Twin Study Suggests Cannabis-Psychosis Link May Be Due to Shared Genetics

While adolescent cannabis use was associated with higher adult psychoticism scores, co-twin control analyses found no evidence of a causal effect, suggesting shared family factors explain the link.

Schaefer, Jonathan D et al.·Journal of abnormal psychology·2021·Strong EvidenceLongitudinal Cohort
RTHC-03500Longitudinal CohortStrong Evidence2021RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Strong Evidence
Sample
N=1,544

What This Study Found

In 1,544 twins, both cumulative adolescent cannabis use and cannabis use disorder were associated with higher adult Psychoticism scores, but comparing twins within pairs (where one used more cannabis) showed no within-pair difference, pointing to familial confounds rather than causal effects.

Key Numbers

1,544 twins for cannabis use analysis; 1,458 for CUD analysis; no significant within-pair effect in co-twin models; no interaction between polygenic risk for schizophrenia and cannabis use on psychoticism.

How They Did This

Longitudinal co-twin control analysis using two cohorts of twins with prospective measures of adolescent cannabis use (N=1,544) and cannabis use disorder symptoms (N=1,458) linked to adult Psychoticism (PID-5), with polygenic risk scores for schizophrenia.

Why This Research Matters

This twin design is one of the strongest methods for separating causal effects from confounding. Finding no within-twin-pair effect challenges the assumption that cannabis directly causes psychotic traits and suggests shared genetic or environmental factors drive both.

The Bigger Picture

If the cannabis-psychosis link is largely explained by shared genetic liability rather than direct causation, it would shift the focus of prevention from cannabis avoidance toward identifying and supporting individuals with underlying genetic vulnerability.

What This Study Doesn't Tell Us

Psychoticism scale measures a broad dimension, not clinical psychosis diagnosis; predominantly White sample from Minnesota; may not generalize to populations with different genetic backgrounds; cannabis potency not measured.

Questions This Raises

  • ?Would similar co-twin designs find the same result using clinical psychosis outcomes rather than dimensional psychoticism?
  • ?Does cannabis potency matter more than frequency in this relationship?

Trust & Context

Key Stat:
No evidence of causal effect when comparing twins who used different amounts of cannabis
Evidence Grade:
Strong genetically informative design using prospective twin cohort data, limited by dimensional rather than clinical outcome measure.
Study Age:
Longitudinal data with adolescent cannabis measures and adult psychoticism assessment.
Original Title:
Adolescent cannabis use and adult psychoticism: A longitudinal co-twin control analysis using data from two cohorts.
Published In:
Journal of abnormal psychology, 130(7), 691-701 (2021)
Database ID:
RTHC-03500

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Does this study prove cannabis doesn't cause psychosis?

Not definitively. It found that the association between adolescent cannabis use and adult psychotic traits was explained by shared family factors. However, it measured broad psychoticism traits rather than clinical psychosis diagnoses.

What is a co-twin control design?

It compares twins within the same pair where one twin used more cannabis than the other. Since twins share genetics and family environment, any remaining difference can be more confidently attributed to cannabis itself. This study found no such difference.

Read More on RethinkTHC

Cite This Study

RTHC-03500·https://rethinkthc.com/research/RTHC-03500

APA

Schaefer, Jonathan D; Jang, Seon-Kyeong; Vrieze, Scott; Iacono, William G; McGue, Matt; Wilson, Sylia. (2021). Adolescent cannabis use and adult psychoticism: A longitudinal co-twin control analysis using data from two cohorts.. Journal of abnormal psychology, 130(7), 691-701. https://doi.org/10.1037/abn0000701

MLA

Schaefer, Jonathan D, et al. "Adolescent cannabis use and adult psychoticism: A longitudinal co-twin control analysis using data from two cohorts.." Journal of abnormal psychology, 2021. https://doi.org/10.1037/abn0000701

RethinkTHC

RethinkTHC Research Database. "Adolescent cannabis use and adult psychoticism: A longitudin..." RTHC-03500. Retrieved from https://rethinkthc.com/research/schaefer-2021-adolescent-cannabis-use-and

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.