Cannabis induced psychosis and subsequent psychiatric disorders
Dharav Shah, Prabhat Chand, Mrunal Bandawar, Vivek Benegal, Pratima Murthy, Cannabis induced psychosis and subsequent psychiatric disorders, Asian Journal of Psychiatry, Volume 30, Published 2017
https://www-sciencedirect-com.york.ezproxy.cuny.edu/science/article/pii/S187620181730388X
I wanted to look up a article based on the first patient that I presented in H&P 1, about the young female who suffered from auditory hallucinations and bizarre behavior under the influence of cannabis. I found that various substances can lead to substance induced psychosis, and cannabis is one of them. Long term use can lead to one suffering from auditory and visual hallucinations, and be out of touch with reality.
This articles talks about how Cannabis is one of the most abused drugs in the world, despite its known affects of psychosis. It shows that when volunteers take it, it presents with both positive (euphoric/paranoia) and negative symptoms, almost shadowing the presentation of schizophrenia. This study is a case record review to look at the long term diagnosis and prognosis of those with cannabis induced psychosis in India and to determine if it is truly cannabis induced, or a independent psych problem. The subjects were screened using the following inclusion criteria: 1. having cannabis induced psychosis (1st episode or recurrent), 2. being between the age of 16-70 years old, 3. both genders were included, 4. those residing close to where the research was taking place, so follow up is easier, 5. committing to follow up for a year. Of the 200 screened, 57 met the inclusion and exclusion criteria. The subjects were then classified as either cannabis induced mood disorder or cannabis induced psychosis disorder. The subject and a close family member were then interviewed using the PRISM diagnostic review (Psych research interview for substance and mental disorders); this helps differentiate between substance induced disorders and independent disorders. The presence of cannabis and other metabolites was also tested in the urine, as well as having the records looked at from 10 years back.
It was found that of those diagnosed with CIP int eh first interview, 34% were found to have independent psych disorders 1 year later. And those who abstained from cannabis had a much favorable outcome vs those who relapsed. Cannabis induced psychosis often presents as a coexistence of psychosis and mood disorders. The results show that those who stop using cannabis after having their first episode of CIP, will have a good overall prognosis, and is psychosis symptoms still persist, then it can be accounted by an independent disorder. Also on the flip side, those who continue to use can eventually have their CIP develop into a more severe independent psych disorder.
As interesting as these results are, I believe that it would have benefitted even more from a larger sample size. I also wish the article specified how they are ensuring that these patients are abstaining from using cannabis, for example are there weekly urine drug tests or THC blood panels? I also think the article could have benefitted from a an attachment of an example of the PRISM questionnaire/review they used to assess the patients.
