Cannabis Use Cessation and the Risk of Psychotic Disorders: A Case–Control Analysis from the First Episode Case–Control EU-GEI WP2 Study: L’arrêt de l’utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l’étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques

Benjamin W. Bond; Bea Duric; Edoardo Spinazzola; Giulia Trotta; Edward Chesney; Zhikun Li; Diego Quattrone; Giada Tripoli; Charlotte Gayer-Anderson; Victoria Rodriguez; Laura Ferraro; Caterina La Cascia; Ilaria Tarricone; Andrei Szöke; Celso Arango; Julio Bobes; Miquel Bernardo; Cristina Marta Del-Ben; Paulo Rossi Menezes; Jean Paul Selten; Bart P.F. Rutten; Lieuwe de Haan; Simona Stilo; Franck Schürhoff; Baptiste Pignon; Tom Freeman; Evangelos Vassos; Robin M. Murray; Isabelle Austin-Zimmerman; Marta Di Forti

doi:10.1177/07067437241290187

Cannabis Use Cessation and the Risk of Psychotic Disorders: A Case–Control Analysis from the First Episode Case–Control EU-GEI WP2 Study: L’arrêt de l’utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l’étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques

Benjamin W. Bond, Bea Duric, Edoardo Spinazzola, Giulia Trotta, Edward Chesney, Zhikun Li, Diego Quattrone, Giada Tripoli, Charlotte Gayer-Anderson, Victoria Rodriguez, Laura Ferraro, Caterina La Cascia, Ilaria Tarricone, Andrei Szöke, Celso Arango, Julio Bobes, Miquel Bernardo, Cristina Marta Del-Ben, Paulo Rossi Menezes, Jean Paul SeltenBart P.F. Rutten, Lieuwe de Haan, Simona Stilo, Franck Schürhoff, Baptiste Pignon, Tom Freeman, Evangelos Vassos, Robin M. Murray, Isabelle Austin-Zimmerman, Marta Di Forti

Research output: Contribution to journal › Article › peer-review

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Abstract

Objectives: To establish whether the risk of psychotic disorders in cannabis users changes with time following cannabis cessation using data from the European Network of National Networks studying Gene–Environment Interactions in Schizophrenia (EU-GEI) case–control study.

Methods: The EU-GEI case–control study collected data from first episode psychosis patients and population controls across sites in Europe and Brazil between May 2010 and April 2015. Adjusted logistic regressions were applied to examine whether the odd of psychosis case status changed: (1) with time following cannabis cessation and (2) across different cannabis use groups.

Results: Psychosis risk declined following cessation of cannabis use (β = −0.002; 95% CI −0.004 to 0.000; P = 0.067). When accounting for duration of use, this effect remained (β = −0.003; 95% CI −0.005 to −0.001; P = 0.013). However, in models adjusting for frequency and potency of use the result was not significant. Analysis of different cannabis use groups indicated that ex-users who stopped 1 to 4 weeks previously had the highest risk for psychotic disorder compared to never users (OR = 6.89; 95% CI 3.91–12.14; P < 0.001); risk declined for those who stopped 5 to 12 weeks previously (OR = 2.70; 95% CI 1.73–4.21; P < 0.001) and 13 to 36 weeks previously (OR = 1.53; 95% CI 1.00–2.33; P = 0.050). Ex-users who stopped 37 to 96 weeks (OR = 1.01; 95% CI 0.66–1.57; P = 0.949), 97 to 180 weeks (OR = 0.73; 95% CI 0.45–1.19; P = 0.204), and 181 weeks previously or more (OR = 1.18; 95% CI 0.76–1.83; P = 0.456) had similar psychosis risk to those who had never-used cannabis.

Conclusion: Risk of psychotic disorder appears to decline with time following cannabis cessation, receding to that of those who have never used cannabis after 37 weeks or more of abstinence. Although, preliminary results suggest that frequent users of high potency types of cannabis might maintain an elevated risk compared to never users even when abstaining for longer than 181 weeks.

Original language	French
Journal	Canadian Journal of Psychiatry
Early online date	15 Jan 2025
DOIs	https://doi.org/10.1177/07067437241290187
Publication status	E-pub ahead of print - 15 Jan 2025

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The EU-GEI project was funded by the European Community's Seventh Framework Programme under grant agreement No. HEALTH-F2-2009-241909 (Project EU-GEI). The Brazilian study was funded by the São Paulo Research Foundation under grant number 2012/0417-0, Medical Research Council (MRC), National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) at South London and Maudsley, NHS Foundation Trust and King's College London and the NIHR BRC at University College London. Wellcome Trust (grant 101272/Z/12/Z). MDF, IAZ, GT, and ES were supported by MRC SRF Fellowship (MRC MR/T007818/1). ES was also supported by Lord Leverhulme's Charitable Trust and the Velvet Foundation and by the Medical Research Council (MRC) [MR/T007818/1]. Dr. Arango receives support from the Spanish Ministry of Science and Innovation, Instituto de Salud Carlos III (ISCIII), co-financed by the European Union, ERDF Funds from the European Commission, “A way of making Europe”, financed by the European Union – NextGenerationEU(PMP21/00051), PI19/01024. CIBERSAM, Madrid Regional Government (B2017/BMD-3740 AGES-CM-2), European Union Structural Funds, European Union Seventh Framework Program, European Union H2020 Program under the Innovative Medicines Initiative 2 Joint Undertaking: Project PRISM-2 (Grant agreement No.101034377), Project AIMS-2-TRIALS (Grant agreement No 777394), Horizon Europe, the National Institute of Mental Health of the National Institutes of Health under Award Number 1U01MH124639-01 (Project ProNET) and Award Number 5P50MH115846-03 (project FEP-CAUSAL), Fundación Familia Alonso, and Fundación Alicia Koplowitz. Funders were not involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review or approval of the manuscript, and decision to submit the manuscript for publication.

Keywords

cannabis potency
cannabis use
cessation
psychotic disorder
risk

ASJC Scopus subject areas

Psychiatry and Mental health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1177/07067437241290187

Cannabis Use Cessation and the Risk of Psychotic Disorders (accepted author manuscript)
Copyright © The Author(s) 2025. Reprinted by permission of SAGE Publications. The final publication is available at The Canadian Journal of Psychiatry via https://doi.org/10.1177/07067437241290187.
Accepted author manuscript, 501 KB

Cite this

Bond, B. W., Duric, B., Spinazzola, E., Trotta, G., Chesney, E., Li, Z., Quattrone, D., Tripoli, G., Gayer-Anderson, C., Rodriguez, V., Ferraro, L., La Cascia, C., Tarricone, I., Szöke, A., Arango, C., Bobes, J., Bernardo, M., Del-Ben, C. M., Menezes, P. R., ... Di Forti, M. (2025). Cannabis Use Cessation and the Risk of Psychotic Disorders: A Case–Control Analysis from the First Episode Case–Control EU-GEI WP2 Study: L’arrêt de l’utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l’étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques. Canadian Journal of Psychiatry. Advance online publication. https://doi.org/10.1177/07067437241290187

Cannabis Use Cessation and the Risk of Psychotic Disorders: A Case–Control Analysis from the First Episode Case–Control EU-GEI WP2 Study: L’arrêt de l’utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l’étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques. / Bond, Benjamin W.; Duric, Bea; Spinazzola, Edoardo et al.
In: Canadian Journal of Psychiatry, 15.01.2025.

Research output: Contribution to journal › Article › peer-review

Bond, BW, Duric, B, Spinazzola, E, Trotta, G, Chesney, E, Li, Z, Quattrone, D, Tripoli, G, Gayer-Anderson, C, Rodriguez, V, Ferraro, L, La Cascia, C, Tarricone, I, Szöke, A, Arango, C, Bobes, J, Bernardo, M, Del-Ben, CM, Menezes, PR, Selten, JP, Rutten, BPF, de Haan, L, Stilo, S, Schürhoff, F, Pignon, B, Freeman, T, Vassos, E, Murray, RM, Austin-Zimmerman, I & Di Forti, M 2025, 'Cannabis Use Cessation and the Risk of Psychotic Disorders: A Case–Control Analysis from the First Episode Case–Control EU-GEI WP2 Study: L’arrêt de l’utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l’étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques', Canadian Journal of Psychiatry. https://doi.org/10.1177/07067437241290187

Bond BW, Duric B, Spinazzola E, Trotta G, Chesney E, Li Z et al. Cannabis Use Cessation and the Risk of Psychotic Disorders: A Case–Control Analysis from the First Episode Case–Control EU-GEI WP2 Study: L’arrêt de l’utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l’étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques. Canadian Journal of Psychiatry. 2025 Jan 15. Epub 2025 Jan 15. doi: 10.1177/07067437241290187

Bond, Benjamin W. ; Duric, Bea ; Spinazzola, Edoardo et al. / Cannabis Use Cessation and the Risk of Psychotic Disorders : A Case–Control Analysis from the First Episode Case–Control EU-GEI WP2 Study: L’arrêt de l’utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l’étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques. In: Canadian Journal of Psychiatry. 2025.

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abstract = "Objectives: To establish whether the risk of psychotic disorders in cannabis users changes with time following cannabis cessation using data from the European Network of National Networks studying Gene–Environment Interactions in Schizophrenia (EU-GEI) case–control study. Methods: The EU-GEI case–control study collected data from first episode psychosis patients and population controls across sites in Europe and Brazil between May 2010 and April 2015. Adjusted logistic regressions were applied to examine whether the odd of psychosis case status changed: (1) with time following cannabis cessation and (2) across different cannabis use groups. Results: Psychosis risk declined following cessation of cannabis use (β = −0.002; 95% CI −0.004 to 0.000; P = 0.067). When accounting for duration of use, this effect remained (β = −0.003; 95% CI −0.005 to −0.001; P = 0.013). However, in models adjusting for frequency and potency of use the result was not significant. Analysis of different cannabis use groups indicated that ex-users who stopped 1 to 4 weeks previously had the highest risk for psychotic disorder compared to never users (OR = 6.89; 95% CI 3.91–12.14; P < 0.001); risk declined for those who stopped 5 to 12 weeks previously (OR = 2.70; 95% CI 1.73–4.21; P < 0.001) and 13 to 36 weeks previously (OR = 1.53; 95% CI 1.00–2.33; P = 0.050). Ex-users who stopped 37 to 96 weeks (OR = 1.01; 95% CI 0.66–1.57; P = 0.949), 97 to 180 weeks (OR = 0.73; 95% CI 0.45–1.19; P = 0.204), and 181 weeks previously or more (OR = 1.18; 95% CI 0.76–1.83; P = 0.456) had similar psychosis risk to those who had never-used cannabis. Conclusion: Risk of psychotic disorder appears to decline with time following cannabis cessation, receding to that of those who have never used cannabis after 37 weeks or more of abstinence. Although, preliminary results suggest that frequent users of high potency types of cannabis might maintain an elevated risk compared to never users even when abstaining for longer than 181 weeks.",

keywords = "cannabis potency, cannabis use, cessation, psychotic disorder, risk",

author = "Bond, {Benjamin W.} and Bea Duric and Edoardo Spinazzola and Giulia Trotta and Edward Chesney and Zhikun Li and Diego Quattrone and Giada Tripoli and Charlotte Gayer-Anderson and Victoria Rodriguez and Laura Ferraro and {La Cascia}, Caterina and Ilaria Tarricone and Andrei Sz{\"o}ke and Celso Arango and Julio Bobes and Miquel Bernardo and Del-Ben, {Cristina Marta} and Menezes, {Paulo Rossi} and Selten, {Jean Paul} and Rutten, {Bart P.F.} and {de Haan}, Lieuwe and Simona Stilo and Franck Sch{\"u}rhoff and Baptiste Pignon and Tom Freeman and Evangelos Vassos and Murray, {Robin M.} and Isabelle Austin-Zimmerman and {Di Forti}, Marta",

year = "2025",

month = jan,

day = "15",

doi = "10.1177/07067437241290187",

language = "French",

journal = "Canadian Journal of Psychiatry",

issn = "0706-7437",

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TY - JOUR

T1 - Cannabis Use Cessation and the Risk of Psychotic Disorders

T2 - A Case–Control Analysis from the First Episode Case–Control EU-GEI WP2 Study: L’arrêt de l’utilisation du cannabis et le risque de troubles psychotiques: Une analyse cas-témoins tirée de l’étude cas-témoins EU-GEI WP2 centrée sur les premiers épisodes psychotiques

AU - Bond, Benjamin W.

AU - Duric, Bea

AU - Spinazzola, Edoardo

AU - Trotta, Giulia

AU - Chesney, Edward

AU - Li, Zhikun

AU - Quattrone, Diego

AU - Tripoli, Giada

AU - Gayer-Anderson, Charlotte

AU - Rodriguez, Victoria

AU - Ferraro, Laura

AU - La Cascia, Caterina

AU - Tarricone, Ilaria

AU - Szöke, Andrei

AU - Arango, Celso

AU - Bobes, Julio

AU - Bernardo, Miquel

AU - Del-Ben, Cristina Marta

AU - Menezes, Paulo Rossi

AU - Selten, Jean Paul

AU - Rutten, Bart P.F.

AU - de Haan, Lieuwe

AU - Stilo, Simona

AU - Schürhoff, Franck

AU - Pignon, Baptiste

AU - Freeman, Tom

AU - Vassos, Evangelos

AU - Murray, Robin M.

AU - Austin-Zimmerman, Isabelle

AU - Di Forti, Marta

PY - 2025/1/15

Y1 - 2025/1/15

N2 - Objectives: To establish whether the risk of psychotic disorders in cannabis users changes with time following cannabis cessation using data from the European Network of National Networks studying Gene–Environment Interactions in Schizophrenia (EU-GEI) case–control study. Methods: The EU-GEI case–control study collected data from first episode psychosis patients and population controls across sites in Europe and Brazil between May 2010 and April 2015. Adjusted logistic regressions were applied to examine whether the odd of psychosis case status changed: (1) with time following cannabis cessation and (2) across different cannabis use groups. Results: Psychosis risk declined following cessation of cannabis use (β = −0.002; 95% CI −0.004 to 0.000; P = 0.067). When accounting for duration of use, this effect remained (β = −0.003; 95% CI −0.005 to −0.001; P = 0.013). However, in models adjusting for frequency and potency of use the result was not significant. Analysis of different cannabis use groups indicated that ex-users who stopped 1 to 4 weeks previously had the highest risk for psychotic disorder compared to never users (OR = 6.89; 95% CI 3.91–12.14; P < 0.001); risk declined for those who stopped 5 to 12 weeks previously (OR = 2.70; 95% CI 1.73–4.21; P < 0.001) and 13 to 36 weeks previously (OR = 1.53; 95% CI 1.00–2.33; P = 0.050). Ex-users who stopped 37 to 96 weeks (OR = 1.01; 95% CI 0.66–1.57; P = 0.949), 97 to 180 weeks (OR = 0.73; 95% CI 0.45–1.19; P = 0.204), and 181 weeks previously or more (OR = 1.18; 95% CI 0.76–1.83; P = 0.456) had similar psychosis risk to those who had never-used cannabis. Conclusion: Risk of psychotic disorder appears to decline with time following cannabis cessation, receding to that of those who have never used cannabis after 37 weeks or more of abstinence. Although, preliminary results suggest that frequent users of high potency types of cannabis might maintain an elevated risk compared to never users even when abstaining for longer than 181 weeks.

AB - Objectives: To establish whether the risk of psychotic disorders in cannabis users changes with time following cannabis cessation using data from the European Network of National Networks studying Gene–Environment Interactions in Schizophrenia (EU-GEI) case–control study. Methods: The EU-GEI case–control study collected data from first episode psychosis patients and population controls across sites in Europe and Brazil between May 2010 and April 2015. Adjusted logistic regressions were applied to examine whether the odd of psychosis case status changed: (1) with time following cannabis cessation and (2) across different cannabis use groups. Results: Psychosis risk declined following cessation of cannabis use (β = −0.002; 95% CI −0.004 to 0.000; P = 0.067). When accounting for duration of use, this effect remained (β = −0.003; 95% CI −0.005 to −0.001; P = 0.013). However, in models adjusting for frequency and potency of use the result was not significant. Analysis of different cannabis use groups indicated that ex-users who stopped 1 to 4 weeks previously had the highest risk for psychotic disorder compared to never users (OR = 6.89; 95% CI 3.91–12.14; P < 0.001); risk declined for those who stopped 5 to 12 weeks previously (OR = 2.70; 95% CI 1.73–4.21; P < 0.001) and 13 to 36 weeks previously (OR = 1.53; 95% CI 1.00–2.33; P = 0.050). Ex-users who stopped 37 to 96 weeks (OR = 1.01; 95% CI 0.66–1.57; P = 0.949), 97 to 180 weeks (OR = 0.73; 95% CI 0.45–1.19; P = 0.204), and 181 weeks previously or more (OR = 1.18; 95% CI 0.76–1.83; P = 0.456) had similar psychosis risk to those who had never-used cannabis. Conclusion: Risk of psychotic disorder appears to decline with time following cannabis cessation, receding to that of those who have never used cannabis after 37 weeks or more of abstinence. Although, preliminary results suggest that frequent users of high potency types of cannabis might maintain an elevated risk compared to never users even when abstaining for longer than 181 weeks.

KW - cannabis potency

KW - cannabis use

KW - cessation

KW - psychotic disorder

KW - risk

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