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Psychiatric Symptoms in Cannabis Users

Published online by Cambridge University Press:  02 January 2018

Huw Thomas
Huw Thomas*
Affiliation:
Mid-Glamorgan Rotational Training Scheme in Psychiatry, Glanrhyd/Penyfai Hospital, Bridgend, Mid Glamorgan, Wales CF31 4LN
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Abstract

The usual phenomena of cannabis intoxication include experiences which in a non-intoxicated state would be considered as psychiatric symptoms. These can be distinguished from adverse reactions to cannabis, the commonest of which is an acute anxiety state. Acute psychotic episodes can also follow ingestion of the drug but are infrequent. These can be classified as acute confusional states and episodes occurring in clear consciousness. Neither presentation consistently shows enough specific features to warrant the diagnosis of ‘cannabis psychosis' as a distinct clinical entity. The evidence that cannabis has a causative role in chronic psychotic or affective disorders is not convincing, although the drug may modify the course of an already established illness. Further controlled studies would be required to clarify the aetiological significance of the drug in these conditions.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 163 , Issue 2 , August 1993 , pp. 141 - 149
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

Ablon, S. L. & Goodwin, F. K. (1974) High frequency of dysphoric reactions to tetrahydrocannabinol among depressed patients. American Journal of Psychiatry, 311, 448–453.Google Scholar
Adams, R. (1942) Marijuana. Bulletin of the New York Academy of Medicine, 18, 705–730.Google Scholar
Alcoholism and Drug Addiction Research Foundation/World Health Organization (1981) Report of an ARF/WHO Scientific Meeting on Adverse Health and Behavioural Consequences of Cannabis Use. Toronto: ARF.Google Scholar
Ames, F. (1958) A clinical and metabolic study of acute intoxication with Cannabis sativa and its role in the model psychoses. Journal of Mental Science, 104, 972–999.Google Scholar
Andreasson, S. & Allebeck, P. (1990) Cannabis and mortality among young men: a longitudinal study of Swedish conscripts. Scandinavian Journal of Social Medicine, 18, 9–15.Google Scholar
Andreasson, S. & Allebeck, P., Engstrom, A., et al (1987) Cannabis and schizophrenia: a longitudinal study of Swedish conscripts. Lancet, ii, 1483–1485.Google Scholar
Andreasson, S. & Allebeck, P. & Rydberg, U. (1989) Schizophrenia in users and non-users of cannabis: a longitudinal study in Stockholm county. Acta Psychiatrica Scandinavica, 79, 505–510.Google Scholar
Beaubrun, M. H. & Knight, F. (1973) Psychiatric assessment of 30 chronic users of cannabis and 30 matched controls. American Journal of Psychiatry, 130, 309–311.Google Scholar
Bialos, D. S. (1970) Adverse marijuana reactions: a critical examination of the literature with selected case material. American Journal of Psychiatry, 127, 819–823.Google Scholar
Breakey, W., Goodel, H., Lorenz, P., et al (1974) Hallucinogenic drugs as precipitants of schizophrenia. Psychological Medicine, 4, 255–261.CrossRefGoogle ScholarPubMed
Brill, H. & Nahas, G. G. (1984) Cannabis intoxication and mental illness. In Marijuana in Science and Medicine (ed. Nahas, G. G.), pp. 263–305. New York: Raven.Google Scholar
Brook, M. G. (1984) Psychosis after cannabis abuse. British Medical Journal, 288, 1381.Google Scholar
Carney, M., Bacelle, L. & Robinson, B. (1984) Psychosis after cannabis abuse. British Medical Journal, 288, 1047.CrossRefGoogle ScholarPubMed
Carney, P. & Lipsedge, M. (1984) Psychosis after cannabis abuse. British Medical Journal, 288, 1381.Google Scholar
Caswell, A. (1991) Marijuana as medicine. Medical Journal of Australia, 156, 497–498.Google Scholar
Chaudry, H. R., Moss, H. B., Bashir, A., et al (1991) Cannabis psychosis following bhang ingestion. British Journal of Addiction, 86, 1075–1081.CrossRefGoogle ScholarPubMed
Chopra, G. & Smith, J. (1974) Psychotic reactions following cannabis use in East Indians. Archives of General Psychiatry, 30, 24–27.CrossRefGoogle ScholarPubMed
Clark, L. D., Hughes, R. & Nakashika, E. (1970) Behavioural effects of marijuana. Archives of General Psychiatry, 23, 193–198.Google Scholar
Darley, C. F., Tinklenberg, J. R., Roth, W. T., et al (1977) Marijuana effects on long-term memory assessment and retrieval. Psychopharmacology, 52, 239–241.Google Scholar
Deahl, M. (1991) Cannabis and memory loss. British Journal of Addiction, 86, 249–252.Google Scholar
Defarias, C. (1955) Use of maconha (Cannabis sativa) in Brazil. Bulletin on Narcotics, 7, 5–19.Google Scholar
Dornbush, R. L., Fink, M. & Freedman, A. M. (1971) Marijuana, memory and perception. American Journal of Psychiatry, 128, 194–197.CrossRefGoogle ScholarPubMed
Drummond, L. M. (1986) Cannabis psychosis: a case report. British Journal of Addiction, 81, 139–142.Google Scholar
Edwards, G. (1983) Psychopathology of a drug experience. British Journal of Psychiatry, 143, 509–512.Google Scholar
Estroff, T. W. & Gold, M. S. (1986) Psychiatric presentations of marijuana abuse. Psychiatric Annals, 16, 221–224.Google Scholar
Frytak, S., Moertel, C. G., O'Fallon, J. R., et al (1979) Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy: a comparison with prochlorperazine and a placebo. Annals of Internal Medicine, 91, 825–830.Google Scholar
Gaonis, Y. & Mechoulam, R. (1964) Isolation, structure, and partial synthesis of an active constituent of hashish. Journal of the American Chemistry Society, 86, 1646–1648.Google Scholar
Gersten, S. P. (1980) Long-term adverse effects of brief marijuana use. Journal of Clinical Psychiatry, 41, 60–61.Google Scholar
Ghodse, H. (1986) Cannabis psychosis. British Journal of Addiction, 81, 473–478.CrossRefGoogle ScholarPubMed
Ghodse, H. (1989) Drugs of abuse and dependence. In Drugs and Addictive Behaviour. A Guide to Treatment. Oxford: Blackwell.Google Scholar
Gold, M. S. (1989) Marijuana. Drugs of Abuse: A Comprehensive Series for Clinicians. Volume 1. London: Plenum.Google Scholar
Grossman, W. (1969) Adverse reactions associated with cannabis products in India. Annals of Internal Medicine, 70, 529–533.Google Scholar
Halikas, J., Goodwin, D. & Guze, S. (1972) Marijuana use and psychiatric illness. Archives of General Psychiatry, 27, 162–165.Google Scholar
Hollister, L. E. (1971) Actions of various marijuana derivatives in man. Pharmacological Review, 23, 349–357.Google ScholarPubMed
Hollister, L. E. (1988) Cannabis-1988. Acta Psychiatrica Scandinavica, 78, 108–118.Google Scholar
Imade, A. G. T. & Ebie, J. C. (1991) A retrospective study of symptom patterns of cannabis-induced psychosis. Acta Psychiatrica Scandinavica, 83, 134–136.Google Scholar
Indian Hemp Drugs Commission (1894) Report. Simla: IHDC.Google Scholar
Isbell, H., Gorodetzsky, C., Jasinski, D., et al (1967) Effects of delta-9-trans-tetrahydrocannabinol in man. Psychopharmacologia, 11, 184–188.CrossRefGoogle ScholarPubMed
Johnson, B. A. (1990) Psychopharmacological effects of cannabis. British Journal of Hospital Medicine, 43, 114–122.Google Scholar
Johnson, B. A., Smith, B. L. & Taylor, P. (1988) Cannabis and schizophrenia. Lancet, i, 592–593.Google Scholar
Jones, R. T. (1971) Marijuana-induced “high”: influence of expectation, setting and previous drug experience. Pharmacological Review, 23, 359–369.Google Scholar
Kay, R. W. (1992) Prevalence and incidence of schizophrenia in Afro-Caribbeans. British Journal of Psychiatry, 160, 421.Google Scholar
Keeler, M. (1967) Adverse reaction to marijuana. American Journal of Psychiatry, 124, 674–677.Google Scholar
Keeler, M. (1968a) Marijuana induced hallucinations. Diseases of the Nervous System, 29, 314–315.Google Scholar
Keeler, M. (1968b) Motivation for marijuana use: a correlate of adverse reaction. American Journal of Psychiatry, 125, 142–146.CrossRefGoogle Scholar
Keeler, M., Reifler, C. B. & Liptzin, M. B. (1968) Spontaneous recurrence of marijuana effect. American Journal of Psychiatry, 125, 384–386.Google Scholar
Keeler, M., Ewing, J. & Rouse, B. (1971) Hallucinogenic effects of marijuana as currently used. American Journal of Psychiatry, 128, 213–216.Google Scholar
Keshaven, M. S. & Lishman, W. A. (1986) Prolonged depersonalisation following cannabis abuse. British Journal of Addiction, 81, 140–141.Google Scholar
Kiplinger, G. F. & Manno, J. E. (1971) Dose response relationships to cannabis in human subjects. Pharmacological Review, 23, 339–347.Google Scholar
Knight, F. (1976) Role of cannabis in psychiatric disturbance. Annals of the New York Academy of Science, 282, 64–71.Google Scholar
Knusden, P. & Vilmar, T. (1984) Cannabis and neuroleptic agents in schizophrenia. Acta Psychiatrica Scandinavica, 69, 162–174.Google Scholar
Kolansky, H. & Moore, W. T. (1971) Effects of marijuana on adolescents and young adults. Journal of the American Medical Association, 216, 486–492.Google Scholar
Kosviner, A., Hawks, D. & Webb, M. G. J. (1974) Cannabis use among British university students. British Journal of Addiction, 69, 35–60.Google Scholar
Kotin, J., Post, R. M. & Goodwin, F. K. (1973) Delta-9-tetrahydrocannabinol in depressed patients. Archives of General Psychiatry, 28, 345–348.CrossRefGoogle ScholarPubMed
Lex, B. W., Griffin, M. L., Mello, N. K., et al (1989) Alcohol, marijuana, and mood states in young women. International Journal of the Addictions, 24, 405–424.Google Scholar
Littlewood, R. (1988) Community initiated research - a study of psychiatrists' conceptualisations of “cannabis psychosis”. Psychiatric Bulletin, 157, 25–33.Google Scholar
Mathers, D. C., Ghodse, A. H., Cann, A. W., et al (1991) Cannabis use in a large sample of acute psychiatric admissions. British Journal of Addiction, 86, 779–784.Google Scholar
Matsuda, L. A., Lolait, S. J., Brownstein, M. J., et al (1990) Structure of a cannabinoid receptor and functional expression of the cloned cDNA. Nature, 346, 561–564.Google Scholar
Melges, F. T., Tinklenberg, J. R., Hollister, L. E., et al (1970) Temporal disintegration and depersonalization during marijuana intoxication. Archives of General Psychiatry, 23, 204–210.CrossRefGoogle Scholar
Meyer, R. E., Pillard, R., Shapiro, L., et al (1971) Administration of marijuana to heavy and casual marijuana users. American Journal of Psychiatry, 128, 198–204.Google Scholar
Nahas, G. & Latour, C. (1992) The human toxicity of marijuana. Medical Journal of Australia, 156, 495–497.CrossRefGoogle ScholarPubMed
Negrete, J. C. (1988) What's happened to the cannabis debate? British Journal of Addiction, 83, 359–372.Google Scholar
Negrete, J. C. (1989) Cannabis and schizophrenia. British Journal of Addiction, 84, 349–351.CrossRefGoogle ScholarPubMed
Negrete, J. C., Knapp, W., Douglas, D., et al (1986) Cannabis affects the severity of schizophrenic symptoms: results of a clinical survey. Psychological Medicine, 16, 515–520.Google Scholar
Nicholi, A. M. (1983) The non-therapeutic use of psychoactive drugs: a modern epidemic. New England Journal of Medicine, 308, 925–933.Google Scholar
Palsson, A., Thulin, S. O. & Tunving, K. (1982) Cannabis psychosis in South Sweden. Acta Psychiatrica Scandinavica, 66, 311–321.CrossRefGoogle ScholarPubMed
Peralta, V. & Cuesto, M. J. (1992) Influence of cannabis abuse on schizophrenic psychopathology. Acta Psychiatrica Scandinavica, 85, 127–130.Google Scholar
Plant, M., Peck, D. & Samuel, E. (1985) Alcohol, Drugs and School-Leavers. London: Tavistock.Google Scholar
Rawlings, D. C. (1969) Drug taking by patients with venereal disease. British Journal of Venereal Disease, 45, 238–240.Google Scholar
Renault, P., Schuster, C., Freedman, D., et al (1974) Repeat administration of marijuana smoke to humans. Archives of General Psychiatry, 31, 95–102.Google Scholar
Rottanburg, D., Robins, A., Ben-Arie, O., et al (1982) Cannabis-associated psychosis with hypomanic features. Lancet, ii, 1364–1366.Google Scholar
Royal College of Psychiatrists (1987) Drug Scenes: A Report on Drugs and Drug Dependence by the Royal College of Psychiatrists. London: Gaskell.Google Scholar
Smith, D. E. (1968) Acute and chronic toxicity of marijuana. Journal of Psychedelic Drugs, 2, 37–47.Google Scholar
Snyder, S. H. (1990) Planning for serendipity. Nature, 346, 508.Google Scholar
Solomons, K. & Neppe, V. M. (1989) Cannabis-its clinical effects. South African Medical Journal, 76, 102–104.Google Scholar
Stimson, G. (1981) Epidemiological research on drug use in general population. In Drug Problems in Britain, pp. 51–75. London: Academic Press.Google Scholar
Swadi, H. (1988) Drug and substance use among 3,333 London adolescents. British Journal of Addiction, 83, 935–942.Google Scholar
Szymanski, H. V. (1981) Prolonged depersonalization after marijuana use. American Journal of Psychiatry, 138, 251–253.Google Scholar
Talbott, J. A. & Teague, J. W. (1969) Marijuana psychosis. Journal of the American Medical Association, 210, 299–305.Google Scholar
Tart, C. T. (1970) Marijuana intoxication: common experiences. Nature, 226, 701–704.Google Scholar
Tennant, F. S. & Groesbeck, C. J. (1972) Psychiatric effects of hashish. Archives of General Psychiatry, 27, 133–136.Google Scholar
Thacore, V. R. (1973) Bhang psychosis. British Journal of Psychiatry, 123, 225–229.Google Scholar
Thacore, V. R. & Shukla, S. R. P. (1976) Cannabis psychosis and paranoid schizophrenia. Archives of General Psychiatry, 33, 383–386.Google Scholar
Thomas, H. (1991) “Cannabis psychosis”. Psychiatric Bulletin, 15, 504.Google Scholar
Thornicroft, G. (1990) Cannabis and psychosis - is there epidemiological evidence for an association? British Journal of Psychiatry, 157, 25–33.Google Scholar
Tunving, K. (1985) Psychiatric effects of cannabis use. Acta Psychiatrica Scandinavica, 72, 209–217.Google Scholar
Waskow, I. E., Olsson, J. E., Salzman, C., et al (1970) Psychological effects of tetrahydrocannabinol. Archives of General Psychiatry, 22, 97–107.CrossRefGoogle ScholarPubMed
Weil, A. T. (1970) Adverse reactions to marijuana. Classification and suggested treatment. New England Journal of Medicine, 282, 997–1000.Google Scholar
Weil, A. T., Zinberg, N. E. & Nelson, J. E. (1968) Clinical and psychological effects of marijuana in man. Science, 162, 1234–1242.Google Scholar
Weller, R. A. & Halikas, J. A. (1985) Marijuana use and psychiatric illness: a follow-up study. American Journal of Psychiatry, 142, 848–850.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) The Description and Classification of Psychiatric Symptoms. An Instruction Manual for the PSE and CA TEGO system. London: Cambridge University Press.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: WHO.Google Scholar
Wray, S. R. & Murthy, N. V. A. (1987) Review of the effects of cannabis on mental and physiological functions. Justification for an intensive and comprehensive programme for the health of the Caribbean people. West Indian Medical Journal, 36, 197–201.Google Scholar
Zinberg, N. E. (1984) Drug, Set and Setting. New Haven: Yale University Press.Google Scholar
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