Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa

Abstract

Background: There is a high prevalence of cannabis use in patients with schizophrenia spectrum and other psychotic disorders, with comorbid cannabis use in this population being associated with poorer long-term outcomes.

Aim: To determine the prevalence of cannabis use in patients with a schizophrenia spectrum and other psychotic disorders.

Setting: The study was conducted at a psychiatric hospital in Durban, KwaZulu-Natal Province, South Africa.

Methods: A review of clinical records of patients admitted to the hospital for the period, June 2018 to June 2020, was conducted.

Results: A total of 370 clinical records were reviewed, of which 48.9% reported current and 51.1% lifetime cannabis use. Being male was significantly associated with current and lifetime cannabis use (OR = 4.90, 95% CI 2.49–9.62 and OR = 6.27, 95% CI 3.28–11.95, respectively). Current alcohol use was also associated with current cannabis use (CCU) (OR = 3.06, 95% CI 1.78–5.28), and age 45 years and older was associated with a lower odds of cannabis use (OR = 0.30, 95% CI 0.09–0.96). Forty-eight per cent of participants were admitted three or more times, and readmission was associated with cannabis use (p = 0.01). There was a lack of association between cannabis use, readmission and human immunodeficiency virus (HIV) status, after controlling for variables such as alcohol use and gender.

Conclusion: Almost 50% of people admitted with schizophrenia spectrum and other psychotic disorders have comorbid current and lifetime cannabis use. There is a need for dual diagnosis units to address comorbid substance use in people with psychotic disorders, as it leads to poorer outcomes.

Contribution: The study found that there is a high prevalence of cannabis use in people with psychosis. Therefore, it is imperative that we revise treatment programs in our psychiatric units and there is an urgent need for dual diagnosis programs that address substance use in this group of patients.