Cannabis Use Changes How Immune Markers Predict 10-Year Psychosis Outcomes

In a 10-year follow-up of 320 first-episode psychosis patients, most baseline immune markers only predicted outcomes among those who used cannabis, suggesting inflammation and cannabis interact in shaping psychosis trajectories.

Kreis, Isabel et al.·Translational psychiatry·2025·Moderate EvidenceLongitudinal Cohort
RTHC-06858Longitudinal CohortModerate Evidence2025RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

Only sTNFR1 independently predicted lower risk of psychiatric readmission and psychotic episodes over 10 years. CRP, IL-1RA, and sgp130 only showed associations with outcomes in cannabis users. In cannabis users specifically, CRP and IL-1RA were linked to lower readmission risk, while sgp130 was linked to higher risk.

Key Numbers

320 first-episode psychosis patients; 10-year follow-up; 5 immune markers tested; only sTNFR1 predicted outcomes independently of cannabis; CRP, IL-1RA, and sgp130 effects were cannabis-dependent.

How They Did This

Longitudinal follow-up of 320 first-episode psychosis patients. Baseline blood immune markers (CRP, IL-1RA, sIL-2R, sTNFR1, sgp130) measured at entry. Outcomes tracked over 10 years: psychiatric readmissions, psychotic episodes per year, and change in positive symptom severity.

Why This Research Matters

Immune markers have been proposed as predictors of psychosis outcomes, but this study shows those associations largely depend on whether someone uses cannabis. This complicates the use of inflammatory biomarkers in clinical prediction and highlights cannabis as a key moderating factor.

The Bigger Picture

The finding that immune-psychosis links depend on cannabis use suggests these two factors may share biological pathways. It challenges the idea that inflammation alone drives psychosis course and points to cannabis-immune interactions as an underexplored mechanism.

What This Study Doesn't Tell Us

Observational design cannot establish causation. Cannabis use measured only at baseline, not tracked over 10 years. Immune markers also measured once at baseline. Specific cannabis types, doses, and frequency not captured.

Questions This Raises

  • ?Does cannabis directly alter immune marker levels in people with psychosis?
  • ?Would tracking cannabis use changes over time reveal different immune-psychosis patterns?

Trust & Context

Key Stat:
CRP, IL-1RA, and sgp130 predicted psychosis outcomes only in cannabis users
Evidence Grade:
Large sample with 10-year follow-up provides strong longitudinal data, but observational design and single-timepoint measurements limit causal inference.
Study Age:
2025 study with extended follow-up capturing a decade of psychosis outcomes.
Original Title:
Recent cannabis use affects the association between baseline immune markers and long-term outcomes in psychosis.
Published In:
Translational psychiatry, 15(1), 282 (2025)
Database ID:
RTHC-06858

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

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Does cannabis cause worse psychosis outcomes through inflammation?

This study cannot establish causation, but it shows that immune markers and cannabis use interact in predicting outcomes, suggesting shared biological pathways that warrant further investigation.

Can blood tests predict psychosis outcomes?

Only sTNFR1 independently predicted better outcomes. Other immune markers were only predictive when cannabis use was factored in, complicating their standalone clinical utility.

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Cite This Study

RTHC-06858·https://rethinkthc.com/research/RTHC-06858

APA

Kreis, Isabel; Fjelnseth Wold, Kristin; Åsbø, Gina; Bärthel Flaaten, Camilla; Engen, Magnus Johan; Lyngstad, Siv Hege; Hustad Widing, Line; Sheikh, Mashhood Ahmed; Frogner Werner, Maren Caroline; Bakken, Eivind; Ueland, Thor; Steen, Nils Eiel; Melle, Ingrid. (2025). Recent cannabis use affects the association between baseline immune markers and long-term outcomes in psychosis.. Translational psychiatry, 15(1), 282. https://doi.org/10.1038/s41398-025-03498-x

MLA

Kreis, Isabel, et al. "Recent cannabis use affects the association between baseline immune markers and long-term outcomes in psychosis.." Translational psychiatry, 2025. https://doi.org/10.1038/s41398-025-03498-x

RethinkTHC

RethinkTHC Research Database. "Recent cannabis use affects the association between baseline..." RTHC-06858. Retrieved from https://rethinkthc.com/research/kreis-2025-recent-cannabis-use-affects

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.