rethinkTHC Search
Menu
Study breakdown

Cannabis-related psychiatric disorders matched schizophrenia as the top reason for psychiatric hospitalization in South Africa

Retrospective CohortModerate evidence
The takeaway

Cannabis-related psychiatric disorders accounted for 31.6% of psychiatric admissions at a South African mental health unit, equal to schizophrenia, making it the joint leading diagnosis.

Psychiatric service planners, South African health policymakers, and global mental health researchers.

31.6% of psychiatric admissions

What the researchers found

Schizophrenia (31.6%) and cannabis-related psychiatric disorders (31.6%) were tied as the most common reasons for psychiatric hospitalization, followed by bipolar type-1 disorder (21.9%) and alcohol-related disorders (15.5%). Most patients were male, single, and admitted involuntarily.

Why it matters

In a resource-limited setting where psychiatric beds are scarce, cannabis-related disorders consuming nearly a third of inpatient capacity has major implications for mental health service planning.

The numbers in context

186 patients with complete data; 58% male; 38% psychotic, 31% violent at admission; cannabis disorders 31.6% = schizophrenia 31.6% > bipolar 21.9% > alcohol 15.5%. Most (72.6%) were single; 45.7% had secondary education.

How the study worked

Retrospective cross-sectional audit of 186 psychiatric in-patient medical records at the East London Mental Health Unit, Eastern Cape, South Africa (January-December 2016).

What this study cannot tell us

Single-center study in one region of South Africa. Retrospective design relying on medical records. Cannot distinguish cannabis as cause versus co-occurring factor. Small sample (186).

How to read the evidence

Moderate: systematic chart review but single-center and retrospective.

When this study was published

Published in 2019.

The bigger picture

While cannabis-related psychiatric admissions are documented globally, the equal prevalence with schizophrenia in this South African setting is striking and may reflect both high cannabis potency in the region and limited outpatient mental health resources.

Questions still open

  • What proportion of the cannabis-related admissions had underlying psychotic disorders that were unmasked by cannabis? Are cannabis-related psychiatric admissions increasing in this region?

Common questions

How common are cannabis-related psychiatric hospitalizations?
In this South African mental health unit, cannabis-related disorders were responsible for 31.6% of all psychiatric admissions, equal to schizophrenia.
Does cannabis cause psychiatric hospitalization?
This study found cannabis-related disorders were a leading reason for admission, but the retrospective design cannot determine whether cannabis caused the disorders or triggered underlying vulnerability.

Read the original research

Demographic and clinical profiles of admitted psychiatric patients of the East London Mental Health Unit in the Eastern Cape, South Africa.

Medicine, 98(52), e18399

Citation

Madala-Witbooi, Nombulelo J; Adeniyi, Oladele Vincent. (2019). Demographic and clinical profiles of admitted psychiatric patients of the East London Mental Health Unit in the Eastern Cape, South Africa.. Medicine, 98(52), e18399. https://doi.org/10.1097/MD.0000000000018399

Explore the wider topic