First episode psychosis with and without the use of cannabis and synthetic cannabinoids: Psychopathology, global functioning and suicidal ideation and antipsychotic effectiveness

Psychiatry Res. 2023 Feb:320:115053. doi: 10.1016/j.psychres.2023.115053. Epub 2023 Jan 7.

Abstract

Background: Natural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk of developing psychotic disorders and exacerbate their course.

Aims: To examine the differences between psychoses not associated with cannabis use and those associated with NC and SCs use, evaluating psychotic symptoms, global functioning, dissociative symptoms and suicidal ideation.

Methods: The sample of 61 patients with First Episode Psychosis (FEP) was divided into 3 groups: non-Cannabis users (non-users, N = 20); NC users (THC-users, N = 21); SCs users (SPICE-users, N = 20). Each group was assessed at FEP and after 3 and 9 months through specific psychopathological scales.

Results: THC-users, and even more SPICE-users, displayed much more severe positive symptoms than non-users. Negative symptoms were higher among non-users. After 9 months the non-users had recovered significantly better than SPICE-users in their global functioning. Dissociative symptoms were significantly greater in substance users. Finally, suicidal ideation was higher in SPICE-users than in both THC-users and non-users.

Discussion: The psychoses induced by NC and SCs showed different symptomatic pictures and outcomes from each other and when compared to the psychoses not associated with the use of substances; such knowledge could be relevant in identifying a specific drug treatment.

Keywords: Antipsychotic treatment; Dissociation; Psychotic onset; Psychotic symptoms; Substances use; Suicide; Synthetic psychosis.

MeSH terms

  • Antipsychotic Agents* / pharmacology
  • Antipsychotic Agents* / therapeutic use
  • Cannabinoid Receptor Agonists
  • Cannabinoids* / adverse effects
  • Cannabis*
  • Hallucinogens*
  • Humans
  • Psychoses, Substance-Induced* / diagnosis
  • Psychotic Disorders* / drug therapy
  • Suicidal Ideation

Substances

  • Antipsychotic Agents
  • Cannabinoids
  • Hallucinogens
  • Cannabinoid Receptor Agonists