Clinical Investigation on the Impact of Cannabis Abuse on Thyroid Hormones and Associated Psychiatric Manifestations in the Male Population.

Anum Muzaffar,Binish Javed,Ahmed M El-Shehawi,Abuzar Khan,Javed Ali,Fazal Subhan,Ameer Khusro,Sarah Albogami,Talha Bin Emran,Fazli Khuda,Muhammad Umar Khayam Sahibzada,Zahid Nazar,Sami Ullah,Syed Mehdi Hussain

doi:10.3389/fpsyt.2021.730388

Abstract

Cannabis abuse is a common public health issue and may lead to considerable adverse effects. Along with other effects, the dependence on cannabis consumption is a serious problem which has significant consequences on biochemical and clinical symptoms. This study intends to evaluate the harmful effects of the use of cannabis on thyroid hormonal levels, cardiovascular indicators, and psychotic symptoms in the included patients. This prospective multicenter study was conducted on cannabis-dependent patients with psychotic symptoms (n = 40) vs. healthy control subjects (n = 40). All participants were evaluated for psychiatric, biochemical, and cardiovascular physiological effects. Patients were selected through Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria and urine samples, exclusively for the evaluation of cannabis presence. Serum thyroid stimulating hormone (TSH), T3, and T4 levels were measured using the immunoassay technique. Patients were assessed for severity of depressive, schizophrenic, and manic symptoms using international ranking scales. Various quantifiable factors were also measured for the development of tolerance by cannabis. Among the patients of cannabis abuse, 47.5% were found with schizophrenia, 20% with schizoaffective symptoms, 10% with manic symptoms, and 22.5% with both manic and psychotic symptoms. In the group–group and within-group statistical analysis, the results of thyroid hormones and cardiovascular parameters were non-significant. The psychiatric assessment has shown highly significant (p < 0.001) difference of positive, negative, general psychopathology, and total scores [through Positive and Negative Syndrome Scale (PANSS) rating scales] in patients vs. the healthy control subjects. The study revealed that cannabis abuse did not significantly alter thyroid hormones and cardiovascular parameters due to the development of tolerance. However, the cannabis abuse might have a significant contributing role in the positive, negative, and manic symptoms in different psychiatric disorders.

Highlights

Substance-induced psychosis (SIPs) is a condition in which psychosis begins in the context of substance used and persists for days to weeks in the absence of that agent(s)
The results have shown that thyroid stimulating hormone (TSH), T3, and T4 levels observed in all the patients were within the normal range of reference
Since the results indicated that harmful use of cannabis in schizophrenia is related to the lower intensity of negative symptoms, especially when cannabis is the only drug abused and the user just starts before the onset of schizophrenia, it can be presumed that cannabis use might be a major factor for schizophrenia [36]

Summary

Introduction

Substance-induced psychosis (SIPs) is a condition in which psychosis begins in the context of substance used and persists for days to weeks in the absence of that agent(s). Cannabis is a widely used addictive agent after tobacco and alcohol. It has a prevalence of 3.6% of the local population in Khyber Pakhtunkhwa, Pakistan [2]. Cannabis psychosis arises after consumption of a large quantity of cannabis It is characterized by a number of symptoms, such as hallucinations, misidentifications, delusions and/or ideas of reference (often of a paranoid or persecutory nature), and psychomotor disturbances. These indications begin with the use of cannabis intoxication but continue beyond its usage [3, 4]

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