Synthetic Cannabinoid Users Had More Severe and Persistent Psychotic Symptoms Than THC Users or Non-Users

Among 62 patients with first-episode psychosis, synthetic cannabinoid (SPICE) users showed more severe positive symptoms, worse global functioning recovery, and higher aberrant salience scores compared to THC users and non-cannabis users.

Ricci, Valerio et al.·Frontiers in psychiatry·2023·Moderate Evidencecomparative-study
RTHC-04880Comparative StudyModerate Evidence2023RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
comparative-study
Evidence
Moderate Evidence
Sample
N=20

What This Study Found

SPICE users had more severe and persistent positive symptoms than THC users and non-users. Non-users showed better recovery in global functioning compared to SPICE users. All groups showed decreasing aberrant salience scores over time, but SPICE users maintained higher global scores and improved less. Negative symptoms were most prominent in non-users.

Key Numbers

N=62 first-episode psychosis patients (20 non-users, 21 THC users, 20 SPICE users). Assessed at 3 timepoints using 5 validated scales. SPICE users showed persistently higher positive symptoms and aberrant salience.

How They Did This

Comparative study of 62 patients with first-episode psychosis divided into non-users (N=20), THC users (N=21), and SPICE users (N=20). Assessed at onset, 3 months, and 6 months using PANSS, GAF, DES-II, SSI, and ASI scales.

Why This Research Matters

Synthetic cannabinoids are far more potent at CB1 receptors than THC, and this study provides clinical evidence that psychosis associated with synthetic cannabinoid use is more severe and harder to recover from than THC-associated or non-substance psychosis.

The Bigger Picture

The aberrant salience findings are particularly interesting. Aberrant salience, the tendency to assign excessive meaning to neutral stimuli, may be a mechanism through which synthetic cannabinoids drive and maintain psychosis more powerfully than THC.

What This Study Doesn't Tell Us

Small sample size (62 total, ~20 per group). Non-randomized group assignment. Cannot control for all confounders between groups. Self-reported substance use. 6-month follow-up may not capture long-term trajectory.

Questions This Raises

  • ?Does the higher aberrant salience in SPICE users persist beyond 6 months?
  • ?Would targeted interventions for aberrant salience improve outcomes in synthetic cannabinoid psychosis?

Trust & Context

Key Stat:
Synthetic cannabinoid users had more severe and persistent psychotic symptoms than THC users
Evidence Grade:
Small comparative study with repeated measures at 3 timepoints using validated scales, but limited by sample size and non-randomized design.
Study Age:
Published in 2023.
Original Title:
Aberrant salience in cannabis-induced psychosis: a comparative study.
Published In:
Frontiers in psychiatry, 14, 1343884 (2023)
Database ID:
RTHC-04880

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study
What do these levels mean? →

Frequently Asked Questions

Are synthetic cannabinoids worse for psychosis than THC?

In this study, first-episode psychosis patients who used synthetic cannabinoids had more severe positive symptoms, worse functional recovery, and higher aberrant salience compared to THC users and non-users.

What is aberrant salience?

Aberrant salience is the tendency to assign excessive meaning to neutral stimuli, which can drive delusional thinking. Synthetic cannabinoid users in this study had persistently higher aberrant salience than other groups.

Read More on RethinkTHC

Cite This Study

RTHC-04880·https://rethinkthc.com/research/RTHC-04880

APA

Ricci, Valerio; Di Muzio, Ilenia; Ceci, Franca; Di Carlo, Francesco; Mancusi, Gianluca; Piro, Tommaso; Paggi, Andrea; Pettorruso, Mauro; Vellante, Federica; De Berardis, Domenico; Martinotti, Giovanni; Maina, Giuseppe. (2023). Aberrant salience in cannabis-induced psychosis: a comparative study.. Frontiers in psychiatry, 14, 1343884. https://doi.org/10.3389/fpsyt.2023.1343884

MLA

Ricci, Valerio, et al. "Aberrant salience in cannabis-induced psychosis: a comparative study.." Frontiers in psychiatry, 2023. https://doi.org/10.3389/fpsyt.2023.1343884

RethinkTHC

RethinkTHC Research Database. "Aberrant salience in cannabis-induced psychosis: a comparati..." RTHC-04880. Retrieved from https://rethinkthc.com/research/ricci-2023-aberrant-salience-in-cannabisinduced

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.