“Bath salts” target the endocannabinoid system in a similar manner to cannabis. In the case of designer drug misuse, subjects seem to be at higher risk of psychotic symptoms.

To investigate the nature and frequency of psychotic symptoms associated with cannabis and/or bath salts misuse in a male inpatient population.

The files of 107 patients admitted to the department of addictions, “Al. Obregia” Psychiatric Hospital Bucharest July 2015–July 2016 were reviewed. Cases had a diagnosis of psychotic disorder with recorded cannabis/bath salts abuse.

Mean age was 26.65 years old (STDV = 5.9). Mean duration of use was of 83.94 months – cannabis; 60.48 months – bath salts and 33.75 months – both substances (BS). Sixty-three patients (73.3%) presented disorganised behaviour; 55.8% (n = 48) formal thought disorder; 45% (n = 39) paranoid delusions. A strong positive association between the length of use of cannabis and disorganised behaviour (n = 33; r = 0.05; P < 0.05) was found. Grandiose ideation was frequent in cannabis users. (X2 = 4.1; n = 0.03; P < 0.05). Multidrug abuse was associated with increased formal thought disorders compared to subjects with cannabis abuse (X2 = 10.9; n = 0.001; P < 0.05). Negative symptoms were more frequent with bath salts users than with users of both substances (X2 = 13.4; X2 = 23.21; X2 = 16.8; P < 0.05).

Positive psychotic symptoms were associated with cannabis and BS abuse, while bath salts promoted negative symptoms.

The author has not supplied his/her declaration of competing interest.