Cannabis use at the end of a first-episode psychosis program quadrupled relapse risk
Among 143 people completing a coordinated specialty care program for first-episode psychosis, those still using cannabis at their last visit had four times the odds of relapse and one-third the odds of continuing psychiatric care.
Quick Facts
What This Study Found
Cannabis use at last program contact was associated with a fourfold higher risk of relapse (aOR 4.06, 95% CI 1.56-10.56) and significantly lower rates of outpatient psychiatric follow-up (aOR 0.32, 95% CI 0.12-0.94) in the 12 months after ending coordinated specialty care. Prior emergency/hospitalization during the program also predicted relapse (aOR 4.69).
Key Numbers
143 individuals; cannabis use at last contact: relapse aOR 4.06 (95% CI 1.56-10.56); outpatient follow-up aOR 0.32 (95% CI 0.12-0.94); prior ED/hospitalization: relapse aOR 4.69 (95% CI 1.78-12.34); no racial/ethnic differences in outcomes
How They Did This
Retrospective analysis of 143 individuals with first-episode psychosis who received coordinated specialty care (CSC) between 2014 and 2021. Electronic health records and linked insurance claims data were used to identify relapse (ED visits or hospitalization) and outpatient follow-up in the 12 months after program exit.
Why This Research Matters
The transition out of first-episode psychosis programs is a vulnerable period. Identifying cannabis use as a strong predictor of both relapse and disengagement from care provides a clear clinical target.
The Bigger Picture
This study reinforces that cannabis use during first-episode psychosis treatment is not just a concurrent problem but a strong predictor of worse outcomes after treatment ends, particularly reduced engagement in ongoing care.
What This Study Doesn't Tell Us
Small sample from a single urban safety-net program; cannot determine if cannabis caused worse outcomes or if people at higher relapse risk are more likely to use cannabis; retrospective design; cannabis use assessed only at last contact, not continuously
Questions This Raises
- ?Would cannabis cessation interventions integrated into first-episode psychosis programs reduce post-program relapse?
- ?Is there a threshold of cannabis use below which risk is not elevated?
Trust & Context
- Key Stat:
- 4x relapse risk with cannabis use at exit (aOR 4.06)
- Evidence Grade:
- Small single-center retrospective study with appropriate multivariable adjustment, but limited by sample size and inability to establish causation.
- Study Age:
- 2024 publication analyzing 2014-2021 data
- Original Title:
- Predictors of relapse and engagement in care one year after ending services in an urban safety net coordinated specialty care program for first episode psychosis.
- Published In:
- Schizophrenia research, 264, 140-146 (2024)
- Authors:
- Hyatt, Andrew, Mullin, Brian, Hasler, Victoria, Madore, Drew, Progovac, Ana M, Cook, Benjamin Lê, DeLisi, Lynn E
- Database ID:
- RTHC-05394
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
How strongly did cannabis predict relapse after first-episode psychosis treatment?
People still using cannabis at their last program visit had four times the odds of relapse (psychiatric emergency visits or hospitalization) in the following year compared to those not using cannabis, after adjusting for other factors.
Did cannabis use also affect follow-up care?
Yes. Cannabis users had only about one-third the odds of continuing outpatient psychiatric care after leaving the program. This double impact of higher relapse risk combined with lower care engagement makes cannabis use at program exit a particularly concerning finding.
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Cite This Study
https://rethinkthc.com/research/RTHC-05394APA
Hyatt, Andrew; Mullin, Brian; Hasler, Victoria; Madore, Drew; Progovac, Ana M; Cook, Benjamin Lê; DeLisi, Lynn E. (2024). Predictors of relapse and engagement in care one year after ending services in an urban safety net coordinated specialty care program for first episode psychosis.. Schizophrenia research, 264, 140-146. https://doi.org/10.1016/j.schres.2023.12.022
MLA
Hyatt, Andrew, et al. "Predictors of relapse and engagement in care one year after ending services in an urban safety net coordinated specialty care program for first episode psychosis.." Schizophrenia research, 2024. https://doi.org/10.1016/j.schres.2023.12.022
RethinkTHC
RethinkTHC Research Database. "Predictors of relapse and engagement in care one year after ..." RTHC-05394. Retrieved from https://rethinkthc.com/research/hyatt-2024-predictors-of-relapse-and
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.