Cannabis & Causes of Psychosis Overview

People with severe mental illnesses often use cannabis at higher rates than the general population, potentially increasing their risk of psychosis.

Currently, there is no detailed, specific information about the differences in effects of THC and CBD on mental health.

Cannabis use among young adults (16-24) in the UK has declined over the last 30 years, but still remains high, raising concerns about mental health risks.

Individuals with severe mental illness are more likely to use potent cannabis strains like skunk and use them more frequently than less potent ones, such as hash.

Studies show a significantly higher prevalence of cannabis use among people with severe mental illness compared to those without, potentially 3-4 times higher.

A significant proportion (up to 42%) of people with schizophrenia have a cannabis use disorder during their lifetime.

A significant proportion (20-50%) of people with bipolar disorder also have a cannabis use disorder.

About 17% of people with major depressive disorder have a comorbidity with cannabis use.

Psychosocial therapies show strong evidence for effectiveness in non-psychiatric populations, but generally less effective in those with severe mental illness.

An intervention that uses financial incentives to reduce substance use, particularly cannabis use.

Using financial incentives to reduce cannabis use in individuals experiencing early psychosis (first three years).

Contingency management shows limited overall benefit in treating cannabis use in early psychosis, but is more effective in those with high treatment engagement.

Treatment challenges in severe mental illness populations include cognitive impairments, interference of mental illness symptoms, and social/economic difficulties which affect treatment engagement and efficacy.

A tailored approach to treatment considering individual needs, symptoms severity, and preferences.

Providing access to potential help, even when there is limited evidence of strong effectiveness.

Using substances (e.g., cannabis) to manage psychiatric symptoms.

Treating both substance use disorder (like cannabis) and a mental illness simultaneously.

A step-by-step approach to treatment that involves engagement, motivation, active treatment, and relapse prevention.

Strategies to minimize the negative impacts of cannabis use on mental health without necessarily aiming for complete abstinence.

Negative attitudes and social barriers that make it hard for people with mental illness and substance use disorders to seek help.

Difficulties in finding specialized mental health services that address both cannabis use and mental illness.

Encouraging people to stay involved in treatment and follow plans to improve outcomes.

Adapting treatment approaches to respect different cultural backgrounds and address disparities in outcomes.

The effects of legalizing cannabis on mental health services and policies.

The Psychotic Risk Scale (PRS) increases with the duration of psychotic episodes. A person who experiences psychosis for a week would have a higher PRS than someone who experiences it for a shorter time.

Schizophrenia is characterized by severe and persistent psychosis.

A high PRS alone does not indicate a guaranteed development of Schizophrenia. It simply increases the risk, but it doesn't mean the person will definitely develop SCZ.

People experiencing psychosis have an excess of dopamine production and release, which contributes to the symptoms.

Dopamine released in psychosis binds to the D2 receptor in the brain, increasing dopamine signaling and contributing to psychotic symptoms.

Dopamine plays a crucial role in assigning importance to ideas and objects. In normal states, it helps us prioritize what's relevant. In psychosis, this function is disrupted.

Individuals experiencing psychosis have difficulty distinguishing important events from general experiences. Everything seems significant, leading to misinterpretations and delusions.

Delusions often arise as attempts to explain the abnormal salience that individuals experiencing psychosis perceive.

This model suggests that certain individuals are more vulnerable to developing psychosis due to genetic or environmental factors. They are more likely to develop psychosis in stressful situations.

This refers to an imbalance in dopamine activity in the striatum, a brain region associated with reward and motivation. This imbalance is thought to contribute to the development of psychosis.

This term refers to the percentage of cases of a disease that could be prevented if a risk factor was eliminated. For example, the PAF for cannabis use in psychosis measures how many cases of psychosis could be prevented if cannabis use was reduced.

This type of cannabis contains a higher concentration of THC, the psychoactive ingredient responsible for the 'high' experience. Studies show that regular use of this type of cannabis is linked to increased risk of psychosis.

This diet is characterized by high intake of fruits, vegetables, olive oil, and fish. It may potentially reduce the risk of psychosis, possibly due to its neuroprotective properties.

Research shows that heavy cannabis use, especially high-potency strains, significantly increases the risk of developing psychosis. The effect is particularly evident in urban areas like London and Amsterdam.

This is a large-scale international research project studying the factors contributing to the development of psychosis across different regions, including India, Nigeria, and Trinidad.

This term refers to the first instance of a person experiencing psychotic symptoms. Research highlights the role of social factors and cannabis use in the development of this, particularly in urban areas.

A plant whose leaves are chewed for hours, providing a weak amphetamine-like effect, and containing 'Cathinone', a substance linked to the synthetic drug 'MMCat'.

Increased cannabis use, particularly of stronger strains like 'Skunk', is associated with a higher risk of developing psychosis. More potent cannabis strains have significantly higher THC levels.

Tetrahydrocannabinol (THC), the psychoactive component of cannabis, acts as a partial agonist at the CB1 receptor, impairing cognitive functions like attention, memory and learning, and potentially causing hallucinations and paranoid thoughts.

Cannabidiol (CBD) acts as an inverse agonist at the CB1 receptor, showing potential antipsychotic effects and a lack of hallucinogenic properties. It might also counteract THC's effects.

Older cannabis strains (1970s) had lower THC and higher CBD content, while newer strains (1980s/90s) have been bred to produce more THC, decreasing CBD content. Skunk, a potent strain, has very high THC and negligible CBD levels.

Studies have shown that THC induces positive psychotic symptoms, particularly paranoia. Pre-treating with CBD can minimize the THC-induced increase in positive symptoms, suggesting a protective role.

Users of strong cannabis strains, like Skunk, are significantly more likely to seek emergency medical treatment compared to users of regular cannabis, potentially due to the potent effects on other organs.

Regular cannabis use can negatively affect attention, memory, and decision-making skills, and may contribute to long-term cognitive decline.

Cannabis use can significantly impact a person's ability to succeed in school or work, and can interfere with social relationships and overall quality of life.

A short-term therapy that helps individuals explore their feelings about cannabis use and motivates them to change their behavior.

Cognitive Behavioral Therapy helps individuals identify and change distorted thinking patterns and behaviors related to cannabis use.

Combines mindfulness practices with cognitive-behavioral therapy to manage cravings and stress, promoting a more present-moment awareness.

A client-centered approach that helps individuals build their own motivation to change their cannabis use behavior.

Includes family members in the treatment process to address family dynamics and communication patterns related to cannabis use.

The primary problem in psychosis is an excessive release of dopamine, particularly in the striatum, leading to a surge in dopamine signaling.

Excess dopamine leads to 'aberrant salience,' meaning everything, no matter how trivial, seems highly important. Individuals experiencing psychosis struggle to distinguish true important events from everyday experiences.

Delusions arise from attempts to explain the unusual salience individuals experience. Because everything seems significant, they try to find meaning in seemingly random events, leading to false beliefs.

The D2 receptor in the brain receives dopamine. When there's an excess of dopamine, the D2 receptor is activated, amplifying dopamine signaling and contributing to psychotic symptoms.

Dopamine fuels psychotic experiences. Just as wind fuels a fire, dopamine fuels the abnormal salience and distorted thinking that characterize psychosis.

These treatments aim to address mental health and substance use disorders, often using therapy, support groups, and behavioral techniques.

Actively participating in therapy sessions, following treatment plans, and showing a willingness to make changes.

These challenges include cognitive difficulties, mental illness symptoms interfering with therapy, social and economic challenges, and the potential for cannabis use as self-medication.

Treatments are generally less effective for people with severe mental illness than those in the general population, and the benefits tend to be smaller.

Continuing to offer treatment options, even if there isn't strong overall evidence, because some individuals do benefit from them.

Schizophrenia is influenced by many genes, each with a small effect, working together to increase susceptibility. It's like a jigsaw puzzle where many small pieces contribute to the bigger picture.

Polygenic Risk Score (PRS) measures an individual's genetic predisposition to develop schizophrenia. A higher PRS indicates a greater likelihood of developing the disorder.

Schizophrenia develops through a cascade of stages involving impaired neurodevelopment, pre/perinatal factors, subtle motor and cognitive difficulties, anxiety/depression, and finally dopamine dysregulation leading to psychosis

Abnormal dopamine levels and activity in the brain, particularly in the striatum, are crucial for the development of psychosis. Excess dopamine disrupts regular brain functioning.

Heavy cannabis use, especially of high-potency strains, significantly increases the risk of developing psychosis. The potency of cannabis plays a major role.

Genes linked to schizophrenia don't directly cause the disorder, but increase a person's susceptibility to developing it. They don't create schizophrenia, but make someone more likely to get it.

Schizophrenia genes are particularly active in brain regions involved in learning and memory, such as the cerebral cortex and hippocampus. These regions are vital for normal thought processes.

Genes linked to schizophrenia also appear in other mental health conditions, such as depression, OCD, and anxiety disorders. This suggests an underlying genetic similarity between these disorders.

Copy Number Variants are changes in DNA that can be duplications or deletions of genetic sections. CNVs can impact how specific genes function and are often associated with developmental disorders.

Experiences like childhood abuse, migration, or bullying can contribute to the development of schizophrenia, especially in individuals with genetic vulnerabilities.

Factors like complications during pregnancy and delivery can affect brain development, potentially increasing schizophrenia risk. These early life events can cause subtle changes in brain wiring.

Individuals with schizophrenia often have excessively high dopamine activity in the brain, particularly in the striatum. This excess dopamine plays a key role in the development of psychotic symptoms.

People with schizophrenia have difficulty distinguishing important events from everyday experiences, perceiving everything as significant. This leads to misinterpretation and delusions.

Dopamine dysregulation in the brain, specifically an increase in dopamine activity in the striatum, is considered the final common pathway to psychosis.

Traditionally, psychosis was seen as a separate, distinct category or disease, with no overlap between 'normal' and 'psychotic' individuals.

Current research suggests that psychosis lies on a continuum, with a range of severity, from mild to severe, making it more similar to other mental health disorders.

A polygenic risk score (PRS) measures an individual's genetic susceptibility to psychosis based on the presence of multiple genes associated with the disorder.

Stressful life events, such as childhood abuse, migration, and chronic stress, can significantly increase the risk of developing psychosis by affecting dopamine levels in the brain.

These are mild psychotic experiences that may occur without causing significant functional impairment. Examples include occasional paranoid thoughts or interest in conspiracy theories.

Prodromal symptoms are early warning signs that an individual may be about to develop psychosis. These symptoms may include social withdrawal, changes in thinking, and unusual behavior.

Individuals who experience longer periods of psychotic episodes tend to have a higher polygenic risk score (PRS), indicating a greater genetic vulnerability to psychosis.

Cannabis use is more common among people with severe mental illness, like schizophrenia and bipolar disorder. This may be due to self-medication, but it also increases psychosis risk.

Individuals experiencing psychosis struggle to distinguish important events from everyday experiences. Everything seems significant, leading to misinterpretations and delusions.

This score measures the likelihood of developing psychosis based on an individual's genes. A higher PRS means a greater genetic predisposition.

This refers to a series of stages leading to schizophrenia. Early factors, like genetic predisposition and early-life stress, can significantly contribute to the development of the disorder.

Dual diagnosis services often prioritize harder drugs like heroin and cocaine, leaving less focus on cannabis use, creating a gap in care for patients with cannabis use issues.

A network in the body that uses cannabinoids like THC and CBD to regulate neurotransmitters and influence various functions, including mood, pain, and memory.

THC, the psychoactive component of cannabis, alters perception, impairs memory, can increase anxiety, and may lead to long-term changes in brain structure and function.

CBD, a non-psychoactive component of cannabis, may have neuroprotective properties, offering potential therapeutic effects like reducing anxiety and psychosis, and counteracting some negative effects of THC.

Cannabis affects various neurotransmitter systems, including dopamine (reward, psychosis), serotonin (mood), GABA (anxiety), and glutamate (cognitive function), influencing mental health.

Understanding the ratio of THC to CBD in cannabis products is crucial, as THC is associated with psychosis risk, while CBD may have protective effects.

Synthetic cannabinoids are often more potent than THC and can increase the risk of psychosis. The composition of these products can vary widely.

The use of cannabis in individuals experiencing psychosis during the first three years of their illness.

The extent to which a person actively participates in therapy sessions, follows treatment plans, and shows a willingness to make changes.

The extent to which treatments are successful in reducing cannabis use and improving mental health.