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

Ricci, Valerio; Ceci, Franca; Francesco, Di Carlo; Ilenia, Di Muzio; Laura, Ciavoni; Monica, Santangelo; Gabriele, Di Salvo; Pettorruso, Mauro; Martinotti, Giovanni; Maina, Giuseppe

doi:10.1016/j.psychres.2023.115053

Cited by 10 publications

(9 citation statements)

References 59 publications

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“…Regarding negative psychotic symptoms, they were more pronounced in non-users compared to both THC-users and SPICE-users, consistent with prior literature ( 23 , 26 , 32 , 33 ) and our previous study ( 21 ). Two hypotheses could explain these findings.…”

Section: Discussionsupporting

confidence: 92%

“…SPICE-users exhibited more severe positive symptoms ( 25 , 27 , 39 ) compared to both NC users and non-users, in line with existing literature ( 26 , 60–62 ). Importantly, during the final evaluation, SPICE-users showed a less pronounced reduction in positive symptoms compared to the other two groups, confirming our previous research ( 21 ). This suggests that SCs may trigger more severe and persistent positive symptoms with a poor response to antipsychotic treatments ( 9 , 63–65 ).…”

Section: Discussionsupporting

confidence: 89%

“…Scientific literature strongly supports a robust association between cannabis use and psychosis ( 15–17 ), particularly in individuals with a genetic vulnerability, increasing the risk of early-onset psychosis and worsening the severity of symptoms ( 18 , 19 ). Specifically, cannabis use is strongly linked to the onset of FEP ( 20 ) carrying a risk that is two times higher ( 15 , 17 ) to four time higher ( 16 ) for experiencing a psychotic disorder than non-users ( 21 ). Furthermore, recent observations suggest that the early onset of cannabis consumption significantly increases the risk of developing psychotic symptoms, especially when initiated before the age of 15 and continuing into adulthood ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

“…The available literature suggests that individuals who use cannabis tend to experience more severe and enduring positive symptoms compared to those who did not use NC and/or SCs. Additionally, these individuals may exhibit less pronounced negative symptoms ( 21 , 25–27 ). Cannabis-related psychosis is associated with an increased number of hospitalization days ( 28 ), lower therapy response ( 29 ), decreased pharmacological compliance ( 30 ), and a higher risk of relapse ( 31 ).…”

Section: Introductionmentioning

confidence: 99%

“…This contributes to higher rates of suicidal ideation and suicide attempts among individuals with cannabis-related psychosis ( 41 ). Recent studies have indicated that psychoses linked to NC and/or SCs use are associated with more prominent dissociative symptoms, with a greater tendency for these symptoms to persist over time, particularly in NC-users ( 21 , 42 ). While there is no direct link between dissociation and suicide ( 21 , 42 ), there is an increased incidence of suicidal thoughts among SCs-users, potentially driven by SCs-induced impulsivity and the emergence of positive symptoms ( 42 ).…”

Section: Introductionmentioning

confidence: 99%

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Aberrant salience in cannabis-induced psychosis: a comparative study

Ricci,

Di Muzio,

Ceci

et al. 2024

Front. Psychiatry

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BackgroundNatural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk and exacerbate the course of psychotic disorders. These could be influenced by the Aberrant Salience (AS) construct. It refers to an excess of attribution of meaning to stimuli that are otherwise regarded as neutral, thereby transform them into adverse, dangerous, or mysterious entities. This leads the patient to engage in aberrant and consequently incorrect interpretative efforts concerning the normal perception of reality and its relationship with our analytical abilities. AS appears to play a significant role in the onset and perpetuation of psychotic disorders. The internal conflict arising from aberrant attributions of significance leads to delusional thoughts, ultimately culminating in the establishment of a self-sustaining psychosis.AimsTo examine the differences between psychoses course not associated with cannabis use and those associated with NC-use and SCs-use, in terms of psychotic and dissociative symptoms, AS, global functioning and suicidal ideation.MethodsA sample of 62 patients with First Episode Psychosis (FEP) was divided into 3 groups: non cannabis users (non-users, N = 20); NC-users or rather Delta-9-tetrahydrocannabinol (THC) users (THC-users, N = 21); SCs-users, commonly referred to as SPICE-users (SPICE-users, N = 20). Each group underwent assessments at the onset of psychotic symptoms, as well as at the 3 months and 6 months marks, utilizing a range of psychopathological scales. These included the Positive and Negative Syndrome Scale (PANSS) for investigating psychotic symptoms, the Global Assessment of Functioning (GAF) scale for assessing overall functioning, the Dissociative Experiences Scale (DES-II) for measuring dissociative symptoms, the Scale for Suicide Ideation (SSI) for evaluating suicidal ideation and the Aberrant Salience Inventory (ASI) scale for gauging AS.ResultsSPICE-users showed more severe and persistent positive symptoms, while negative symptoms were mostly represented among non-users. Non-users showed better recovery than SPICE-users in global functioning. All groups showed a decrease in both ASI scores and subscale scores. SPICE-users exhibited higher global AS scores and less improvement in this aspect compared to other groups.ConclusionThis study may help understanding the role of AS in both non-substance-related and substance-induced psychosis. This knowledge may lead clinician to a better diagnosis and identify patient-tailored psychopharmacological treatment.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Aberrant salience in cannabis-induced psychosis: a comparative study

Ricci,

Di Muzio,

Ceci

et al. 2024

Front. Psychiatry

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The Association Between Adolescent Vaping and Subsequent Use of Other Substances and Risk Factors for Polysubstance Use

Salmon

Pappas

Taillieu

et al. 2023

Int J Ment Health Addiction

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Objectives Adolescent vaping has become a public health concern. The aim of this study was to examine the associations between adolescent vaping and subsequent use of other substances and risk factors for polysubstance use. Methods The Well-being and Experiences Study is a longitudinal, intergenerational study conducted in Manitoba, Canada. The sample for this study consisted of adolescents and emerging adults who participated in Waves 1 (N = 1,002; 2017-18; aged 14–17 years) and 2 (n = 756; 2019; aged 15–20 years). Multinomial logistic regression analysis was performed. Results Adolescent vaping was associated with continued use of alcohol, cannabis, and cigarettes (adjusted relative risk ratio [aRRR] range: 12.92–19.39), new onset use of cannabis (aRRR: 6.04) and cigarettes (aRRR: 3.66), and concurrent and simultaneous polysubstance use (aRRR range: 3.14–24.25). Several risk factors were identified for concurrently using three or four substances in the past year (aRRR range: 1.76–2.86) and simultaneously using alcohol, cannabis, and nicotine (aRRR range: 1.99–3.11). Among those who reported vaping nicotine at Wave 2, 33.6% of males and 24.2% of females reported doing so as a coping mechanism. Conclusions Adolescent vaping is a risk factor for subsequent use of other substances and polysubstance use. Efforts are needed to prevent vaping initiation and help adolescents with cessation. Strategies should include selective interventions for those with histories of childhood adversity and mental health disorder.

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