This study aimed to assess:

1. a) the socio-demographic characteristics of patients with schizophrenia who were using cannabis at time of first appearing of psychotic symptoms;

2. b) the impact of cannabis on the duration of untreated psychosis (DUP) and on pathways to care;

3. c) the influence of cannabis on the clinical onset and on the first three years of the disorder.

Twenty-two patients with a recent onset (< 3 years) of schizophrenia were consequently recruited at the Department of Psychiatry of the University of Naples SUN. Socio-demographic characteristics, pathways to care and DUP were investigated by ad-hoc schedules.

About 60% of patients were using cannabis at onset of schizophrenia. All of them were male and did not have a job and with a lower education level. “Cannabis users” had a first contact with general practitioners earlier than “non cannabis users”, but their DUP was longer, as a consequence of significant delays in access to mental health care. Cannabis users showed higher rates of suicide attempts and relapses in the first three years, suggesting a more severe course of the disorder in the “critical period” of schizophrenia in this population.

The results of the study emphasize the need:

1. a) to carry out sensitization campaigns among young people in order to reduce the use of cannabis and other illicit drugs;

2. b) to promote information on schizophrenia for general practitioners.