TOPLINE:

Cannabis-associated psychosis (CAP) is associated with better cognitive function, lower cortical excitatory or inhibitory balance, fewer negative symptoms, and greater reductions in mood symptoms than non-CAP, a new study showed.

METHODOLOGY:

• A prospective, longitudinal, observational study conducted in India included 66 men (mean age, 27 years) hospitalized for new-onset psychosis associated with confirmed cannabis exposure and 53 matched men (mean age, 30 years) hospitalized for new-onset non-CAP.
• At admission and after 4 weeks of standardized inpatient treatment, the participants were assessed using the CogState Schizophrenia Battery and Hopkins Verbal Learning Test (HVLT), EEG, the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Rating Scale, and the Young Mania Rating Scale.
• Cannabis exposure was confirmed via patient self-report, information obtained from family members, structured interviews, and urine toxicology.
• Outcomes included cognitive test performance, EEG measures of cortical excitatory or inhibitory balance, and symptom scores for psychosis.

TAKEAWAY:

• Cognitive test performance significantly improved in the CAP group but not in the non-cannabis-related psychosis group over 4 weeks, with significant interactions for HVLT total immediate recall (P = .008) and CogState composite score (P = .025).
• At admission, the CAP group had a significantly higher power spectral density exponent on EEG (P = .03), indicating a lower cortical excitatory or inhibitory balance, which remained stable over time.
• The CAP group presented with significantly lower PANSS negative and total scores at admission and after 4 weeks of treatment (all P < .001). They had higher scores for depression and mania at admission (both P < .001), but there were no between-group differences after 4 weeks.
• In a follow-up analysis of 16 CAP participants, 10 were rehospitalized after resuming use of cannabis, “highlighting its role in illness recurrence,” the researchers of the study noted.

IN PRACTICE:

“First-episode cannabis-related psychosis differs from psychosis unrelated to cannabis in its cognitive, electrophysiological, and behavioral profile,” the investigators of the study wrote.

“Because cannabis and potent cannabis derivatives are increasingly available, and because the rates of CAP continue to increase, further work is necessary to replicate our findings and determine whether psychosis related to cannabis has a distinct course, response to existing treatments, and prognosis,” they added.

SOURCE:

The study was led by Deepak Cyril D’Souza, MD, Yale University School of Medicine, New Haven, Connecticut. It was published online on June 02 in the American Journal of Psychiatry.

LIMITATIONS: 

The study included only men, and the post-discharge follow-up sample was small, which limited the generalizability of the findings. Additionally, some variables could not be adjusted for in the analysis, such as illness onset or duration, which may have influenced the findings.

DISCLOSURES:

The study was funded by the National Institute on Drug Abuse and the Brain & Behavior Research Foundation. Disclosure information for the study investigators is available in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.