How Cannabis Triggers Psychotic-Like Experiences in Otherwise Healthy People
High-potency cannabis, genetic predisposition, and environmental stressors combine to increase psychotic-like experiences in non-clinical populations, with evidence suggesting the relationship runs both ways.
Quick Facts
What This Study Found
Across 38 studies, four major risk factor categories emerged for psychotic-like experiences (PLEs) in non-clinical populations: biological vulnerabilities (metabolic profiles, genetics, neurobiology), substance use patterns (especially high-potency cannabis), socio-demographic factors (digital media, ethnic density, gender), and downstream consequences (suicidal behavior, cognitive impairment). The cannabis-PLE relationship appeared bidirectional.
Key Numbers
38 studies analyzed; four risk factor categories identified; bidirectional relationship found between cannabis use and PLEs; high-potency cannabis showed strongest substance-related associations
How They Did This
Systematic review following PRISMA guidelines, searching PubMed/Medline and Scopus for peer-reviewed studies through January 2024 examining risk factors for PLEs in non-clinical samples. Registered with PROSPERO. 38 articles analyzed after screening.
Why This Research Matters
Psychotic-like experiences are more common in the general population than most people realize, and cannabis -- particularly high-potency products -- is one of the strongest modifiable risk factors. Understanding that the relationship may be bidirectional (people experiencing PLEs may also seek out cannabis) complicates simple cause-and-effect narratives.
The Bigger Picture
This review supports a multifactorial model where genetics, cannabis use patterns, and social-environmental factors all feed into whether someone develops psychotic-like experiences. It moves beyond the simplistic "cannabis causes psychosis" framing while still highlighting potency as a key variable.
What This Study Doesn't Tell Us
Focused on non-clinical populations, so findings may not generalize to people with diagnosed psychotic disorders. Cross-sectional designs in many included studies limit causal inference. Search limited to two databases.
Questions This Raises
- ?Could regular screening for PLEs in young cannabis users prevent progression to clinical psychosis?
- ?How do different cannabis potency thresholds map onto PLE risk?
- ?What role does digital media use play as an independent or interactive risk factor?
Trust & Context
- Key Stat:
- 38 studies analyzed across four risk factor categories
- Evidence Grade:
- Systematic review with PROSPERO registration and PRISMA methodology, but many included studies were cross-sectional, limiting causal conclusions.
- Study Age:
- Published in 2025 with literature through January 2024.
- Original Title:
- Cannabis use and psychotic-like experiences: A systematic review of biological vulnerability, potency effects, and clinical trajectories.
- Published In:
- Psychiatry research, 348, 116496 (2025)
- Authors:
- Ricci, Valerio(14), Chiappini, Stefania(6), Martinotti, Giovanni(18), Maina, Giuseppe
- Database ID:
- RTHC-07486
Evidence Hierarchy
Analyzes all available research on a topic using a structured method.
What do these levels mean? →Frequently Asked Questions
What are psychotic-like experiences?
PLEs include things like hearing voices, paranoid thoughts, or unusual perceptual experiences that occur in otherwise healthy people without a diagnosed psychotic disorder. They are more common than clinical psychosis.
Does high-potency cannabis definitely cause psychosis?
The review found strong associations but also evidence that the relationship is bidirectional -- people experiencing PLEs may be more likely to use cannabis. Multiple factors interact, making simple cause-and-effect statements insufficient.
Who is most at risk?
People with specific genetic predispositions, those using high-potency cannabis, younger users, and those exposed to certain environmental stressors like discrimination or high digital media use showed elevated risk.
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Cite This Study
https://rethinkthc.com/research/RTHC-07486APA
Ricci, Valerio; Chiappini, Stefania; Martinotti, Giovanni; Maina, Giuseppe. (2025). Cannabis use and psychotic-like experiences: A systematic review of biological vulnerability, potency effects, and clinical trajectories.. Psychiatry research, 348, 116496. https://doi.org/10.1016/j.psychres.2025.116496
MLA
Ricci, Valerio, et al. "Cannabis use and psychotic-like experiences: A systematic review of biological vulnerability, potency effects, and clinical trajectories.." Psychiatry research, 2025. https://doi.org/10.1016/j.psychres.2025.116496
RethinkTHC
RethinkTHC Research Database. "Cannabis use and psychotic-like experiences: A systematic re..." RTHC-07486. Retrieved from https://rethinkthc.com/research/ricci-2025-cannabis-use-and-psychoticlike
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.