First episode psychosis with and without the use of cannabis and synthetic cannabinoids: Psychopathology, global functioning and suicidal ideation and antipsychotic effectiveness

Background: Natural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk of developing psychotic disorders and exacerbate their course. Aims: To examine the differences between psychoses not associated with cannabis use and those associated with NC and SCs use, evaluating psychotic symptoms, global functioning, dissociative symptoms and suicidal ideation. Methods: The sample of 61 patients with First Episode Psychosis (FEP) was divided into 3 groups: non-Cannabis users (non-users, N = 20); NC users (THC-users, N = 21); SCs users (SPICE-users, N = 20). Each group was assessed at FEP and after 3 and 9 months through specific psychopathological scales. Results: THC-users, and even more SPICE-users, displayed much more severe positive symptoms than non-users. Negative symptoms were higher among non-users. After 9 months the non-users had recovered significantly better than SPICE-users in their global functioning. Dissociative symptoms were significantly greater in substance users. Finally, suicidal ideation was higher in SPICE-users than in both THC-users and non-users. Discussion: The psychoses induced by NC and SCs showed different symptomatic pictures and outcomes from each other and when compared to the psychoses not associated with the use of substances; such knowledge could be relevant in identifying a specific drug treatment.