Distinguishing between cannabis-induced psychotic disorder and psychotic disorder with concurrent cannabis use: a diagnostic challenge
Romanian Journal of Psychiatry & Psychotherapy June 30, 2020 Cristiana Ţăpoi 1 citation
About one-third of people experiencing a first episode of psychosis have used cannabis. Some meet criteria for cannabis-induced psychotic disorder (CIPD), which is thought to have better outcomes than primary psychotic disorders. This review of 12 studies from 2002 to 2019 found that CIPD appears distinct from primary psychotic disorder with cannabis use. Patients with CIPD tend to have less severe overall psychotic symptoms, greater insight, more visual hallucinations, depersonalization, derealization, more intense manic symptoms, and hostility. They are more likely to have a close relative with a substance use disorder but less likely to have one with a psychotic disorder. However, 25-45% of those initially treated for CIPD later meet criteria for a chronic psychotic disorder, and ongoing cannabis use predicts poor prognosis regardless of initial diagnosis.