Prenatal Cannabis Exposure Linked to Hallucinatory Experiences in Children | Research

The takeaway

Among 11,854 children in the ABCD Study, those with prenatal cannabis exposure had 58% higher odds of hallucinatory-like psychotic experiences, with different risk factors associated with different symptom clusters.

Child psychiatrists, prenatal health researchers, parents concerned about cannabis exposure effects, and psychosis prevention specialists.

What the researchers found

Three distressing PLE subgroups were identified: hallucinatory-like, paranoid-like, and multiple domains. Prenatal cannabis exposure specifically predicted hallucinatory-like PLEs (OR = 1.578), while schizophrenia genetic risk predicted paranoid-like PLEs. All groups showed associations with childhood adversity and poor school environments.

Why it matters

This study suggests prenatal cannabis exposure may specifically affect certain types of psychotic experiences in children, potentially through distinct neurodevelopmental pathways that differ from genetic predisposition.

The numbers in context

11,854 children. 3,155 with at least one distressing PLE. Three clusters: hallucinatory-like (n=1,110), paranoid-like (n=1,229), multiple domains (n=816). Prenatal cannabis: OR = 1.578 (95% CI: 1.231-2.023) for hallucinatory-like PLEs.

How the study worked

Cross-sectional analysis of 11,854 children from the ABCD Study v5.1, using K-medoid clustering of psychotic-like experiences and multinomial models examining genetic and environmental risk factors.

What this study cannot tell us

Cross-sectional analysis of one time point. Prenatal cannabis exposure is retrospectively reported and may be inaccurate. PLEs are self-reported by children. Cannot establish causation.

How to read the evidence

Large national sample with sophisticated clustering analysis, but cross-sectional design and retrospectively reported prenatal exposure limit causal inference.

When this study was published

Recent analysis from the ongoing ABCD Study, the largest US study of children's brain development.

The bigger picture

The ABCD Study is the largest long-term study of brain development in children. Finding that prenatal cannabis exposure predicts a specific subtype of psychotic experiences adds important nuance to the growing literature on prenatal cannabis effects.

Questions still open

Does prenatal cannabis exposure affect specific brain circuits involved in hallucination-like perceptions? Will these children go on to develop clinical psychotic disorders at higher rates?

Common questions

Can prenatal cannabis exposure cause psychosis in children?

This study found a 58% increased odds of hallucinatory-like experiences, but PLEs are common in children and usually don't lead to psychotic disorders. The association is concerning but doesn't prove causation.

What are psychotic-like experiences in children?

PLEs include things like hearing voices or having paranoid thoughts. They're relatively common in childhood and usually transient, but distressing PLEs can indicate higher risk for later psychiatric conditions.

Read the original research

Cluster profiles of distressing psychotic-like experiences among children and associations with genetic risk, prenatal cannabis exposure, and social-environmental characteristics.

Schizophrenia research, 278, 119-127

View on PubMed ↗Publisher’s paper ↗

Citation

Yuan, Qingyue; Chen, Yinxian; Xu, Ying; Dimitrov, Lina V; Risk, Benjamin B; Walker, Elaine F; Huels, Anke; Ku, Benson S. (2025). Cluster profiles of distressing psychotic-like experiences among children and associations with genetic risk, prenatal cannabis exposure, and social-environmental characteristics.. Schizophrenia research, 278, 119-127. https://doi.org/10.1016/j.schres.2025.03.034