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Abstract
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The laws legalizing recreational cannabis use, the increasing strength of cannabis and cannabis derivatives, and the growing availability and commercialization of cannabis call attention to the possible implications for mental health, and specifically for the incidence of psychosis.
Several lines of evidence suggest that exposure to cannabis and synthetic cannabinoids may contribute to the risk for psychosis1. The spectrum of psychosis outcomes linked to cannabis and cannabinoids range from short-lived psychotic states to chronic psychotic disorders. In addition to observational data, experimental laboratory studies provide compelling evidence that cannabis, its principal psychoactive constituent delta-9-tetrahydrocannabinol, and synthetic cannabinoids induce acute brief psychotic states characterized by positive, negative and cognitive symptoms resembling the symptoms of schizophrenia2.
Cannabis may induce a psychotic disorder (cannabis-induced psychotic disorder, CIPD) lasting days to weeks, that often requires clinical intervention, resolves with the termination of use, and recurs with re-exposure. In Denmark, the increasing potency of cannabis has been associated with an increased incidence of CIPD3. Interestingly, up to 50% of patients diagnosed with CIPD are re-diagnosed years later with schizophrenia or bipolar disorder, suggesting that CIPD may be a harbinger of a chronic psychotic disorder4. Furthermore, the rate of "conversion" to schizophrenia seems greatest for CIPD relative to other substance-induced psychoses. However, whether CIPD evolves into schizophrenia, or whether CIPD and schizophrenia are related yet distinct, remains unclear...
Language: en |