Cannabis, psychosis and schizophrenia: unravelling a complex interaction.

A dose-response relationship exists between cannabis use and psychosis, and for individuals with schizophrenia, cannabis worsens their symptoms. These findings support a multi-causal model where vulnerability interacts with a precipitating agent to produce disease. Although this model is common in epidemiology, communicating it has been difficult because the increased risk at the population level is weak and the vulnerabilities are rare, and because people bring strongly held preconceptions to interpreting complex multi-causal phenomena.

Study at a glance

Abstract

The relationship between cannabis and psychosis and schizophrenia has tested the field of addiction for decades, and in some ways serves as measure of our ability to provide a credible contribution to public health. As cannabis is used widely, many people are interested in the risks the drug poses to mental health. This paper focuses upon a seminal study examining this, the trajectory of subsequent research findings and what this has meant for understanding and communicating risk factor information. These studies provided evidence of a dose-response relationship between cannabis and psychosis, and that for those individuals with schizophrenia cannabis exacerbated their symptoms. The findings fit with a multi-causal model in which vulnerability interacts with a precipitating agent to produce a disease outcome. Even though this is a common model in epidemiology, it has proved difficult to communicate it in this case. This may be because at a population level the increased risk is weak and the vulnerabilities relatively rare. It may also be because people bring strongly held preconceptions to interpreting a complex multi-causal phenomenon.