Nearly Half of Psychosis Patients in South Africa Used Cannabis | Research

The takeaway

Among 370 psychiatric inpatients in South Africa, 48.9% reported current cannabis use and 51.1% lifetime use, with cannabis use associated with more frequent hospital readmissions.

Psychiatrists, mental health policymakers, substance abuse program designers

48.9% current cannabis use among psychosis inpatients

What the researchers found

Current cannabis use was 48.9% and lifetime use 51.1%. Males had nearly 5x higher odds of current cannabis use (OR=4.90) and 6x higher for lifetime use (OR=6.27). Current alcohol use was associated with cannabis use (OR=3.06). Being 45+ was protective (OR=0.30). Cannabis use was associated with more readmissions (P=0.01), with 48% admitted 3+ times.

Why it matters

Nearly half of psychosis inpatients in this setting used cannabis, yet dual diagnosis treatment programs are lacking. This prevalence has direct implications for how psychiatric services should be structured.

The numbers in context

370 records; 48.9% current use; 51.1% lifetime; male OR 4.90 (current), 6.27 (lifetime); alcohol co-use OR 3.06; 48% admitted 3+ times

How the study worked

Retrospective review of 370 clinical records of patients admitted to a psychiatric hospital in Durban, South Africa, from June 2018 to June 2020.

What this study cannot tell us

Retrospective chart review dependent on accuracy of clinical records. Single-center study in KwaZulu-Natal may not represent all South African psychiatric populations.

How to read the evidence

Retrospective chart review from a single center, providing clear prevalence data but limited by clinical record accuracy.

When this study was published

Published in 2022

The bigger picture

The very high prevalence of cannabis use among psychosis patients in this South African setting mirrors findings from high-income countries, suggesting this is a global clinical challenge requiring integrated treatment approaches.

Questions still open

Would integrated dual diagnosis programs reduce readmission rates? How does cannabis potency and availability in South Africa compare to settings where similar rates have been reported?

Common questions

How common is cannabis use among people with psychosis?

In this South African psychiatric hospital, 48.9% of patients with psychotic disorders had current cannabis use and 51.1% had lifetime use, with males far more likely to use.

Does cannabis use affect psychosis hospital readmissions?

Yes. Cannabis use was significantly associated with readmission (P=0.01), and 48% of the sample had been admitted 3 or more times.

Read the original research

Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa.

The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa, 28, 1927

View on PubMed ↗Publisher’s paper ↗

Citation

Mona, Khanya; Ntlantsana, Vuyokazi; Tomita, Andrew M; Paruk, Saeeda. (2022). Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa.. The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa, 28, 1927. https://doi.org/10.4102/sajpsychiatry.v28i0.1927