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Factors Moderating the Association Between Cannabis Use and Psychosis Risk: A Systematic Review

Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, 3584CX Utrecht, The Netherlands
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Brain Sci. 2020, 10(2), 97; https://doi.org/10.3390/brainsci10020097
Received: 21 January 2020 / Revised: 7 February 2020 / Accepted: 10 February 2020 / Published: 12 February 2020
(This article belongs to the Special Issue Cannabis: Neuropsychiatry and Its Effects on Brain and Behavior)
Increasing evidence indicates a relationship between cannabis use and psychosis risk. Specific factors, such as determinants of cannabis use or the genetic profile of cannabis users, appear to moderate this association. The present systematic review presents a detailed and up-to-date literature overview on factors that influence the relationship between cannabis use and psychosis risk. A systematic search was performed according to the PRISMA guidelines in MEDLINE and Embase, and 56 studies were included. The results show that, in particular, frequent cannabis use, especially daily use, and the consumption of high-potency cannabis are associated with a higher risk of developing psychosis. Moreover, several genotypes moderate the impact of cannabis use on psychosis risk, particularly those involved in the dopamine function, such as AKT1. Finally, cannabis use is associated with an earlier psychosis onset and increased risk of transition in individuals at a clinical high risk of psychosis. These findings indicate that changing cannabis use behavior could be a harm reduction strategy employed to lower the risk of developing psychosis. Future research should aim to further develop specific biomarkers and genetic profiles for psychosis, thereby contributing to the identification of individuals at the highest risk of developing a psychotic disorder.
Keywords: cannabis use; psychotic disorder; genetics; age of onset; clinical high risk cannabis use; psychotic disorder; genetics; age of onset; clinical high risk
MDPI and ACS Style

van der Steur, S.J.; Batalla, A.; Bossong, M.G. Factors Moderating the Association Between Cannabis Use and Psychosis Risk: A Systematic Review. Brain Sci. 2020, 10, 97.

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