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Study breakdown

Cannabis use was not associated with cognitive impairment in people with first-episode psychosis

Cross SectionalPreliminary evidence
The takeaway

Among 89 people with first-episode psychosis, lifetime cannabis users showed no differences from non-users on verbal memory, verbal fluency, or attention, though cannabis users had more positive symptoms and non-users had more negative symptoms.

Psychiatrists treating first-episode psychosis, researchers studying cannabis and psychosis

No cognitive differences between cannabis users and non-users with first-episode psychosis

What the researchers found

Of 89 FEP patients, 61 (68.5%) were lifetime cannabis users. Cannabis users had significantly more positive psychotic symptoms, while non-users displayed more negative symptoms. There were no differences between groups on tests of verbal memory, verbal fluency, or attention.

Why it matters

The concern that cannabis compounds cognitive deficits in psychosis has treatment implications. This finding of no additive cognitive effect is reassuring but must be interpreted carefully.

The numbers in context

89 FEP patients; 61 (68.5%) lifetime cannabis users. Cannabis users: more positive symptoms. Non-users: more negative symptoms. No cognitive differences on any task.

How the study worked

Cross-sectional study of 89 people diagnosed with first-episode psychosis. Cannabis use defined as 3+ times/week for 4+ weeks. Cognitive battery assessed verbal memory, verbal fluency, and attention. Controlled for recency of use and other illicit substance use.

What this study cannot tell us

Cross-sectional; relatively small sample; lifetime use definition does not capture current exposure; limited cognitive battery (3 domains); cannot determine if pre-existing cognitive abilities differ.

How to read the evidence

Small cross-sectional study with limited cognitive measures in a first-episode psychosis population.

When this study was published

Published in 2020.

The bigger picture

This adds to a mixed literature on cannabis and cognition in psychosis. The symptom profile differences (more positive symptoms in users, more negative in non-users) may reflect different illness subtypes rather than direct cannabis effects.

Questions still open

  • Do cannabis users and non-users with psychosis represent different illness subtypes? Would more sensitive cognitive measures detect differences?

Common questions

Does cannabis worsen thinking problems in psychosis?
This study found no evidence that cannabis use added to cognitive impairment in first-episode psychosis. Cannabis users and non-users performed similarly on verbal memory, fluency, and attention tests.
Why did cannabis users have different symptoms?
Cannabis users had more positive symptoms (hallucinations, delusions) while non-users had more negative symptoms (withdrawal, flat affect). This could mean cannabis is associated with a different presentation of psychosis rather than simply making existing illness worse.

Read the original research

The relationship between cannabis use and cognition in people diagnosed with first-episode psychosis.

Psychiatry research, 293, 113424

Citation

de Vos, Chloé; Leopold, Karolina; Blanke, Elisabeth S; Siebert, Stefan; Baumgardt, Johanna; Burkhardt, Eva; Bechdolf, Andreas. (2020). The relationship between cannabis use and cognition in people diagnosed with first-episode psychosis.. Psychiatry research, 293, 113424. https://doi.org/10.1016/j.psychres.2020.113424

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