Clinical characteristics of synthetic cannabinoid-induced psychotic disorders: a single-center analysis of hospitalized patients

Abstract

This study was designed to evaluate synthetic cannabinoid (SC)-induced psychotic disorders in terms of their structure and clinical characteristics among hospitalized patients in Russia. It was a longitudinal, observational cohort study which included a total of 46 male patients who underwent the inpatient treatment in the intensive care unit or emergency department due to the SC-induced psychoses. Data on sociodemographic and disease-related characteristics, psychometric assessment scales obtained in face-to-face interviews, were recorded in all patients. The duration of catamnestic follow-up period was 2 years, with the major focus on manifestation of the schizophrenic process. Mean (SD) age of the patients with psychotic disorders induced by the SC use was 23.2 (3.5) years. Among 46 patients, 29 (63%) were SC-dependent and 17 (37%) were diagnosed with SC abuse. Average age at onset was 16.4 for psychoactive substances and 19.7 years for SC use. Marijuana was the most common first used substance. Based on our observations, we identified four clinical variants of the SC-induced psychoses. Our findings revealed that psychotic disorders are typical for the SC intoxication and most commonly influence young adults. Based on our observations, we identified four clinical variants of the SC-induced psychoses and revealed the signs which may indicate them. This study emphasizes the role of appropriate psychiatric management of SC-induced psychoses, since often only catamnestic long-term follow-up enables clinicians to determine the correct diagnosis and reveal the manifestation of the schizophrenic process.

Keywords:

• Synthetic cannabinoid
• psychosis
• substance-induced psychosis
• cannabinoid use disorder
• withdrawal
• addiction
• differential diagnosis
• psychopathology
• patients

Declaration of interest statement

The authors declare that there is no conflict of interest regarding the publication of this article.

Ethics approval and consent to participate

Written informed consent was obtained from each subject following a detailed explanation of the objectives and protocol of the study, which was conducted in accordance with the ethical principles stated in the Declaration of Helsinki and approved by the Ethics Committee of the Moscow Research and Practical Centre on Addictions of the Moscow Department of Healthcare.

Notes

a One patient told: “I’ve seen an unknown man who came to me. He said that he had searched me a lot to kill me. Then he said that he wanted to put me in prison and instantly transformed into the police officer. He interrogated me and bound my wrists. I ran away as I was real scared that he could kill me. I ran, shouted, and called for help. Nonetheless he always caught and handcuffed me …”

Another patient recounts: “I’ve seen cockroaches coming out of the woodwork. At first I got scared, but then I began to look at them. I wondered where they were crawling to. Then blue mice appeared. Mice were angry and tried to bite me. I realized that something bad was going on and felt the intense fear. I saw that I was not at my home and tried to understand where I was, but I was afraid to move anywhere. I began to shout and call for help. I heard my voice inside my head, it sounded hollow, much as it passed through the tube. I realized that no one will hear me, the history is finished, that it’s all over. Blue mice will eat me…”

For ethical reasons slang was substituted by literary language.

Additional information

Notes on contributors

V. Yu. Skryabin

All authors made substantial contributions to conception and design, acquisition of data, and analysis and interpretation of data; all authors participated in drafting the article and revising it critically for important intellectual content; and all authors gave final approval of the version to be submitted.