Cannabis Use Was Extremely Common in South African Teens with First-Episode Psychosis
Among 45 South African adolescents with first-episode psychosis, 56% reported lifetime cannabis use (96% of whom were male), and the average delay from symptom onset to treatment was nearly 7 months.
Quick Facts
What This Study Found
Researchers assessed 45 adolescents (mean age 15.9) with first-episode psychosis in KwaZulu-Natal, South Africa. Cannabis use was strikingly prevalent: 56% reported lifetime use, and 96% of cannabis users were male.
The mean duration of untreated psychosis was 27.2 weeks (nearly 7 months), with younger children experiencing longer delays. The prodromal period (early warning signs before full psychosis) was poorly recognized by 49% of patients and caregivers.
Male patients had slightly later onset (15.7 vs. 15.3 years) but dramatically higher cannabis use, suggesting that environmental factors like cannabis use may play different roles in psychosis onset for males versus females.
Key Numbers
45 adolescents; mean age 15.9; 69% male; 56% lifetime cannabis use; 96% of cannabis users were male; mean DUP 27.2 weeks; negative correlation between DUP and age of onset (p<0.05)
How They Did This
Cross-sectional assessment of 45 adolescents with first-episode psychosis using clinical interview, PANSS rating scale, SOS score, WHO ASSIST questionnaire, and urine cannabis testing.
Why This Research Matters
This study from a low-to-middle income country highlights that cannabis-psychosis associations observed in Western research also appear in African settings, and that delays in treatment are substantial, potentially worsening outcomes.
The Bigger Picture
The near-exclusive association of cannabis use with male adolescent psychosis patients raises questions about whether cannabis is a gendered risk factor or whether boys are simply more likely to use cannabis. Either way, the combination of cannabis use and delayed treatment represents a concerning pattern.
What This Study Doesn't Tell Us
Small sample (45 patients). Single site in South Africa. Cross-sectional design cannot determine whether cannabis contributed to psychosis onset. Self-reported substance use may be unreliable. No comparison group of adolescents without psychosis.
Questions This Raises
- ?Does cannabis contribute to psychosis onset in this population, or do pre-psychotic symptoms lead to cannabis use?
- ?Would earlier recognition of prodromal symptoms reduce the 7-month treatment delay?
- ?Why is cannabis use so much more common in male psychosis patients?
Trust & Context
- Key Stat:
- 56% lifetime cannabis use; 96% of users were male
- Evidence Grade:
- Small cross-sectional clinical study from a single site. Provides important descriptive data but cannot establish causal relationships.
- Study Age:
- Published in 2015. Cannabis availability and mental health service access in South Africa continue to evolve.
- Original Title:
- Clinical correlates of first episode early onset psychosis in KwaZulu-Natal, South Africa.
- Published In:
- Journal of child and adolescent mental health, 27(2), 103-11 (2015)
- Authors:
- Paruk, Saeeda(4), Jhazbhay, Khadija, Singh, Keshika(2), Sartorius, Benn, Burns, Jonathan K
- Database ID:
- RTHC-01034
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Does cannabis cause psychosis in teenagers?
This study cannot answer that question. It found very high cannabis use among teen psychosis patients (56%), particularly males, but could not determine whether cannabis contributed to psychosis or whether early psychotic symptoms led to cannabis use.
Why was treatment delayed so long?
The average delay was 27 weeks (7 months). Nearly half of patients and caregivers did not recognize the early warning signs of psychosis. Younger children had even longer delays, possibly because symptoms were attributed to normal developmental behavior.
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Cite This Study
https://rethinkthc.com/research/RTHC-01034APA
Paruk, Saeeda; Jhazbhay, Khadija; Singh, Keshika; Sartorius, Benn; Burns, Jonathan K. (2015). Clinical correlates of first episode early onset psychosis in KwaZulu-Natal, South Africa.. Journal of child and adolescent mental health, 27(2), 103-11. https://doi.org/10.2989/17280583.2015.1080710
MLA
Paruk, Saeeda, et al. "Clinical correlates of first episode early onset psychosis in KwaZulu-Natal, South Africa.." Journal of child and adolescent mental health, 2015. https://doi.org/10.2989/17280583.2015.1080710
RethinkTHC
RethinkTHC Research Database. "Clinical correlates of first episode early onset psychosis i..." RTHC-01034. Retrieved from https://rethinkthc.com/research/paruk-2015-clinical-correlates-of-first
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.