ) levels (p = 0.046), but this finding was not significant after adjusting for covariates and multiple comparisons. Among cannabinoid-positive participants, IL-6 levels negatively correlated with PANSS total score (p = 0.040), as well as positive (p = 0.035) and negative (p = 0.024) subscales. Results suggest inflammatory alterations among psychotic individuals with comorbid cannabinoid use.

Keywords: Cannabis; IFN-γ; IL-6; Inflammation; Marijuana; Schizophrenia; Synthetic cannabinoids.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Cannabinoids / adverse effects
  • Female
  • Humans
  • Inflammation Mediators / blood*
  • Male
  • Marijuana Use / blood*
  • Marijuana Use / epidemiology
  • Marijuana Use / psychology*
  • Middle Aged
  • Psychotic Disorders / blood*
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology*
  • Severity of Illness Index*
  • Young Adult

Substances

  • Biomarkers
  • Cannabinoids
  • Inflammation Mediators