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Psychotic symptom and cannabis relapse in recent-onset psychosis

Prospective study

School of Applied Psychology, Griffith University, and ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Melbourne

S. Dawe, PhD

School of Applied Psychology, Griffith University, Melbourne

D. J. Kavanagh, PhD

Department of Psychiatry, University of Queensland, Queensland

R. M. Young, PhD

School of Psychology & Counselling, Queensland University of Technology, Queensland, Australia

Correspondence: Dr Leanne Hides, ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, Locked Bag 10, Parkville, Melbourne, Victoria Australia, 3052. Tel: +61 3 9342 2800; fax: +61 3 9342 2944; email: lhides{at}unimelb.edu.au

Declaration of interest None.

Funding detailed in Acknowledgements.

Background Cannabis use appears to exacerbate psychotic symptoms and increase risk of psychotic relapse. However, the relative contribution of cannabis use compared with other risk factors is unclear. The influence of psychotic symptoms on cannabis use has received little attention.

Aims To examine the influence of cannabis use on psychotic symptom relapse and the influence of psychotic symptom severity on relapse in cannabis use in the 6 months following hospital admission.

Method At baseline, 84 participants with recent-onset psychosis were assessed and 81 were followed up weekly for 6 months, using telephone and face-to-face interviews.

Results A higher frequency of cannabis use was predictive of psychotic relapse, after controlling for medication adherence, other substance use and duration of untreated psychosis. An increase in psychotic symptoms was predictive of relapse to cannabis use, and medication adherence reduced cannabis relapse risk.

Conclusions The relationship between cannabis use and psychosis may be bidirectional, highlighting the need for early intervention programmes to target cannabis use and psychotic symptom severity in this population.

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