Synthetic cannabinoid users experiencing first-episode psychosis show more severe positive psychotic symptoms, persistent aberrant salience, and limited recovery of alexithymia over six months compared to natural cannabis users and non-users. Dissociative symptoms are more prominent in both user groups, with synthetic cannabinoid users showing minimal improvement. Negative symptoms are higher in non-users but decrease across all groups. Alexithymia correlates with specific aberrant salience subscales, particularly Feelings of Increased Significance and Sense Sharpening. These findings indicate synthetic cannabinoids are associated with more severe and persistent psychotic symptoms and emotional dysregulation than natural cannabis.
Psychoses linked to natural cannabis and synthetic cannabinoids present distinct symptom profiles and outcomes compared to psychoses without cannabis use. In a sample of 61 first-episode psychosis patients, those using natural cannabis, and especially synthetic cannabinoids, had more severe positive symptoms, while non-users had more negative symptoms. After nine months, non-users recovered better in global functioning than synthetic cannabinoid users. Dissociative symptoms were greater among substance users, and suicidal ideation was highest in synthetic cannabinoid users. These differences may guide specific drug treatments.