Academic Journal
Functional recovery trajectories in cannabis-induced first-episode psychosis: The role of dissociative symptoms in the discrepancy between symptomatic improvement and functional outcomes.
| Τίτλος: | Functional recovery trajectories in cannabis-induced first-episode psychosis: The role of dissociative symptoms in the discrepancy between symptomatic improvement and functional outcomes. |
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| Συγγραφείς: | Ricci V; Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole, 10043, Orbassano, Turin, Italy. Electronic address: valerio.ricci@unito.it., Paggi A; NIHR Oxfor Health Clinical Researche Facilty. Oxford HealCth NHS Foundation Trust, Oxfor, UK., Martinotti G; Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio Chieti-Pescara, 66100, Chieti, Italy., Maina G; Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, San Luigi Gonzaga Hospital, University of Turin, Regione Gonzole, 10043, Orbassano, Turin, Italy; Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Italy. |
| Πηγή: | Psychiatry research [Psychiatry Res] 2026 Sep; Vol. 363, pp. 117240. Date of Electronic Publication: 2026 May 25. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier/North-Holland Biomedical Press Country of Publication: Ireland NLM ID: 7911385 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-7123 (Electronic) Linking ISSN: 01651781 NLM ISO Abbreviation: Psychiatry Res Subsets: MEDLINE |
| Imprint Name(s): | Publication: Limerick : Elsevier/North-Holland Biomedical Press Original Publication: Amsterdam, Elsevier/North-Holland Biomedical Press. |
| Ιατρικοί όροι (MeSH): | Dissociative Disorders*/physiopathology , Recovery of Function*/physiology , Psychoses, Substance-Induced*/physiopathology , Psychoses, Substance-Induced*/complications , Marijuana Abuse*/complications, Humans ; Female ; Adult ; Male ; Prospective Studies ; Young Adult ; Psychotic Disorders ; Adolescent |
| Περίληψη: | Background: Functional recovery in cannabis-induced first-episode psychosis (FEP) remains incompletely understood. Dissociative symptoms, frequently associated with cannabis use, may represent a key but underexplored determinant of functional trajectories. Methods: This prospective cohort study followed 72 patients meeting DSM-5 criteria for cannabis-induced psychotic disorder over 24 months. Functional recovery trajectories were identified using growth mixture modeling (GMM) of GAF scores. Mediation analyses examined whether dissociation (DES) mediates the relationship between continued cannabis use and functional outcomes. Results: GMM identified three trajectories: Rapid Recovery (34.7%, n = 25; GAF +29.1 points), Gradual Recovery (40.3%, n = 29; GAF +15.7 points), and Persistent Impairment (25.0%, n = 18; GAF +4.7 points). These trajectory findings should be considered exploratory given the modest sample size. Symptom-function discrepancy was observed in 31.9% of patients, characterized by significant PANSS reduction without functional gains and elevated baseline dissociation (DES=33.8 vs. 18.1, p < 0.001). Baseline dissociation independently predicted trajectory membership (OR=3.24 per SD, p < 0.001), with depersonalization/derealization showing the strongest associations. Dissociation mediated 35% of cannabis's effect on functional outcomes (β=-0.15, 95%CI [-0.25,-0.06]); combined with depression and hopelessness, psychological mediators accounted for 76% of total effect. A high-risk subgroup (elevated dissociation, depression, continued cannabis use; 22%) showed minimal improvement despite treatment. Conclusions: Dissociative symptoms represent powerful independent predictors of functional recovery in cannabis-induced FEP, partially independent of psychotic symptom resolution. Routine dissociation assessment and targeted interventions alongside cannabis cessation may optimize functional outcomes in this population. (Copyright © 2026 The Authors. Published by Elsevier B.V. All rights reserved.) |
| Competing Interests: | Declaration of competing interest The authors declare the following potential conflicts of interest: G. Martinotti has been a consultant and/or a speaker and/or has received research grants from Angelini, Doc Generici, Janssen-Cilag, Lundbeck, Otsuka, Pfizer Inc, Servier and Recordati. A.Paggi nothing to declare G.Maina has been a consultant and/or a speaker and/or has received research grants from Angelini, Doc Generici, Janssen-Cilag, Lundbeck, Otsuka, Pfizer Inc, Servier and Recordati. V. Ricci has been a consultant and/or a speaker and/or has received research grants from Angelini, Janssen-Cilag, All other authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in this manuscript. The authors confirm that this research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest regarding the specific content of this study. |
| Contributed Indexing: | Keywords: Cannabis-induced psychosis; Depersonalization; Dissociation; First-episode psychosis; Functional recovery |
| Entry Date(s): | Date Created: 20260530 Date Completed: 20260610 Latest Revision: 20260610 |
| Update Code: | 20260611 |
| DOI: | 10.1016/j.psychres.2026.117240 |
| PMID: | 42217403 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1872-7123 |
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| DOI: | 10.1016/j.psychres.2026.117240 |