Psychotic disorders hospitalizations associated with cannabis abuse or dependence: A nationwide big data analysis

Abstract

Objectives We aimed to describe and correlate the hospital panorama of psychotic disorders (PD) with cannabis use (CU) trends in all Portuguese public hospitals. Methods We conducted a retrospective observational study that analysed all hospitalizations that occurred in Portuguese public hospitals from 2000 to 2015. Hospitalizations with a primary diagnosis of PD or schizophrenia were selected based on Clinical Classification Software diagnostic single‐level 659. Episodes associated with CU were identified by the International Classification of Diseases Version 9, Clinical Modification code 304.3/305.2 that correspond to cannabis dependence/cannabis abuse. Results The number of hospitalizations with a primary diagnosis of PD and schizophrenia associated with CU rose 29.4 times during the study period, from 20 to 588 hospitalizations yearly (2000 and 2015, respectively) with a total of 3,233 hospitalizations and an average episode cost of €3,500. Male patients represented 89.8% of all episodes, and the mean/median age at discharge were 30.66/29.00 years, respectively. From all hospitalizations with a primary diagnosis of PD or schizophrenia, the ones with a secondary diagnosis of CU rose from 0.87% in 2000 to 10.60% in 2015. Conclusions The increase on secondary diagnosis coding and the change on cannabis patterns of consumption in Portuguese population with an increasing frequency of moderate/high dosage cannabis consumers may explain the rise on PD hospitalizations.

Adverse effects of heavy cannabis use: even plants can harm the brain

“…Further independent evidence comes from Portugal that has registered a steady increase in the rate of hospital admissions for psychotic disorders with comorbid CUD. 45 Similar data were reported in Denmark. 59 Both countries have seen a rise in the potency of available cannabis over the same period.…”

State Cannabis Legalization and Psychosis-Related Health Care Utilization

“…32 A limited number of studies have further identified increased rates of psychotic disorders associated with state and regional cannabis legalization in the US and with national policies in Canada and Portugal. [33][34][35][36] As states continue to introduce cannabis legislation, a thorough and comprehensive understanding of their potential health outcomes is essential. Yet to our knowledge, no studies have examined trends in psychosis-related outcomes as a function of medical and recreational cannabis laws across all US states.…”

Substance Addiction Consequences: Outpatients Severity Indicators in a Medication-Based Program

“…As for people with mood disorders, the severity is generally higher than that associated with other comorbidities, mainly in terms of family problems and psychological distress, while recognizing the negative impact of the association between drug use and mood disorders, such as, problems in keeping up a professional activity and financial stability (Frank et al 2019;Winkelman et al 2018). Another condition associated with greater severity is psychotic disorders, as in other studies (Gonçalves-Pinho et al 2019;Hanna et al 2017), although we are at a time in which discussions are taking place about the benefit of using some substances in the treatment of mental disorders (Black et al 2019;Khan et al 2020). It is clear that the association of more comorbidities is progressively related to greater severity, as in other studies (Winkelman et al 2018), especially with regard to mood disorders, which are more prevalent in female users (Keyser-Marcus et al 2015).…”