Differences in demographic and clinical characteristics between cannabis users and non-drug users: A retrospective study of patients at first hospitalization due to psychotic symptoms. (October 2018)

• Record Type: Journal Article
• Authors: Balan Moshe, Livia; Weizman, Abraham; Ben Dor, David H.; Konas, Shai; Fischel, Zvi; Aizenberg, Dov; Gothelf, Doron; Valevski, Avi
• Is Part Of: Psychiatry research. Volume 268(2018)
• Page Start: 454
• Page End: 459
• Publication Date: 2018-10
• Subjects: Stability of diagnosis -- Severe mental illness -- Re-hospitalization -- Schizophrenia -- Cannabis-induced psychosis -- First episode psychosis; THC ∆9-tetrahydrocannabinol; FEP, first-episode psychosis -- SIP substance-induced psychosis -- SMI severe mental illness -- EMR electronic medical record, PER, psychiatric emergency room -- GMHC Geha Mental Health Center; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2018.07.037
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: We compared 1st admission due to psychotic symptoms among cannabis- and non-drug users. Cannabis users had more non-severe mental illness (SMI) diagnoses. Both groups had a high conversion rate (80%) to SMI diagnoses at re-hospitalization. Cannabis use at 1st hospitalization did not affect conversion rate to SMI. SMI diagnoses, but not cannabis use, were predictors for re-hospitalization. Abstract: This retrospective, chart review, cohort study compared demographic and clinical characteristics of cannabis -users and non-drug users at first admission due to psychotic symptoms at Geha Mental Health Center, Israel, between August 2002 and December 2013. We assessed the role of current cannabis use as a risk for re-hospitalization during this period as well as the stability of psychotic diagnoses at re-hospitalization. A total of 318 patients were included in the study, of which 106 (33.3%) were cannabis -users. The cannabis-user group had a shorter duration of hospitalization than the non-drug user group but without a significant difference in 5-year re-hospitalization rates. The latter had a higher rate of severe mental illness (SMI) diagnoses at first hospitalization (53.3% vs. 20.3%, respectively), but the difference disappeared at the second hospitalization. The two groups demonstrated a 79–80% rate of conversion from a non-SMI to an SMI diagnosis between the admissions. The results indicate the instability of non-SMI diagnoses at first hospitalization due to psychotic symptoms, regardless of concurrent cannabis use. The high conversion rate from non-SMI to SMI in current cannabis-users may be due to under-diagnosis of SMI at first admission or an effect of cannabis on the development of SMI.