Mental Disorders Associated with the Abuse of Synthetic Cannabinoids (Spices)

Introduction: the abuse of synthetic cannabinoids may trigger the development of mental disorders characterized by distortions of disease processes that can cause incorrect diagnosis.

Objective: to study the phenomenon of the abuse of synthetic cannabinoids (Spice) as a trigger psychotic episode in psychiatric patients (with schizophrenia and personality disorders) and risk factors for developing paranoid schizophrenia.

Patients and research methods: 291 men were examined: 241 with dependence on synthetic cannabinoids — 101 of them were diagnosed with personality and behavior disorders in adulthood, 140 with a diagnosis of paranoid schizophrenia and 50 with a diagnosis of paranoid schizophrenia without drug dependence.

Research methods: clinicalpsychopathological, psychometric (SANS, CGI, MMPI), follow-up, statistical R (R version 3.2.4).

Results: intoxication conditions caused by synthetic cannabinoids can provoke the development of psychotic episodes and be a trigger for the manifestation of schizophrenia. There are four variants of narcotic intoxication: delirious, schizophrenic, with pseudo-hallucinations, with delirium. The personalities of patients addicted to synthetic cannabinoids are similar in the prevalence of emotionally unstable, rigid, introverted, deviant traits. Patients with personality disorders, dependent on synthetic cannabinoids, differed from typical drug addicts in such patterns of behavior as disorganization, conflict, unpredictability, spontaneity, thoughtlessness of actions, impulsivity, and nonconformity. The stigmatizing signs of the schizophrenic process in patients who are dependent on synthetic cannabinoids are the symptoms of abulia–apathy of mild severity. Patients with schizophrenia, dependent on synthetic cannabinoids, differed from patients without dependence on drugs by the phenomenon of the absence of an emotional defect expressed in the expressiveness of emotions, the desire for communication.

Conclusion: the phenomenon of synthetic cannabinoid abuse is a trigger of a psychotic episode in both schizophrenic patients and those with personality disorders in whom antisocial, schizoid and paranoid personality traits prevail. The abuse of synthetic cannabinoids is a risk factor for the development of paranoid schizophrenia, which differs from schizophrenia without drug dependence by a mild degree of stigmatizing symptoms of abulia–apathy and social activity during periods of short-term remissions.

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