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Chapter 10 - Is There a Cannabis-Associated Psychosis Sub-type?

Lessons from Biological Typing in the B-SNIP Project and Implications for Treatment

from Part III - Cannabis and the Brain

Published online by Cambridge University Press:  12 May 2023

By
Godfrey D. Pearlson  and
Matcheri S. Keshavan
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-associated psychosis’ (CAP) refers to a chronic psychotic illness that arises in the context of significant current or past cannabis use. This chapter is an interrogation of the large-scale, multi-centre cross-sectional study of individuals with an established psychotic illness, the bipolar–schizophrenia network on intermediate phenotypes (B-SNIP). B-SNIP used biological characteristics to sub-divide individuals with psychotic illnesses into distinct sub-group,s known as ‘Biotypes’. A subtype associated with adolescent cannabis exposure, Biotype-3, was characterized to have the distinct profile of a significant excess of adolescent cannabis use histories preceding the onset of psychosis, histories of childhood abuse, distinctly preserved cognition, hippocampal morphological and neurochemical abnormalities, normal evoked and resting electrophysiology, more normal MRI grey matter patterns, near-normal saccades and smooth pursuit eye movements, and the lowest schizophrenia polygenic risk scores. Further work is necessary to study CAP in order to find treatments specific for CAP.

Keywords

cannabiscannabinoidsTHCcannabidiolpsychosisbiotypecognitionbrain structureglutamateGABA
Type
Chapter
Information
Marijuana and Madness , pp. 91 - 106
Publisher: Cambridge University Press
Print publication year: 2023

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