title: Psychiatric comorbidity associated with synthetic cannabinoid use compared to cannabis.
abstract: Synthetic cannabinoids (SC) use has had a dramatic increase in recent years, but data regarding their adverse effects on mental health is limited. In this study, we compared clinical presentations of SC users with cannabis users in a psychiatric inpatient setting.
  
  
  
  Digital charts of all patients who were admitted to a dual diagnosis psychiatric unit in one year were reviewed. Patients who had any current substance use disorder were categorized in four groups: (1) SC use and cannabis use (SC+MJ+), (2) SC use without cannabis use (SC+MJ-), (3) cannabis use without SC use (SC-MJ+), and (4) No SC or cannabis use (SC-MJ-).
  
  
  
  A total of 594 charts were included. SC+MJ- patients had significantly more psychotic symptoms (OR: 4.44, 95% CI: 1.98-9.94), followed by SC+MJ+ (OR: 3.61, 95% CI: 1.87-6.97) and SC-MJ+ (OR: 1.87, 95%CI: 1.33-2.64) patients. The SC+MJ- group also had more agitation and aggression was most prominent in SC+MJ+ subjects. Multivariate analyses showed that the psychiatric associations of SC and cannabis use remained significant even after controlling for potential confounds such as other substance use.
  
  
  
  The prominent psychiatric features of SC users as compared to cannabis users in an inpatient setting are psychotic presentations and agitation, which have important treatment implications.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Mount Sinai Beth Israel Medical Center, Icahn School of Medicine at Mount Sinai at New York, NY, USA.
authors.forename: Anahita
authors.initials: A
authors.lastname: Bassir Nia
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Mount Sinai Beth Israel Medical Center, Icahn School of Medicine at Mount Sinai at New York, NY, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Medrano
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Mount Sinai Beth Israel Medical Center, Icahn School of Medicine at Mount Sinai at New York, NY, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Perkel
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Mount Sinai Beth Israel Medical Center, Icahn School of Medicine at Mount Sinai at New York, NY, USA.
authors.forename: Igor
authors.initials: I
authors.lastname: Galynker
authors.affiliation: Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai at New York, Mount Sinai Behavioral Health System, New York, NY, USA yasmin.hurd@mssm.edu.
authors.forename: Yasmin L
authors.initials: YL
authors.lastname: Hurd
mesh_terms: D000328:Adult; D002186:Cannabinoids / Q000009:adverse effects*; D002188:Cannabis / Q000009:adverse effects*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology / Q000209:etiology; D011605:Psychoses, Substance-Induced / Q000453:epidemiology* / Q000209:etiology*; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000209:etiology*; D012189:Retrospective Studies; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000209:etiology
chemical_list: D002186:Cannabinoids
keywords: K2; Spice; Synthetic cannabinoids; agitation; cannabis; psychosis