Cannabis-related psychosis hospitalizations in Portugal increased 29-fold from 2000 to 2015

In Portuguese public hospitals, hospitalizations with a primary diagnosis of psychotic disorder and secondary diagnosis of cannabis abuse or dependence rose from 20 per year in 2000 to 588 per year in 2015, a 29-fold increase.

Gonçalves-Pinho, Manuel et al.·International journal of methods in psychiatric research·2020·Moderate EvidenceRetrospective Cohort
RTHC-02577Retrospective CohortModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Cannabis-related psychotic disorder hospitalizations rose 29.4 times over 15 years. Among all psychosis hospitalizations, those with a cannabis diagnosis increased from 0.87% in 2000 to 10.60% in 2015. Patients were predominantly male (89.8%) with a mean age of about 31 years.

Key Numbers

Hospitalizations rose from 20 (2000) to 588 (2015). Total: 3,233 hospitalizations. Average cost: about 3,500 euros per episode. 89.8% male. Mean age: 30.66 years. Cannabis coding rose from 0.87% to 10.60% of all psychosis hospitalizations.

How They Did This

Retrospective observational study analyzing all hospitalizations in Portuguese public hospitals from 2000 to 2015. Cases were identified by primary diagnosis of psychotic disorder/schizophrenia with secondary diagnosis of cannabis dependence or abuse (ICD-9 codes).

Why This Research Matters

The dramatic increase occurred during a period of changing cannabis consumption patterns in Portugal, including higher potency products and more frequent use, suggesting a dose-response relationship at the population level.

The Bigger Picture

While improved diagnostic coding may partly explain the trend, the authors note that changes in cannabis consumption patterns, including more potent products and higher-dose users, likely contributed to the increase.

What This Study Doesn't Tell Us

Administrative data relies on coding accuracy, and increased awareness of cannabis-psychosis links may have led to more frequent secondary diagnosis coding over time. The study cannot establish causation between cannabis use and psychosis.

Questions This Raises

  • ?How much of the increase reflects actual rises in cannabis-related psychosis versus improved diagnostic coding?
  • ?Has the trend continued after 2015?
  • ?How does Portugal's decriminalization policy factor into these patterns?

Trust & Context

Key Stat:
29-fold increase in cannabis-related psychosis hospitalizations
Evidence Grade:
Moderate: nationwide hospital data over 15 years, though limited by diagnostic coding changes over time.
Study Age:
Published in 2020 in International Journal of Methods in Psychiatric Research.
Original Title:
Psychotic disorders hospitalizations associated with cannabis abuse or dependence: A nationwide big data analysis.
Published In:
International journal of methods in psychiatric research, 29(1), e1813 (2020)
Database ID:
RTHC-02577

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Did more people actually get psychosis from cannabis?

The study cannot definitively answer this. The 29-fold increase may partly reflect better recognition and coding of cannabis-related psychosis by clinicians, rather than a pure increase in cases. However, changing cannabis consumption patterns likely also played a role.

Who was most affected?

Nearly 90% were male, with a mean age around 31 years. The gender and age profile is consistent with the known demographics of both heavy cannabis use and first-episode psychosis.

Read More on RethinkTHC

Cite This Study

RTHC-02577·https://rethinkthc.com/research/RTHC-02577

APA

Gonçalves-Pinho, Manuel; Bragança, Miguel; Freitas, Alberto. (2020). Psychotic disorders hospitalizations associated with cannabis abuse or dependence: A nationwide big data analysis.. International journal of methods in psychiatric research, 29(1), e1813. https://doi.org/10.1002/mpr.1813

MLA

Gonçalves-Pinho, Manuel, et al. "Psychotic disorders hospitalizations associated with cannabis abuse or dependence: A nationwide big data analysis.." International journal of methods in psychiatric research, 2020. https://doi.org/10.1002/mpr.1813

RethinkTHC

RethinkTHC Research Database. "Psychotic disorders hospitalizations associated with cannabi..." RTHC-02577. Retrieved from https://rethinkthc.com/research/goncalves-pinho-2020-psychotic-disorders-hospitalizations-associated

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.