Academic Journal
Cognitive, Electrophysiological, and Behavioral Presentation of First-Episode Psychosis With or Without Cannabis Exposure.
| Τίτλος: | Cognitive, Electrophysiological, and Behavioral Presentation of First-Episode Psychosis With or Without Cannabis Exposure. |
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| Συγγραφείς: | D'Souza DC; Department of Psychiatry, Yale University School of Medicine, New Haven, CT., Cortes-Briones J; Department of Psychiatry, Yale University School of Medicine, New Haven, CT., Raj J; Central Institute of Psychiatry, Ranchi, India., Ganesh S; Central Institute of Psychiatry, Ranchi, India., Vidya KL; Central Institute of Psychiatry, Ranchi, India., Krishna Tikka S; Department of Psychiatry, All India Institute of Medical Sciences, Bibinagar, India., Shreekantiah U; Central Institute of Psychiatry, Ranchi, India., Singh N; Department of Psychiatry, Yale University School of Medicine, New Haven, CT., Murthy P; National Institute of Mental Health and Neurosciences, Bengaluru, India., Urrutia-Gandolfo J; Department of Psychiatry, Yale University School of Medicine, New Haven, CT., Ram D; Central Institute of Psychiatry, Ranchi, India., Sharma P; National Institute of Mental Health and Neurosciences, Bengaluru, India., Sinha VK; Central Institute of Psychiatry, Ranchi, India., Goyal N; Central Institute of Psychiatry, Ranchi, India. |
| Πηγή: | The American journal of psychiatry [Am J Psychiatry] 2026 Aug 01; Vol. 183 (8), pp. 552-561. Date of Electronic Publication: 2026 Jun 03. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: American Psychiatric Association Country of Publication: United States NLM ID: 0370512 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-7228 (Electronic) Linking ISSN: 0002953X NLM ISO Abbreviation: Am J Psychiatry Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Arlington, VA : American Psychiatric Association |
| Ιατρικοί όροι (MeSH): | Psychotic Disorders*/physiopathology , Psychotic Disorders*/psychology , Psychoses, Substance-Induced*/physiopathology , Psychoses, Substance-Induced*/psychology , Psychoses, Substance-Induced*/diagnosis , Marijuana Abuse*/psychology , Marijuana Abuse*/complications , Marijuana Abuse*/physiopathology , Cognition*, Humans ; Male ; Electroencephalography ; Prospective Studies ; Adult ; Neuropsychological Tests ; Psychiatric Status Rating Scales ; Young Adult ; Adolescent |
| Περίληψη: | Objective: Cannabis use is a known risk factor for psychosis, but it remains unclear whether cannabis-associated psychosis (CAP) differs meaningfully from non-cannabis-associated psychosis (NCAP) in clinical presentation, biology, or illness course. The objective of this study was to characterize the presentation and course of first-episode psychosis with and without cannabis exposure. Methods: In this prospective study, males hospitalized for new-onset psychosis with confirmed cannabis exposure (CAP; N=66) were compared with those without cannabis exposure (NCAP; N=53). Participants were assessed at admission and after 4 weeks of standardized inpatient treatment, using cognitive tests (CogState Schizophrenia Battery, Hopkins Verbal Learning Test), electroencephalography (EEG), and symptom scales (Positive and Negative Syndrome Scale [PANSS], Calgary Depression Rating Scale [CDRS], Young Mania Rating Scale [YMRS]). Results: Cognitive test performance significantly improved in the CAP group but not in the NCAP group, despite the absence of group differences at the time of admission. At admission, relative to the NCAP group, the CAP group had significantly higher power spectral density exponent in the EEG, a proxy index of cortical excitatory/inhibitory (E/I) balance. CAP participants presented with lower PANSS negative and total scores but greater depressive (CDRS) and manic (YMRS) symptoms at admission. Psychosis symptoms improved with treatment in both groups, but the CAP group experienced greater improvement in mood symptoms. Follow-up data were available for 16 CAP participants; 10 were rehospitalized for psychosis exacerbation after resuming cannabis use, whereas relapse was rare among those who remained abstinent. Conclusions: Relative to the NCAP group, the CAP group exhibited better cognitive function, lower cortical E/I balance, lesser negative symptoms, and greater mood symptoms. Cannabis resumption was associated with relapse, highlighting its role in illness recurrence. Together, these results raise the possibility that cannabis-associated psychosis is a distinct subtype of first-episode psychosis. Given the increasing rates of psychosis related to cannabis, further studies are needed to examine its long-term trajectory and refine treatment approaches. |
| Competing Interests: | Dr. Cortes-Briones owns equity in Wavelet Medical. The other authors report no financial relationships with commercial interests. |
| Contributed Indexing: | Keywords: Behavior; Cannabis; Cognition; EEG; Excitation/Inhibition Balance; Psychosis |
| Entry Date(s): | Date Created: 20260603 Date Completed: 20260801 Latest Revision: 20260801 |
| Update Code: | 20260801 |
| DOI: | 10.1176/appi.ajp.20250726 |
| PMID: | 42231079 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1535-7228 |
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| DOI: | 10.1176/appi.ajp.20250726 |