A review of Indian research on co-occurring cannabis use disorders& psychiatric disorders

Abstract

Background & objectives:Cannabis is a widely used illicit drug and its use is often associated with co-occurring psychiatric disorders. This systematic review was aimed to provide information on the published Indian studies on co-occurring cannabis use disorders and psychiatric disorders.Methods:An electronic search of available Indian literature using relevant search terms was carried out in May 2015 and 52 articles in English language published from India were included in the current review.Results:Studies on cannabis and associated psychotic disorders (n=16) chiefly described acute episodes with predominant positive symptoms, following cannabis use. Some studies (n=6) observed an overall increased prevalence of all psychiatric disorders and symptoms owing to cannabis use, while others (n=14) elaborated on high rates of substance use in those with psychiatric disorders. The effect of cannabis use on cognitive function was the focus of some of the Indian studies (n=7). All these studies barring one had all male subjects, and a single study described the service delivery model for those with dual diagnosis disorders in India. Most of the research used cross-sectional observational design and focussed on treatment-seeking population.Interpretation & conclusions:A review of Indian literature on cannabis use and its association with psychiatric disorders indicates a high co-prevalence of psychotic disorders, especially in vulnerable individuals as well as high rates of co-occurrence of other psychiatric comorbidities. However, there is limited focus on exploring the aetiological association between cannabis use and psychiatric disorders; understanding the neurobiology of this association and management-related issues.

The Association Between Cannabis Use and Schizophrenia: Causative or Curative? A Systematic Review

“…There are clear psychiatric comorbidity and cognitive decline in cannabis use disorder [13]. A person ever exposed to cannabis in his/her lifetime is at a higher risk of schizophrenia development [10].…”

“…The confounding factors to cannabis use and schizophrenia development can be gender, family history, genetic predisposition, and more [20]. Cannabis interacts with pre-existing genetic and environmental factors and leads to early schizophrenia [13,15,17,21]. A person who will inevitably develop a psychotic illness has generalized brain dysfunction, whereas a person who needs cannabis exposure with their genetic predisposition to develop psychosis has a more selective effect of psychosis and selective cognitive defect [21].…”

“…Among chronic users, comparison of cognitive effect between weaker and stronger preparation users showed a decline among stronger preparation users in the form of poor concentration and attention, memory impairment [13]. Younger and more frequent users are at higher risk of developing cognitive decline [13]. Adolescent cannabis use impacts cognition in the future [21].…”

“…A person ever exposed to cannabis in his/her lifetime is at a higher risk of schizophrenia development [ 10 ]. There is a high frequency of psychotic disorders with cannabis users, and cannabis also alters the age of onset and course and presentation of the disease [ 13 ]. Cannabis-induced psychosis is a part of the schizophrenia spectrum that eventually convert to schizophrenia [ 10 ].…”

Cannabis and Psychosis: Are We any Closer to Understanding the Relationship?

“…Cannabis is used in most countries across the world although again we know more about use of the drug among western populations than any other. A recent review of the Indian literature investigating psychiatric problems including psychosis associated with cannabis use found a limited focus on aetiology and that all the studies bar one had all male samples [ 24 ]. This clearly leaves us with a skewed view of the impact on health resulting from use of cannabis.…”