Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-17T16:07:11.445Z Has data issue: false hasContentIssue false

Cannabis and psychotic illness

Published online by Cambridge University Press:  02 January 2018

D.C. Mathers
Affiliation:
St George's Hospital Medical School, London
A.H. Ghodse
Affiliation:
St George's Hospital Medical School, London

Abstract

In-patients with psychotic symptoms and cannabis-positive urine analysis were assessed by PSE within one week of admission and again at one and six months. Concurrently admitted psychotic patients with drug-free urine analysis were controls. At one week the two groups differed significantly on only five PSE items: changed perception, thought insertion, non-verbal auditory hallucinations, delusions of control, and delusions of grandiose ability. One item (delayed sleep) differed at one month, and none at six months. The symptom cluster at one week is consistent with acute cannabis intoxication. Subjects and controls were mostly single, poorly educated, unemployed people with histories of psychotic disorders, and given major tranquillisers on admission. Compared with controls, subjects were younger, less likely to have psychiatric histories, more often male, Afro-Caribbeans with a history of convictions and compulsory admissions. The commonest diagnosis was schizophrenia. Use of the label ‘cannabis-induced psychosis’ may obscure a diagnosis of paranoid schizophrenia. A short-lived psychotic episode does occur in clear consciousness after cannabis intoxication, but chronic cannabis-induced psychosis was not found.

Type
Papers
Copyright
Copyright © 1992 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ames, F. (1958) A clinical and metabolic study of acute intoxication with cannabis sativa and its role in model psychoses. Journal of Mental Science, 104, 972999.CrossRefGoogle ScholarPubMed
Andreasson, S., Allebeck, P., Engstrom, A., et al (1987) Cannabis and schizophrenia. Lancet, 2, 14831486.Google ScholarPubMed
Andreasson, S., Allebeck, P., & Rydberg, U. C. (1989) Schizophrenia in users and non users of cannabis: a longitudinal study. Acta Psychiatrica Scandinavica, 79, 505510.CrossRefGoogle Scholar
Bialos, D. S. (1970) Adverse marijuana reactions: a critical examination of the literature with selected case material. American Journal of Psychiatry, 126, 119123.Google Scholar
Breakey, W. R., Goodell, H., Lorenz, P. C., et al (1974) Hallucinogenic drugs as precipitants of schizophrenia. Psychological Medicine, 4, 255261.CrossRefGoogle ScholarPubMed
Bromberg, W. (1939) Marihuana: a psychiatric study. Journal of the American Medical Association, 113, 412.CrossRefGoogle Scholar
Carney, M. P. W. & Bacelle, L. (1984) Psychosis after cannabis use. British Medical Journal, 288, 1047.CrossRefGoogle Scholar
Chopra, G. S. (1969) Man and marijuana. International Journal of Addiction, 4, 215247.CrossRefGoogle Scholar
Chopra, G. S. & Smith, J. W. (1974) Psychotic reactions following cannabis use in East Indians. Archives of General Psychiatry, 30, 2427.CrossRefGoogle ScholarPubMed
Dalby, J. T. & Duncan, B. J. (1987) Shared paranoid disorder preceded by cannabis abuse: a case report. Canadian Journal of Psychiatry, 132, 6465.CrossRefGoogle Scholar
Davison, K. & Wilson, C. H. (1972) Maintenance of depression in chronic cannabis intoxication. British Journal of Addiction, 67, 225228.Google Scholar
Edwards, G. (1963) Psychopathology of a drug experience. British Journal of Addiction, 143, 162174.Google Scholar
Ghodse, A. H. (1986) Cannabis psychosis. British Journal of Addiction, 81, 473478.CrossRefGoogle ScholarPubMed
Groddeck, G. (1988) The Meaning of Illness. London: Karnac Books.Google Scholar
Halikas, J. A., Goodwin, D. W. & Guze, S. B. (1972) Marijuana use and psychiatric illness. Archives of General Psychiatry, 27, 162165.CrossRefGoogle Scholar
Harding, T. & Knight, F. (1973) Marijuana modified mania. Archives of General Psychiatry, 29, 635637.CrossRefGoogle ScholarPubMed
Indian Hemp Drugs Commission (1893–94) Report of the Commission. Simla: Government Printing Office.Google Scholar
Isbell, H., Gorodetzsky, C. W., Janiski, D., et al (1967) Effects of (-) delta 9 trans tetra hydrocannabinol in man. Psychopharmacologia (Berlin), 11, 184188.CrossRefGoogle Scholar
Johnson, B. S., Smith, B. L. & Taylor, P. (1988) Cannabis and schizophrenia. Lancet, i, 592593.CrossRefGoogle Scholar
Klonoff, H. (1973) Strategy and tactics of marijuana research. Canadian Medical Association Journal, 20, 145149.Google Scholar
Knight, F. (1976) Role of cannabis in psychiatric disturbance. Annals of the New York Academy of Science, 282, 6471.CrossRefGoogle ScholarPubMed
Knudsen, J. & Vilmar, P. (1984) Cannabis and neuroleptic agents in schizophrenia. Acta Psychiatrica Scandinavica, 69, 162174.CrossRefGoogle ScholarPubMed
Kolansky, H. & Moore, W. T. (1971) Effects of marijuana on adolescents and young adults. Journal of the American Medical Association, 216, 486492.CrossRefGoogle ScholarPubMed
Law, B. & Moffat, A. T. (1984) The influence of the metabolism elimination of cannabinoids on forensic analysis and interpretation. In The Proceedings of the Oxford Symposium on Cannabis. “Marijuana 1984”. IX International Congress on Pharmacology. 3rd Satellite Symposium on Cannabis (ed. Harvey, D. J.). London: IRL Press.Google Scholar
Littlewood, R. (1988a) From vice to madness: the semantics of naturalistic and personalistic understanding in Trinidadian local medicine. Social Science and Medicine, 11, 129148.CrossRefGoogle Scholar
Littlewood, R. (1988b) Community initiated research: a study of psychiatrists' conceptualisations of “cannabis psychosis”. Psychiatric Bulletin, 486489.CrossRefGoogle Scholar
Mathers, D. C., Ghodse, A. H., Caan, A. W., et al (1991) Cannabis use amongst a large sample of acute psychiatric admissions. British Journal of Addiction, 86, 779784.CrossRefGoogle Scholar
Mayors Committee on Marijuana (1944) The Marijuana Problem in the City of New York. Lancaster, PA: Jacques Cattell Press.Google Scholar
Meyer Gross, W., Slater, E. & Roth, M. (1960) Clinical Psychiatry. London: Cassell.Google Scholar
Millman, R. S. & Sbriglio, R. (1986) Patterns of use and psychopathology in chronic marijuana users. Psychiatric Clinics of North America, 9, 533545.CrossRefGoogle ScholarPubMed
Moran, C. (1959) Depersonalisation and agoraphobia associated with marijuana use. British Journal of Medical Psychology, 86, 187196.Google Scholar
Mott, J. (1985) Self reported cannabis use in Great Britain in 1981. British Journal of Addiction, 80, 3743.CrossRefGoogle ScholarPubMed
Moureau de Tours, J. J. (1845) Du Hashish et de l'alienation mentale. Paris: Masson.Google Scholar
Murray, G. F. (1986) Marijuana and social control – a sociological perspective on deviance. International Journal of Addiction, 21, 657669.CrossRefGoogle ScholarPubMed
Negrete, J. C. (1973) Psychological adverse effects of cannabis smoking: a tentative classification. Canadian Medical Association Journal, 108, 195202.Google Scholar
Negrete, J. C. (1988) What's happened to the cannabis debate? British Journal of Addiction, 83, 359372.CrossRefGoogle Scholar
Negrete, J. C. (1989) Cannabis and schizophrenia (editorial). British Journal of Addiction, 84, 349351.CrossRefGoogle Scholar
Negrete, J. C. & Knapp, W. P. (1986) The effects of cannabis use on the clinical condition of schizophrenics. National Institute for Drug Abuse Research Monograph Series, 67, 321327.Google ScholarPubMed
Onyango, R. S. (1986) Cannabis psychosis in young psychiatric inpatients. British Journal of Addiction, 81, 419423.CrossRefGoogle ScholarPubMed
O'Shaughnessy, W. B. (1838–40) On the preparations of the Indian hemp, or ganja. Transactions of the Medical and Physicians Society, Bengal, 71, 102; 421–461.Google Scholar
Rottanburg, D., Ben-Arie, O., Robins, A. H., et al (1982) Cannabis associated psychosis with hypomanic features. Lancet, 2, 13641366.CrossRefGoogle ScholarPubMed
Schwartz, R. H. (1987) Marijuana: an overview. Paediatric Clinics of North America, 34, 305317.CrossRefGoogle ScholarPubMed
Spencer, D. J. (1970) Cannabis induced psychosis. British Journal of Addiction, 65, 369372.Google Scholar
Stamler, R. T., Fahlman, R. C. & Vigeant, H. (1985) Illicit traffic and abuse of cannabis in Canada. Bulletin of Narcotics, 37, 4.Google ScholarPubMed
Sylbing, G. & Persoon, J. M. G. (1985) Cannabis use amongst youth in the Netherlands. WHO Bulletin on Narcotics, 37, 5761.Google Scholar
Syzmanski, H. V. (1981) Prolonged depersonalisation after marijuana use. American Journal of Psychiatry, 138, 231.Google Scholar
Talbott, J. A. & Teague, J. W. (1969) Marijuana psychosis. Journal of the American Medical Association, 210, 299302.CrossRefGoogle Scholar
Thacore, V. R. & Shukla, S. R. P. (1976) Cannabis psychosis and paranoid schizophrenia. Archives of General Psychiatry, 33, 383386.CrossRefGoogle ScholarPubMed
Thornicroft, G. (1990) Cannabis and psychosis. Is there epidemiological evidence for association? British Journal of Psychiatry, 157, 2534.CrossRefGoogle Scholar
Tunving, K. (1987) Psychiatric aspects of cannabis use in adolescents and young adults. Paediatrician, 14, 8391.Google ScholarPubMed
Weil, A., Zinberg, N. & Nelsen, J. (1968) Clinical and psychological effects of marijuana in man. Science, 162, 1234.CrossRefGoogle ScholarPubMed
Wert, R. C. & Raulin, M. L. (1986) The chronic cerebral effects of cannabis use: psychological findings and conclusions. International Journal of Addiction, 21, 629642.CrossRefGoogle ScholarPubMed
Wing, J. K. (1983) Use and misuse of the PSE. British Journal of Psychiatry, 143, 111117.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Syndromes: An Instruction Manual for PSE and Catego Program. Cambridge: Cambridge University Press.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Diagnosis in Accordance with the Ninth Revision of the International Classification of Diseases (ICD–9). Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.