1
|
Padhi D, Shukla P, Chaudhury S. Sociodemographic and clinical profile of cannabis-induced psychosis: A comparative study. Ind Psychiatry J 2021; 30:S132-S139. [PMID: 34908679 PMCID: PMC8611598 DOI: 10.4103/0972-6748.328804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/19/2021] [Accepted: 05/27/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Cannabis is the most widely used drug in the world. An association between cannabis use and mental illness, in particular psychotic illness, was recognized since long. Various cultures have traditionally used cannabis for different purposes, and continuous increasing use of cannabis is promoting psychosis also. AIM The present study has tried to identify the differences in profile between the two groups and thus proposing possible variables underlying cannabis and psychosis. MATERIALS AND METHODS This cross-sectional descriptive hospital-based study included 50 consecutive cannabis-using patients with psychosis and equal number of age-matched patients with schizophrenia but no cannabis intake. Permission was taken from the institutional ethics committee. All subjects gave written informed consent. Detailed history regarding psychotic symptoms and different parameters of cannabis use were collected from the key informant as well as the patients in the ward. Both the groups' psychotic symptoms were assessed using scale for assessment of the positive symptoms. RESULTS There is no significant difference between both the groups with respect to age. Cannabis-using patients with psychosis showed high symptomatology in the areas of pressure of speech, distractible speech, and clanging. On the other hand, patients with schizophrenia but no cannabis intake showed high symptomatology in the areas of derailment, incoherence, illogicality, and global rating of positive formal thought disorder. CONCLUSION Continuous heavy use of cannabis can induce a psychotic disorder distinct from acute schizophrenia. Cannabis-induced psychosis has distinct demographic, premorbid, and clinical features.
Collapse
Affiliation(s)
- Debasish Padhi
- Department of Psychiatry, Rama Medical College, Kanpur, Uttar Pradesh, India
| | - Priyanka Shukla
- Department of Psychology, CSJM University, Kanpur, Uttar Pradesh, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr D Y Patil Medical College, Hospital and Research Centre, Dr D Y Patil University, Pune, Maharashtra, India
| |
Collapse
|
2
|
Abstract
SummaryForty-five cases of psychotic patients with admission urinalysis positive for cannabis were compared with psychotic controls without evidence of cannabis use. Cases and controls were matched for age, sex and year of admission, and were compared for socio-demographic data, circumstances of admission, diagnosis, and symptoms at admission. Three differences were found: cases were more likely to be Afro-Caribbean than white (P = 0.01), to manifest incoherence of speech (P= 0.02) and agitation (P= 0.01). In other respects the case and control groups were indistinguishable, and no pattern of symptoms characterised the “cannabis psychosis“group. These findings do not support the view that “cannabis psychosis” has a distinct psycho-phenomenological pattern Epidemiological studies are required to further clarify the association for psychotic patients between Afro-Caribbean ethnic groups and the likelihood of having a positive urine test for cannabis.
Collapse
|
3
|
Sideli L, Di Forti M, Ferraro L, Montana S, Tripoli G, Quattrone D, Colizzi M, La Barbera D, La Cascia C. The Relationship Between Dissociative Experiences and Cannabis Use: a Systematic Review. CURRENT ADDICTION REPORTS 2019. [DOI: 10.1007/s40429-019-0235-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
4
|
Ortiz-Medina MB, Perea M, Torales J, Ventriglio A, Vitrani G, Aguilar L, Roncero C. Cannabis consumption and psychosis or schizophrenia development. Int J Soc Psychiatry 2018; 64:690-704. [PMID: 30442059 DOI: 10.1177/0020764018801690] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: Cannabis consumption produces psychopathology, in some cases psychotic episodes, which are of our interest in this work. However, the relationship between cannabis use and psychosis has not been fully elucidated. The objectives of this work are to (1) review the current state of knowledge on the association of cannabis use with the risk of the development of psychosis or psychotic symptoms in people without schizophrenia and (2) assess the consistency of the hypothesis that cannabis use is associated with increased risk of psychosis in people without schizophrenia. METHOD: This work included research done in humans until May 2018 with the keywords 'cannabis' and 'psychosis', published in English and Spanish, in the PubMed database. RESULTS: In all, 66 papers were analyzed, of which 23 were cohort trials and 43 were reviews. CONCLUSION: Cannabis use doubles the risk of developing psychosis in vulnerable people. There even exists a relationship regarding the dose used and the age of first use. Gene-environment interactions that modulate the association between cannabis use and the presence of psychosis have also been described.
Collapse
Affiliation(s)
- María Bettina Ortiz-Medina
- 1 Area of Research, Department of Medical Psychology, Faculty of Medical Sciences, National University Asuncion, San Lorenzo, Paraguay.,2 Hospital de Clínicas, Faculty of Medical Sciences, National University of Asuncion, San Lorenzo, Paraguay
| | - Marta Perea
- 3 Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency of Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,4 Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Bellaterra, Spain
| | - Julio Torales
- 2 Hospital de Clínicas, Faculty of Medical Sciences, National University of Asuncion, San Lorenzo, Paraguay.,5 Department of Psychiatry, Faculty of Medical Sciences, National University of Asuncion, San Lorenzo, Paraguay
| | - Antonio Ventriglio
- 6 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giovanna Vitrani
- 6 Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lourdes Aguilar
- 7 Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,8 Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain
| | - Carlos Roncero
- 3 Addiction and Dual Diagnosis Unit, Department of Psychiatry, Vall d'Hebron University Hospital, Public Health Agency of Barcelona (ASPB), CIBERSAM, Barcelona, Spain.,7 Psychiatric Service, University of Salamanca Health Care Complex, Salamanca, Spain.,8 Institute of Biomedicine of Salamanca, University of Salamanca, Salamanca, Spain
| |
Collapse
|
5
|
Katchan V, David P, Shoenfeld Y. Cannabinoids and autoimmune diseases: A systematic review. Autoimmun Rev 2016; 15:513-28. [DOI: 10.1016/j.autrev.2016.02.008] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 02/03/2016] [Indexed: 12/21/2022]
|
6
|
Baldacchino A, Hughes Z, Kehoe M, Blair H, Teh Y, Windeatt S, Crome IB. Cannabis Psychosis: Examining the Evidence for a Distinctive Psychopathology in a Systematic and Narrative Review. Am J Addict 2015; 21 Suppl 1:S88-98. [DOI: 10.1111/j.1521-0391.2012.00295.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
7
|
Greineisen WE, Turner H. Immunoactive effects of cannabinoids: considerations for the therapeutic use of cannabinoid receptor agonists and antagonists. Int Immunopharmacol 2010; 10:547-55. [PMID: 20219697 DOI: 10.1016/j.intimp.2010.02.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 02/19/2010] [Indexed: 12/20/2022]
Abstract
The active constituents of Cannabis sativa have been used for centuries as recreational drugs and medicinal agents. Today, marijuana is the most prevalent drug of abuse in the United States and, conversely, therapeutic use of marijuana constituents are gaining mainstream clinical and political acceptance. Given the documented contributions of endocannabinoid signaling to a range of physiological systems, including cognitive function, and the control of eating behaviors, it is unsurprising that cannabinoid receptor agonists and antagonists are showing significant clinical potential. In addition to the neuroactive effects of cannabinoids, an emerging body of data suggests that both endogenous and exogenous cannabinoids are potently immunoactive. The central premise of this review article is that the immunological effects of cannabinoids should be considered in the context of each prescribing decision. We present evidence that the immunological effects of cannabinoid receptor agonists and antagonists are highly relevant to the spectrum of disorders for which cannabinoid therapeutics are currently offered.
Collapse
Affiliation(s)
- William E Greineisen
- Laboratory of Immunology and Signal Transduction, Department of Biology, Chaminade University, Honolulu, Hawaii 96816, USA
| | | |
Collapse
|
8
|
Taylor S. Medicalizing cannabis—Science, medicine and policy, 1950–2004: An overview of a work in progress. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630802114038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
9
|
Les troubles psychiatriques et somatiques induits par le cannabis. ANNALES PHARMACEUTIQUES FRANÇAISES 2008; 66:245-54. [DOI: 10.1016/j.pharma.2008.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2008] [Indexed: 11/18/2022]
|
10
|
Abstract
Recent epidemiological studies and advances in understanding of brain cannabinoid function have renewed interest in the long-recognized association between cannabinoids and psychosis. This chapter presents evidence supporting and refuting the association between cannabinoids and psychosis. Cannabinoids can induce acute transient psychotic symptoms or an acute psychosis in some individuals. What makes some individuals vulnerable to cannabinoid-related psychosis is unclear. Also clear is that cannabinoids can also exacerbate psychosis in individuals with an established psychotic disorder, and these exacerbations may last beyond the period of intoxication. Less clear is whether cannabis causes a persistent de novo psychosis. The available evidence meets many but not all the criteria for causality, including dose-response, temporality, direction, specificity, and biological plausibility. On the other hand, the large majority of individuals exposed to cannabinoids do not experience psychosis or develop schizophrenia and the rates of schizophrenia have not increased commensurate with the increase in rates of cannabis use. Similar to smoking and lung cancer, it is more likely that cannabis exposure is a component cause that interacts with other factors, for example, genetic risk, to "cause" schizophrenia. Nevertheless, in the absence of known causes of schizophrenia, the role of component causes such as cannabis exposure (exogenous hypothesis) is important and warrants further study. There is also tantalizing evidence from postmortem, neurochemical, and genetic studies suggesting CB1 receptor dysfunction (endogenous hypothesis) in schizophrenia that warrants further investigation. Further work is necessary to identify those factors that place individuals at higher risk for cannabinoid-related psychosis, to identify the biological mechanisms underlying the risks and to further study whether CB1 receptor dysfunction contributes to the pathophysiology of psychotic disorders.
Collapse
Affiliation(s)
- Deepak Cyril D'Souza
- Department of Psychiatry, Yale University School of Medicine, VA Connecticut Healthcare System, West-Haven, Connecticut 06516, USA
| |
Collapse
|
11
|
Abstract
Cannabis has been used for recreational, medicinal and religious purposes in different cultures since ancient times. There have been various reports of adverse effects due to or associated with cannabis consumption, including psychotic episodes. Historically, our understanding of these clinical observations has been significantly hindered by a lack of knowledge regarding their underlying neurobiological and pharmacological processes. However, the discovery of the endogenous cannabinoid system has allowed a greater understanding of these adverse effects to develop. From a clinical perspective, toxic or transient psychotic reactions to the administration of herbal cannabis preparations or specific cannabinoid compounds have to be differentiated from longer-lasting, persistent schizophrenia-like disorders associated with the use of cannabis/cannabinoids. The latter are most likely to be associated with a predisposition or vulnerability to schizophrenia. Interestingly, the recently suggested role of the endogenous cannabinoid system in schizophrenia not related to previous cannabinoid consumption introduces an additional perspective on the mechanism underlying cannabis-associated schizophrenia-like disorders, as well as on the effects of cannabis consumption in schizophrenia. At present, acute psychopharmacological treatment options for cannabis-associated transient and persistent schizophrenia-like psychotic episodes are similar and are based on the use of benzodiazepines and antipsychotics. However, new pharmacological strategies using the endogenous cannabinoid system as a primary target are under development. Long-term psychotherapeutic treatment options involve case management strategies and are mainly based on specialised psychotherapeutic programmes to encourage cannabis users to stop their use of the drug.
Collapse
Affiliation(s)
- F Markus Leweke
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany.
| | | | | |
Collapse
|
12
|
Phillips LJ, Curry C, Yung AR, Yuen HP, Adlard S, McGorry PD. Cannabis use is not associated with the development of psychosis in an 'ultra' high-risk group. Aust N Z J Psychiatry 2002; 36:800-6. [PMID: 12406123 DOI: 10.1046/j.1440-1614.2002.01089.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The association between cannabis use and the development of a first psychotic episode was studied in a group of 100 young people identified as being at very high risk for the onset of psychosis. METHOD The 'ultra' high risk cohort was identified by the presence of subthreshold psychotic symptoms, or a combination of first-degree relative with a psychotic disorder and recent functional decline. Thirty-two per cent of the cohort developed an acute psychotic episode over the 12-month period after recruitment. As a component of a larger research study, the level of cannabis use by participants in the year prior to enrollment in the study was assessed at intake. RESULTS Cannabis use or dependence in the year prior to recruitment to this study was not associated with a heightened risk of developing psychosis over the following 12-month period and therefore did not appear to contribute to the onset of a psychotic disorder. CONCLUSION The results of this study suggest that cannabis use may not play an integral role in the development of psychosis in a high-risk group. While this study does not support a role for cannabis in the development of first-episode psychosis, we cannot conclude that cannabis use should be completely ignored as a candidate risk factor for onset of psychosis. A number of weaknesses of the study (the low level of cannabis use in the current sample, the lack of monitoring of cannabis use after intake) suggest that it may be premature to dismiss cannabis use as a risk factor for the development of psychosis and further research is urged in this area.
Collapse
Affiliation(s)
- Lisa J Phillips
- Personal Assessment and Chris Evaluation (PACE) Clinic, Parkville, Victoria, Australia.
| | | | | | | | | | | |
Collapse
|
13
|
Abstract
OBJECTIVE The existence of cannabis-induced psychosis (CP) remains controversial, partly because of methodological problems. We hypothesize that acute schizophrenia (AS) and CP can have distinct demographic, premorbid and clinical features. METHOD We compared 26 patients with CP to 35 with AS, after their cannabis-consumption status was confirmed by repeated urine screens. Patients with CP were assessed after at least 1 week but not more than 1 month of abstinence. Symptoms were evaluated with the Present State Examination (PSE). RESULTS In group CP, male gender, expansive mood and ideation, derealization/depersonalization, visual hallucinations, and disturbances of sensorium were more frequent than in group AS. Premorbid schizoid personality traits were more frequently associated to AS and antisocial personality traits to CP. CONCLUSION The continuous heavy use of cannabis can induce a psychotic disorder distinct from AS. These two clinical entities share some features but they differ in others.
Collapse
Affiliation(s)
- L A Núñez
- Psychiatry Service, Hospital de Navarra, Pamplona, Spain.
| | | |
Collapse
|
14
|
Sharpley M, Hutchinson G, McKenzie K, Murray RM. Understanding the excess of psychosis among the African-Caribbean population in England. Review of current hypotheses. Br J Psychiatry Suppl 2001; 40:s60-8. [PMID: 11315227 DOI: 10.1192/bjp.178.40.s60] [Citation(s) in RCA: 206] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Increased rates of schizophrenia continue to be reported among the African-Caribbean population in England. AIMS To evaluate the competing biological, psychological and social explanations that have been proposed. METHOD Literature review. RESULTS The African-Caribbean population in England is at increased risk of both schizophrenia and mania; the higher rates remain when operational diagnostic criteria are used. The excess of the two psychotic disorders are probably linked: African-Caribbean patients with schizophrenia show more affective symptoms, and a more relapsing course with greater social disruption but fewer chronic negative symptoms, than White patients. No simple hypothesis explains these findings. CONCLUSIONS More complex hypotheses are needed. One such links cultural variation in symptom reporting, the use of phenomenological constructs by psychiatrists and social disadvantage.
Collapse
Affiliation(s)
- M Sharpley
- Department of Psychiatry, Institute of Psychiatry, King's College London, UK
| | | | | | | |
Collapse
|
15
|
Abstract
BACKGROUND Cannabis is commonly regarded as an innocuous drug and the prevalence of lifetime and regular use has increased in most developed countries. However, accumulative evidence highlights the risks of dependence and other adverse effects, particularly among people with pre-existing psychiatric disorders. AIMS To re-evaluate the adverse effects of cannabis in the general population and among vulnerable individuals, including those with serious psychiatric disorders. METHOD A wide-ranging review of the topics related to these issues. Results and conclusions An appreciable proportion of cannabis users report short-lived adverse effects, including psychotic states following heavy consumption, and regular users are at risk of dependence. People with major mental illnesses such as schizophrenia are especially vulnerable in that cannabis generally provokes relapse and aggravates existing symptoms. Health workers need to recognise, and respond to, the adverse effects of cannabis on mental health.
Collapse
Affiliation(s)
- A Johns
- Department of Forensic Psychiatry, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
| |
Collapse
|
16
|
Abstract
OBJECTIVE The purpose of this study was to examine the level of cannabis use in psychotic patients admitted to two acute admission wards in New Zealand. Symptomatology was investigated using the Brief Psychiatric Rating Scale (BPRS). METHOD During a 1 -month period, all acute admissions to Tokanui Hospital with psychosis were interviewed and symptoms rated on the BPRS (n = 35). Cannabis use was recorded with a questionnaire and urine test. Those positive for cannabis were compared to those negative. RESULTS Thirty patients (86%) had tried cannabis at least once and 11 (31%) were positive on urine screen. Those with positive urine tests were significantly more likely to use cannabis most days (p < 0.001). This positive urine test group was less likely to be thought disordered, suspicious or deluded (as measured by the BPRS). CONCLUSIONS Cannabis use was widespread in this sample of patients with psychosis and may affect their symptomatology. Larger studies are needed to examine these associations in more detail.
Collapse
Affiliation(s)
- S Sembhi
- Mental Health Care of Older People, Whittington Hospital, London, United Kingdom
| | | |
Collapse
|
17
|
Affiliation(s)
- N A Firth
- School of Dental Science, University of Melbourne, Victoria, Australia
| |
Collapse
|
18
|
Abstract
OBJECTIVE The aim of the paper is to review the effects of Cannabis sativa on the human brain. METHOD A selective literature review was undertaken. RESULTS/CONCLUSIONS Cannabis sativa causes an acute and, with regular heavy ingestion, a subacute encephalopathy. There is no evidence of irreversible cerebral damage resulting from its use, although impairment of information processing might be a long-term consequence of heavy prolonged use. The precise relationship of cannabis to the functional psychoses such as schizophrenia has yet to be clarified.
Collapse
Affiliation(s)
- D J Castle
- Mills Street Clinical Research Unit, Bentley, Perth, Western Australia, Australia
| | | |
Collapse
|
19
|
Abstract
Koro in the background of drug abuse is quite rare. The present report of Koro during the first experience with cannabis is the only account of its kind in the world Koro literature to date. The nature and extent of this genital depersonalization is discussed.
Collapse
Affiliation(s)
- A N Chowdhury
- Department of Psychiatry, Institute of Postgraduate Medical Education & Research, UNDCP Nodal Centre for Drug Abuse Prevention, Calcutta, India
| | | |
Collapse
|
20
|
Abstract
The usual phenomena of cannabis intoxication include experiences which in a non-intoxicated state would be considered as psychiatric symptoms. These can be distinguished from adverse reactions to cannabis, the commonest of which is an acute anxiety state. Acute psychotic episodes can also follow ingestion of the drug but are infrequent. These can be classified as acute confusional states and episodes occurring in clear consciousness. Neither presentation consistently shows enough specific features to warrant the diagnosis of 'cannabis psychosis' as a distinct clinical entity. The evidence that cannabis has a causative role in chronic psychotic or affective disorders is not convincing, although the drug may modify the course of an already established illness. Further controlled studies would be required to clarify the aetiological significance of the drug in these conditions.
Collapse
Affiliation(s)
- H Thomas
- Mid-Glamorgan Rotational Training Scheme in Psychiatry, Glanrhyd/Penyfai Hospital, Wales
| |
Collapse
|
21
|
Abstract
Among patients being treated for specific behaviour-control problems, there exists an important subgroup of 'multi-impulsive' patients whose treatment might be facilitated if the full range of their problems were recognised and dealt with as one general issue of impulse control. In women in particular, loss of control of eating may be prevalent and easily concealed from staff, and may thwart treatment. This survey of 50 women attending an alcoholic-treatment unit explored the prevalence of behavioural-control problems other than those of alcohol. Three-quarters of the women also had other behavioural problems. Over half the sample had thought of taking an overdose and just under half had actually taken one; about a quarter had cut themselves deliberately; half described impulsive physical violence; half acknowledged a period of 'promiscuity'; and at least 16% had had a clinically diagnosable eating disorder. More research is needed but we believe that all self-damaging behaviour should be addressed simultaneously to prevent 'revolving door' relapses as emotional distress is transferred from one behaviour to another.
Collapse
Affiliation(s)
- C Evans
- Department of Mental Health Sciences, St George's Hospital Medical School, London
| | | |
Collapse
|
22
|
Abstract
In-patients with psychotic symptoms and cannabis-positive urine analysis were assessed by PSE within one week of admission and again at one and six months. Concurrently admitted psychotic patients with drug-free urine analysis were controls. At one week the two groups differed significantly on only five PSE items: changed perception, thought insertion, non-verbal auditory hallucinations, delusions of control, and delusions of grandiose ability. One item (delayed sleep) differed at one month, and none at six months. The symptom cluster at one week is consistent with acute cannabis intoxication. Subjects and controls were mostly single, poorly educated, unemployed people with histories of psychotic disorders, and given major tranquillisers on admission. Compared with controls, subjects were younger, less likely to have psychiatric histories, more often male, Afro-Caribbeans with a history of convictions and compulsory admissions. The commonest diagnosis was schizophrenia. Use of the label 'cannabis-induced psychosis' may obscure a diagnosis of paranoid schizophrenia. A short-lived psychotic episode does occur in clear consciousness after cannabis intoxication, but chronic cannabis-induced psychosis was not found.
Collapse
|
23
|
Abstract
A first episode of psychosis occurred in a young woman of West Indian parentage and one of identical twins following a brief period of high consumption of a drink made from Colubrina plant extract (mabi bark). The course of the psychosis is described and possible underlying mechanisms and the relationship to amphetamine psychosis are discussed.
Collapse
Affiliation(s)
- A Hassiotis
- Whittington Hospital, Psychiatric Unit, Highgate Hill, London
| | | |
Collapse
|
24
|
Abstract
A study was carried out on a group of 95 schizophrenic patients (DSM-III-R criteria) under the age of 35, 23 of whom were cannabis abusers in the past year. The objective of the study was to evaluate the effect of cannabis on positive and negative schizophrenic symptoms, evaluated using Andreasen's Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS). There were no statistically significant differences between the groups on the SAPS; the group of cannabis abusers had higher scores except for the delusions subscale. On the SANS nonabusers scored higher, with a significant difference on the alogia subscale. The results suggest that the consumption of cannabis by schizophrenic patients could attenuate negative symptoms, which would support the self-medication hypothesis of cannabis abuse.
Collapse
Affiliation(s)
- V Peralta
- Psychiatry Unit, Virgen del Camino Hospital, Pamplona, Spain
| | | |
Collapse
|
25
|
Chaudry HR, Moss HB, Bashir A, Suliman T. Cannabis psychosis following bhang ingestion. BRITISH JOURNAL OF ADDICTION 1991; 86:1075-81. [PMID: 1932878 DOI: 10.1111/j.1360-0443.1991.tb01874.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The purpose of this preliminary investigation is to systematically characterize the signs and symptoms of cannabis psychosis in individuals who presented for psychiatric treatment in Pakistan after ingestion of bhang; a beverage containing cannabis. In order to control for the behavioral effects of cannabis alone, symptoms produced by bhang ingestion among non-patients consuming the same beverage were compared with those symptoms found among psychotic patients. Patients differed from controls in that a higher proportion of patients were found to be chronic users of bhang, and had a past history of psychotic episodes. Presenting symptoms of bhang-induced psychosis found in patients included grandiosity, excitement, hostility, uncooperativeness, disorientation, hallucinatory behavior and unusual thought content. Neuroleptic treatment successfully attenuated psychotic symptoms within five days of the initiation of the episode. The presenting symptoms of bhang-induced psychosis are consistent with a brief mania-like disorder with paranoid psychotic features, and cognitive dysfunction. Several etiologic hypotheses are proposed.
Collapse
Affiliation(s)
- H R Chaudry
- King Edward Medical College, Mayo Hospital, Lahore, Pakistan
| | | | | | | |
Collapse
|
26
|
Mathers DC, Ghodse AH, Caan AW, Scott SA. Cannabis use in a large sample of acute psychiatric admissions. BRITISH JOURNAL OF ADDICTION 1991; 86:779-84. [PMID: 1878628 DOI: 10.1111/j.1360-0443.1991.tb03104.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A sample of 908 patients drawn from two London Psychiatric Hospitals is described in terms of age, sex, self-reported drug and alcohol history, drug urinalysis results and initial psychiatric diagnosis. Some (34.5%) of respondents admitted to using cannabis at least once in their lifetime and 13% of those tested had urines positive for cannabis on admission. Cannabis use is commoner in young males. These is a higher likelihood that an initial diagnosis of 'psychosis' will be made at admission if patients either report use of cannabis or present a urine sample positive for cannabis.
Collapse
Affiliation(s)
- D C Mathers
- Department of Addictive Behaviour, St George's Hospital Medical School, London, UK
| | | | | | | |
Collapse
|
27
|
Leikin JB, Krantz AJ, Zell-Kanter M, Barkin RL, Hryhorczuk DO. Clinical features and management of intoxication due to hallucinogenic drugs. MEDICAL TOXICOLOGY AND ADVERSE DRUG EXPERIENCE 1989; 4:324-50. [PMID: 2682130 DOI: 10.1007/bf03259916] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Hallucinogenic drugs are unique in that they produce the desired hallucinogenic effects at what are considered non-toxic doses. The hallucinogenic drugs can be categorised into 4 basic groups: indole alkaloid derivatives, piperidine derivatives, phenylethylamines and the cannabinols. The drugs reviewed include lysergic acid diethylamide (LSD), phencyclidine (PCP), cocaine, amphetamines, opiates, marijuana, psilocybin, mescaline, and 'designer drugs.' Particularly noteworthy is that each hallucinogen produces characteristic behavioural effects which are related to its serotonergic, dopaminergic or adrenergic activity. Cocaine produces simple hallucinations, PCP can produce complex hallucinations analogous to a paranoid psychosis, while LSD produces a combination of hallucinations, pseudohallucinations and illusions. Dose relationships with changes in the quality of the hallucinatory experience have been described with amphetamines and, to some extent, LSD. Flashbacks have been described with LSD and alcohol. Management of the intoxicated patient is dependent on the specific behavioural manifestation elicited by the drug. The principles involve differentiating the patient's symptoms from organic (medical or toxicological) and psychiatric aetiologies and identifying the symptom complex associated with the particular drug. Panic reactions may require treatment with a benzodiazepine or haloperidol. Patients with LSD psychosis may require an antipsychotic. Patients exhibiting prolonged drug-induced psychosis may require a variety of treatments including ECT, lithium and l-5-hydroxytryptophan.
Collapse
Affiliation(s)
- J B Leikin
- Department of Medicine, Rush-Presbyterian-St Luke's Medical Center, Chicago
| | | | | | | | | |
Collapse
|
28
|
|
29
|
|