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Evidence suggests that cannabis-induced psychotic-like experiences may be a marker of psychosis proneness. The effect of such experiences on cannabis use has not systematically been examined.
We undertook a mixed-methods online survey of 1231 cannabis users (including 926 continued users) using the Cannabis Experiences Questionnaire. We examined the effect of psychotic-like and pleasurable experiences on cessation of cannabis and intention to quit. Socio-demographic variables, cannabis use parameters and substance misuse history were included as covariates. Free-text data explored subjective reasons for changes in use.
Cessation of cannabis use was associated with greater psychotic-like experiences [p < 0.001, Exp(B) 1.262, 95% confidence interval (CI) 1.179–1.351], whilst continued cannabis users were more likely to report pleasurable experiences [p < 0.001, Exp(B) 0.717, 95% CI 0.662–0.776]. Intention to quit cannabis in continued users was associated with greater psychotic-like experiences [p < 0.003, Exp(B) 1.131, 95% CI 1.044–1.225], whilst intention to not quit was significantly associated with increased pleasurable experiences [p < 0.015, Exp(B) 0.892, 95% CI 0.814–0.978]. Whereas former users clearly ascribed cessation to negative experiences, continued users who expressed intention to quit less readily ascribed the intention to negative experiences.
Elucidation of psychotic-like experiences may form the basis of a therapeutic intervention for those who wish to quit. Cessation in those with cannabis-induced psychotomimetic experiences may offset the risk for the development of a psychotic disorder, in this higher risk group.
The PRODIGY trial (Prevention of long term social disability amongst
young people with emerging psychological difficulties, ISRCTN47998710) is
a pilot trial of social recovery cognitive–behavioural therapy
The PRODIGY qualitative substudy aimed to (a) explore individual
experiences of participating in the pilot randomised, controlled trial
(recruitment, randomisation, assessment) and initial views of therapy,
and (b) to explore perceived benefits of taking part in research
v. ethical concerns and potential risks.
Qualitative investigation using semi-structured interviews with thematic
Analysis revealed participant experiences around the key themes of
acceptability, disclosure, practicalities, altruism and engagement.
Participants in both trial arms perceived themselves as gaining benefits
from being involved in the study, above and beyond the intervention. This
has implications for the design of future research and services for this
client group, highlighting the importance of being flexible and an
individualised approach as key engagement tools.
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