van der Steur · Brain sciences 2020 · systematic review · n=56 studies

Factors Moderating the Association Between Cannabis Use and Psychosis Risk: A Systematic Review.

Level 3 - non-randomized controlled study

Systematic review of observational and etiological studies

PubMed 32059350 · doi:10.3390/brainsci10020097 · record verified 2026-08-26

What was done

A systematic review conducted according to PRISMA guidelines searching MEDLINE and Embase to identify factors moderating the relationship between cannabis use and psychosis risk. A total of 56 studies were included and qualitatively synthesized.

What was found

Frequent use (particularly daily consumption) and high-potency cannabis were associated with a higher risk of developing psychosis. Genetic factors, particularly those modulating dopamine pathways (such as the AKT1 genotype), moderated this risk. Among individuals at clinical high risk for psychosis, cannabis use was associated with an earlier age of onset and an increased risk of transition to full psychosis. The abstract reports directional associations without quantitative pooled effect estimates.

Why it matters

It highlights that cannabis-associated psychosis risk is not uniform, identifying specific behavioral patterns (frequency, potency) and genetic profiles that could inform targeted harm-reduction and clinical risk stratification.

Limits

The abstract does not provide quantitative meta-analytic effect sizes, confidence intervals, or measures of between-study heterogeneity. As a synthesis of observational studies, the underlying evidence remains susceptible to confounding and retrospective reporting bias.

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