Study register · detailKohortenstudie · Psychosis Risk · 2026
The role of hopelessness and depression in cannabis-induced first-episode psychosis: a 24-month prospective study.
Ricci et al.·Addictive behaviorsImpact 3.2
Clear benefitGRADEVery low0 citations
Samplen = 72 Pat.
Duration24 months with follow-ups at 6…
EndpointPANSS
Blindingn.a.
DesignKohortenstudie
”Key finding
Hopelessness and depression are independent predictors of psychosis symptom severity and partially mediate the relationship between cannabis use and persistent psychotic symptoms; addressing them represents a potentially modifiable treatment target.
Summary
Prospective 24-month study on cannabis-induced first-episode psychosis (n=72); hopelessness (beta=0.30, p<0.001) and depression (beta=0.34, p<0.001) independently predict symptom severity. Mediation analysis: hopelessness and depression mediate 31% and 35%, respectively, of the relationship between cannabis use and persistent psychotic symptoms. Combination of high hopelessness, depression and continued cannabis use increases relapse risk (HR=4.32, 95% CI [2.41, 7.75]).
P
PopulationAdults with cannabis-induced first-episode psychosis (CIP), n=72
I
InterventionProspective observation with assessment of hopelessness, depression, psychosis symptoms and cannabis use over 24 months
O
OutcomeHopelessness (β=0,30; p<0,001) and depression (β=0,34; p<0,001) independently predict psychosis symptom severity; combination of high hopelessness, clinically relevant depression and continued cannabis use increases relapse risk (HR=4,32; 95%-CI [2,41; 7,75])
Confidence in the evidence
Very lowLowModerateHigh
Very low
The lowest GRADE level, the effect estimate remains uncertain.
Cannabis use is a recognized risk factor for psychosis, yet the psychological mechanisms mediating this relationship remain incompletely understood. This 24-month prospective observational study investigated the role of hopelessness and depression in the development, maintenance, and outcomes of cannabis-induced first-episode psychosis (CIP). Participants (N = 72) with CIP were assessed at baseline and followed up at 6, 12, and 24 months. Hopelessness (Beck Hopelessness Scale), depressive symptoms (Calgary Depression Scale for Schizophrenia), psychotic symptoms (PANSS), and cannabis use patterns were evaluated. Both hopelessness (beta = 0.30, p < 0.001) and depression (beta = 0.34, p < 0.001) independently predicted psychotic symptom severity after controlling for confounding variables. Mediation analyses revealed that hopelessness and depression partially mediated the relationship between cannabis use and persistent psychotic symptoms, accounting for 31% and 35% of the total effect, respectively. Continued cannabis use during follow-up was associated with increased hopelessness and depression, which predicted worse clinical outcomes. The combination of high hopelessness, clinically significant depression, and continued cannabis use conferred a particularly elevated risk for relapse (HR = 4.32, 95% CI [2.41, 7.75]). These findings highlight the importance of assessing and addressing hopelessness and depression in CIP patients and suggest that these psychological factors represent potentially modifiable treatment targets that may improve outcomes in this vulnerable population.