Cannabis use disorder nearly tripled the odds of needing intensive psychiatric outreach in Lebanon | Research

The takeaway

Among patients with psychosis in Lebanon, those with comorbid cannabis use disorder had 2.83 times the odds of being enrolled in an assertive outreach program, indicating more severe illness requiring intensive follow-up.

Psychiatrists treating dual-diagnosis patients, global mental health researchers, and substance abuse counselors.

Cannabis use disorder: 2.83x odds of needing intensive outreach

What the researchers found

Cannabis use disorder was a significant predictor of enrollment in the Psychosis Recovery Outreach Program (OR 2.83, 95% CI 1.25-6.37). Other predictors included being prescribed long-acting injectable antipsychotics (OR 9.99), multiple oral antipsychotics (OR 4.57), multiple ER visits (OR 8.7), and psychiatric admission (OR 13.91).

Why it matters

Cannabis use disorder alongside psychosis signals a more severe clinical course requiring intensive treatment. This confirms in a non-Western setting what has been observed elsewhere.

The numbers in context

45 PROP patients. 77.8% male. 80% under 39 years. 22.7% had comorbid cannabis use disorder. 46.7% schizophrenia, 48.9% schizoaffective disorder. Cannabis use disorder OR 2.83 for program enrollment.

How the study worked

Retrospective analysis of 45 patients enrolled in the Psychosis Recovery Outreach Program at a psychiatric facility in Lebanon. Logistic regression identified predictors of enrollment compared to patients receiving standard treatment. Twelve-month data collected.

What this study cannot tell us

Small sample (45 patients). Single facility in Lebanon. Retrospective design. Enrollment in outreach program is a proxy for severity, not a direct outcome measure. Selection bias possible.

How to read the evidence

Small retrospective study from a single facility, but significant odds ratios and novel non-Western context.

When this study was published

Published in 2022.

The bigger picture

The finding that cannabis use disorder predicts need for intensive psychiatric outreach replicates Western findings in a Middle Eastern context, suggesting this relationship is not culturally specific.

Questions still open

Does treating cannabis use disorder improve psychosis outcomes in this population? Would similar results emerge in other non-Western psychiatric settings?

Common questions

Does cannabis use make psychosis worse?

In this Lebanese study, patients with psychosis and cannabis use disorder were nearly three times more likely to need intensive outreach treatment, suggesting more severe illness requiring closer follow-up.

Is the cannabis-psychosis link seen outside Western countries?

Yes. This study from Lebanon found cannabis use disorder was a significant predictor of more severe psychosis requiring intensive treatment, consistent with findings from Western countries.

Read the original research

Predictors of admission to an assertive outreach service for psychosis in Lebanon.

PLOS global public health, 2(12), e0001428

View on PubMed ↗Publisher’s paper ↗

Citation

Kassir, Ghida; El Hayek, Samer; Charara, Raghid; Cherro, Michele; Itani, Hala; El Khoury, Joseph. (2022). Predictors of admission to an assertive outreach service for psychosis in Lebanon.. PLOS global public health, 2(12), e0001428. https://doi.org/10.1371/journal.pgph.0001428