Tag: psychotic episodes

Study: Adolescent Cannabis Use Linked to Doubling Risk of Psychotic and Bipolar Disorders

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Adolescents who use cannabis could face a significantly higher risk of developing serious psychiatric disorders by young adulthood, according to a large new study published in JAMA Health Forum. The longitudinal study followed nearly half a million adolescents ages 13 to 17 through age 26 and found that past-year cannabis use during adolescence was associated with a significantly higher risk of incident psychotic (doubled), bipolar (doubled), depressive and anxiety disorders.

The study was conducted by researchers from Kaiser Permanente, the Public Health Institute’s Getting it Right from the Start, the University of California, San Francisco and the University of Southern California, and was funded by a grant from NIH’s National Institute on Drug Abuse (R01DA0531920).

The study analysed electronic health record data from routine paediatric visits between 2016 and 2023. Cannabis use preceded psychiatric diagnoses by an average of 1.7 to 2.3 years. The study’s longitudinal design strengthens evidence that adolescent cannabis exposure is a potential risk factor for developing mental illness.

“As cannabis becomes more potent and aggressively marketed, this study indicates that adolescent cannabis use is associated with double the risk of incident psychotic and bipolar disorders, two of the most serious mental health conditions,” said Lynn Silver, MD, program director of the Getting it Right from the Start, a program of the Public Health Institute, and a study co-author.

The evidence increasingly points to the need for an urgent public health response — one that reduces product potency, prioritises prevention, limits youth exposure and marketing and treats adolescent cannabis use as a serious health issue, not a benign behaviour. 

Lynn Silver, MD, Program Director, PHI’s Getting it Right from the Start

Cannabis is the most used illicit drug among U.S. adolescents. The Monitoring the Future study shows use rising with grade level — from about 8% in 8th grade to 26% in 12th grade — and according to the 2024 National Survey on Drug Use and Health, more than 10% of all U.S. teens aged 12 to 17 report past-year use. At the same time, average THC levels in California cannabis flower now exceed 20%, far higher than in previous decades, and concentrates can exceed 95% THC.

Unlike many prior studies, the research examined any self-reported past-year cannabis use, with universal screening of teens during standard pediatric care, rather than focusing only on heavy use or cannabis use disorder.

“Even after accounting for prior mental health conditions and other substance use, adolescents who reported cannabis use had a substantially higher risk of developing psychiatric disorders — particularly psychotic and bipolar disorders,” said Kelly Young-Wolff, PhD, lead author of the study and senior research scientist at the Kaiser Permanente Division of Research.

This study adds to the growing body of evidence that cannabis use during adolescence could have potentially detrimental, long-term health effects. It’s imperative that parents and their children have accurate, trusted, and evidence-based information about the risks of adolescent cannabis use.

Kelly Young-Wolff, PhD, Lead Study Author and Senior Research Scientist, Kaiser Permanente Division of Research

The study also found that cannabis use was more common among adolescents enrolled in Medicaid and those living in more socioeconomically deprived neighbourhoods, raising concerns that expanding cannabis commercialisation could exacerbate existing mental health disparities.

Source: Public Health Institute

Emotion Plays a Major Role in Psychosis Onset and Persistence

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New research from King’s College London has highlighted the important role that emotions play in the onset and persistence of psychosis.

The research, published in Early Intervention in Psychiatry, advocates for the development of emotion-focused interventions that seek to prevent a person’s relapse in their health as well as maintain their recovery.

Psychosis is a symptom of mental illness typified by hallucinations, delusional thoughts and disorganised thinking. While previous research has implicated emotion in the onset and continuation of psychosis, there has not yet been a universally acknowledged theory to account for the influence that emotions can have on it.

Researchers in this study conducted a systematic review of 78 studies comparing the experiences of healthy controls with individuals at Clinical High Risk (CHR), a diagnosis of schizophrenia (SZ), and those experiencing their First Episode of Psychosis (FEP). Researchers wanted to better understand both the role of emotions, as well as emotional coping strategies, in their experiences.

This systematic review found that SZ and CHR individuals demonstrated significant impairments in their emotional awareness, their understanding of self and others, and their ability to regulate their emotions when compared to healthy controls. They also demonstrated a heightened emotional reactivity.

The researchers, from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s, found that individuals with schizophrenia reported high levels of “Negative Affect” – a reduction or absence of normal emotional expression – which was a strong predictor of paranoia.

“Experiencing emotions is a natural part of everyday life. However, our study highlights that people with psychosis experience emotions with more intensity, which can significantly contribute to the emergence and maintenance of their psychosis symptoms. Therefore, psychological interventions that explicitly target emotions and emotional coping in psychosis could help prevent relapse and maintain recovery.”

Dr Anna Georgiades, a Lecturer in Early Intervention in Psychosis at King’s IoPPN and the study’s senior author

The researchers also wanted to explore how individuals at CHR and those with schizophrenia employed coping mechanisms to manage emotional situations. They found that, while the healthy controls were more likely to adopt “Adaptive Coping Strategies”, in which individuals seek to manage stress and difficult situations in healthy and constructive ways, people with psychosis were more likely to employ maladaptive techniques that were associated with an increase in their symptoms and increased depression.

Dr Anna Georgiades, a Lecturer in Early Intervention in Psychosis at King’s IoPPN and the study’s senior author said,  “There are two ways in which a person might manage an emotionally stressful situation; either by removing the stressor, or by seeking to manage the stress that is being caused.

“From the studies we reviewed, we consistently found that people with psychosis used more unhelpful emotional coping such as avoidance and suppression rather than helpful emotional coping such as problem solving or changing the way they think about the situation.

“By reducing unhelpful emotional coping and by increasing more helpful emotional coping (ie, by increasing active problem solving and the skill in changing one’s view of a situation), we could prevent relapse and maintain recovery. This therefore has important implications for the psychological treatment of psychosis.”

Source: King’s College London