Regular cannabis users showed better facial emotion recognition, including those with schizophrenia | Research

The takeaway

Lifetime regular cannabis use was associated with better facial emotion recognition across patients with schizophrenia, their siblings, and healthy controls, with later onset of use linked to better performance in those with higher genetic risk.

Schizophrenia researchers and clinicians interested in social cognition and cannabis.

Better emotion recognition in cannabis users across all three groups

What the researchers found

Better facial emotion recognition was associated with lifetime regular cannabis use across all three groups: schizophrenia patients (B=1.36), siblings (B=2.17), and healthy controls (B=3.10). In patients and siblings (higher genetic risk), those who started cannabis after age 16 performed better than earlier starters and non-users. In healthy controls, cannabis users performed better regardless of age of onset.

Why it matters

Social cognitive deficits are a core feature of schizophrenia. The surprising finding that cannabis use is associated with better, not worse, emotion recognition challenges assumptions about cannabis and cognitive function.

The numbers in context

6,229 total participants. Effect sizes: schizophrenia B=1.36, siblings B=2.17, healthy controls B=3.10. Age 16 threshold significant for schizophrenia patients and siblings but not controls.

How the study worked

Cross-sectional analysis of 6,229 participants from the EUGEI study: 2,039 with schizophrenia, 2,141 siblings, and 2,049 healthy controls. Facial emotion recognition measured using the Degraded Facial Affect Recognition Task (DFAR).

What this study cannot tell us

Cross-sectional design cannot determine causation. Selection bias is likely. Current cannabis use was not associated with better performance. Self-reported cannabis history.

How to read the evidence

Very large sample across three well-defined groups, but cross-sectional design and likely selection bias limit interpretation.

When this study was published

Published in 2022.

The bigger picture

This could reflect a selection effect (those with better social cognition are more likely to use cannabis socially) rather than cannabis improving emotion recognition.

Questions still open

Do people with better social cognition gravitate toward cannabis use, or does cannabis experience enhance emotion recognition? Why does age of first use matter only for those with higher genetic risk?

Common questions

Does this mean cannabis improves social cognition?

Not necessarily. The association could reflect selection bias, where people with better social skills are more likely to use cannabis in social settings. Current cannabis use was not linked to better performance.

Did age of first cannabis use matter?

For those with higher genetic risk (schizophrenia patients and siblings), starting cannabis after age 16 was associated with better emotion recognition than starting earlier. For healthy controls, cannabis users performed better regardless of when they started.

Read the original research

The association between cannabis use and facial emotion recognition in schizophrenia, siblings, and healthy controls: Results from the EUGEI study.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 63, 47-59

View on PubMed ↗Publisher’s paper ↗

Citation

Fusar-Poli, Laura; Pries, Lotta-Katrin; van Os, Jim; Radhakrishnan, Rajiv; Pençe, Ayşegül Yay; Erzin, Gamze; Delespaul, Philippe; Kenis, Gunter; Luykx, Jurjen J; Lin, Bochao D; Akdede, Berna; Binbay, Tolga; Altınyazar, Vesile; Yalınçetin, Berna; Gümüş-Akay, Güvem; Cihan, Burçin; Soygür, Haldun; Ulaş, Halis; Cankurtaran, Eylem Şahin; Kaymak, Semra Ulusoy; Mihaljevic, Marina M; Andric-Petrovic, Sanja; Mirjanic, Tijana; Bernardo, Miguel; Mezquida, Gisela; Amoretti, Silvia; Bobes, Julio; Saiz, Pilar A; García-Portilla, Maria Paz; Sanjuan, Julio; Aguilar, Eduardo J; Santos, José Luis; Jiménez-López, Estela; Arrojo, Manuel; Carracedo, Angel; López, Gonzalo; González-Peñas, Javier; Parellada, Mara; Maric, Nadja P; Atbaşoğlu, Cem; Üçok, Alp; Alptekin, Köksal; Saka, Meram Can; Aguglia, Eugenio; Arango, Celso; Rutten, Bart Pf; Guloksuz, Sinan. (2022). The association between cannabis use and facial emotion recognition in schizophrenia, siblings, and healthy controls: Results from the EUGEI study.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 63, 47-59. https://doi.org/10.1016/j.euroneuro.2022.08.003