Socioenvironmental and Developmental Predictors of Cannabis Initiation and Use in Psychosis: a Systematic Scoping Review

Abstract Purpose of Review Despite significant attention directed towards examining the effect of cannabis use on psychosis pathology, little is known about socioenvironmental or developmental predictors of cannabis use and initiation nor about motivations for cannabis initiation in psychosis populations. This is especially salient given that individuals across the psychosis spectrum have been shown to both use cannabis at higher rates and initiate cannabis significantly earlier in life compared to healthy counterparts, which have independently been associated with poorer outcomes in psychosis-spectrum groups. The present systematic scoping review therefore aims to increase knowledge regarding correlates of cannabis use and initiation across the psychosis continuum with particular attention to potentially modifiable risk factors and to opportunities for prevention and intervention. Recent Findings A systematic scoping review evaluated literature from several medical databases (PubMed (MedLine), SCOPUS, PsycInfo, Embase) through an iterative review process following PRISMA-ScR guidelines. A priori inclusion and exclusion criteria were used to determine eligibility of studies. The initial searches yielded 3549 studies. The subsequent review process involved the collaborative title and abstract screening of 2983 studies. 415 studies were reviewed in full, and 33 studies remained for extraction and were included in the final review. Summary Collectively, findings from this review point most strongly to the impact of acculturation, early life adversity, premorbid functioning, developmental conditions, social pressure, and availability of cannabis on initiation and use in psychosis cohorts. Findings from this review may inform broad-spectrum early intervention strategies related to cannabis use prevention that have clinical utility in both psychosis-spectrum and healthy populations.