Synthetic Cannabinoid Users Had Worse Psychosis Outcomes at 9 Months Than THC Users or Non-Users

Among 61 patients with first-episode psychosis, synthetic cannabinoid (SPICE) users showed more severe positive symptoms, higher dissociative symptoms and suicidal ideation, and worse global functioning recovery at 9 months compared to THC users and non-users.

Ricci, Valerio et al.·Psychiatry research·2023·Moderate Evidencecomparative-study
RTHC-04881Comparative StudyModerate Evidence2023RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

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

What This Study Found

THC users and especially SPICE users displayed more severe positive symptoms than non-users. Negative symptoms were higher among non-users. After 9 months, non-users had recovered significantly better than SPICE users in global functioning. Dissociative symptoms were significantly greater in substance users. Suicidal ideation was highest in SPICE users.

Key Numbers

N=61 (20 non-users, 21 THC users, 20 SPICE users). Assessed at 3 timepoints over 9 months. SPICE users had worst positive symptoms and suicidal ideation. Non-users had best functional recovery.

How They Did This

Comparative study of 61 first-episode psychosis patients divided into non-users (N=20), THC users (N=21), and SPICE users (N=20), assessed at onset, 3 months, and 9 months using validated psychopathological scales.

Why This Research Matters

The 9-month follow-up extends earlier findings at 6 months, confirming that psychosis associated with synthetic cannabinoids follows a more severe and persistent course. The elevated suicidal ideation in SPICE users is a critical clinical concern.

The Bigger Picture

Synthetic cannabinoids bind CB1 receptors with much greater potency than THC, producing more intense psychoactive effects. This clinical data confirms what pharmacology would predict: more potent receptor activation correlates with worse psychotic outcomes.

What This Study Doesn't Tell Us

Small sample size (~20 per group). Non-randomized group assignment. Self-reported substance use. Single-center study. Cannot control for all confounders between groups.

Questions This Raises

  • ?Does the outcome gap between SPICE and THC users widen or narrow beyond 9 months?
  • ?Would specific antipsychotic strategies improve outcomes for synthetic cannabinoid psychosis?

Trust & Context

Key Stat:
SPICE users had the highest suicidal ideation among all first-episode psychosis groups
Evidence Grade:
Small comparative study with 9-month follow-up using validated scales, limited by sample size and non-randomized design.
Study Age:
Published in 2023.
Original Title:
First episode psychosis with and without the use of cannabis and synthetic cannabinoids: Psychopathology, global functioning and suicidal ideation and antipsychotic effectiveness.
Published In:
Psychiatry research, 320, 115053 (2023)
Database ID:
RTHC-04881

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

Is synthetic cannabis more dangerous for psychosis than natural cannabis?

In this study, synthetic cannabinoid users had more severe positive symptoms, higher suicidal ideation, and worse functional recovery than THC users at 9 months after first-episode psychosis.

Do people with psychosis who dont use cannabis recover better?

Non-users showed significantly better global functioning recovery at 9 months compared to SPICE users, though they had higher negative symptoms initially.

Read More on RethinkTHC

Cite This Study

RTHC-04881·https://rethinkthc.com/research/RTHC-04881

APA

Ricci, Valerio; Ceci, Franca; Di Carlo, Francesco; Di Muzio, Ilenia; Ciavoni, Laura; Santangelo, Monica; Di Salvo, Gabriele; Pettorruso, Mauro; Martinotti, Giovanni; Maina, Giuseppe. (2023). First episode psychosis with and without the use of cannabis and synthetic cannabinoids: Psychopathology, global functioning and suicidal ideation and antipsychotic effectiveness.. Psychiatry research, 320, 115053. https://doi.org/10.1016/j.psychres.2023.115053

MLA

Ricci, Valerio, et al. "First episode psychosis with and without the use of cannabis and synthetic cannabinoids: Psychopathology, global functioning and suicidal ideation and antipsychotic effectiveness.." Psychiatry research, 2023. https://doi.org/10.1016/j.psychres.2023.115053

RethinkTHC

RethinkTHC Research Database. "First episode psychosis with and without the use of cannabis..." RTHC-04881. Retrieved from https://rethinkthc.com/research/ricci-2023-first-episode-psychosis-with

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.