Cannabis use and psychosis: a review of reviews

Eur Arch Psychiatry Clin Neurosci. 2020 Jun;270(4):403-412. doi: 10.1007/s00406-019-01068-z. Epub 2019 Sep 28.


We conducted a systematic review of meta-analyses and systematic reviews to evaluate the impact of cannabis use on the onset and course of psychoses. Following a systematic literature search of five data bases (2005-2016) and consecutive structured evaluation, we were able to include 26 systematic reviews and meta-analyses. The methodological quality of the included publications were in the range of high and poor. The scientific literature indicates that psychotic illness arises more frequently in cannabis users compared to non-users, cannabis use is associated with a dose-dependent risk of developing psychotic illness, and cannabis users have an earlier onset of psychotic illness compared to non-users. Cannabis use was also associated with increased relapse rates, more hospitalizations and pronounced positive symptoms in psychotic patients. We make recommendations about the type of research that is required to better characterize the relationship between cannabis use and the development and outcomes of psychosis.

Keywords: CBD; Cannabinoids; Cannabis; Evidence-based medicine; Psychosis; Schizophrenia; THC.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Humans
  • Marijuana Use / adverse effects*
  • Marijuana Use / epidemiology*
  • Psychotic Disorders / epidemiology*
  • Psychotic Disorders / etiology*