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Chapter 14 - Cannabis and Psychosis Proneness

from Part V - Cannabis and Psychosis

Published online by Cambridge University Press:  12 May 2023

By
Rajiv Radhakrishnan ,
Shubham Kamal ,
Sinan Guloksuz  and
Jim van Os
Edited by
Deepak Cyril D'Souza ,
David Castle  and
Sir Robin Murray
Deepak Cyril D'Souza
Affiliation:
Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine
David Castle
Affiliation:
University of Tasmania, Australia
Sir Robin Murray
Affiliation:
Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
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Summary

Cannabis use is associated with the development of psychosis in multiple studies. With increasing cannabis use worldwide, it is important to identify individuals who are at risk of developing psychosis following cannabis use. The concept of psychosis proneness has evolved over the past century from schizotypy, to denote people at clinical high risk for psychosis (CHR), those at genetic risk of schizophrenia (defined by polygenic risk score for schizophrenia), and those who experience attenuated psychotic symptoms in the general population. Across these definitions of psychosis proneness, cannabis use has been shown to increase the risk of psychosis expression. General population samples show that cannabis interacts with other environmental risk factors, such as childhood trauma and urbanicity, as well as with genetic liability in an additive manner, such that the risk of psychosis expression is greater with increasing number of risk factors. The role of affective dysregulation in increasing the risk of psychosis expression is also recognized. While biological and psychological studies suggest the role of striatal dopamine release, reasoning bias, impairment in face processing, and working memory, the precise biological underpinnings of the effects of cannabis use on psychosis proneness remain to be elucidated.

Keywords

cannabispsychosisschizophreniapsychosis pronenesspolygenic risk scorerisk factors
Type
Chapter
Information
Marijuana and Madness , pp. 139 - 147
Publisher: Cambridge University Press
Print publication year: 2023

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References

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