Dual case study of continued use vs cessation of cannabis in psychosis: a theoretically informed approach to a hard problem
ISSN: 1757-0972
Article publication date: 10 February 2022
Issue publication date: 8 March 2022
Abstract
Purpose
Cannabis use in the context of psychosis has been shown to have a negative impact on prognosis and yet it is difficult to treat. Recent randomized controlled trials all have negative findings and novel approaches is sought after. This paper aims to use an embodied cognition framework to add to the understanding of cannabis use in psychosis.
Design/methodology/approach
The paper presents longitudinal, qualitative data on two individuals diagnosed with schizophrenia and using cannabis at least twice weekly prior to inclusion in the study. Factors influencing cannabis use were mapped in dialogue with the participants. Each participant was interviewed six times over the course of a year. The analysis was informed theoretically to describe processes maintaining or ameliorating cannabis use over time.
Findings
This study shows that a systems approach for understanding changes in cannabis use is meaningful; the richness of observations add to the understanding of differences in outcomes. Findings suggest that reductions in cannabis use in psychosis could be dependent on synergistic effects between contextual conditions. Attending closer to the experience of patients may help inform future interventions. However, interventions focusing on single mechanisms may be futile, if an array of individual, formative experiences are a prerequisite for change. A systemic understanding of dual diagnosis calls for tailored, individualized interventions.
Originality/value
The research tests a novel systemic perspective on cannabis use in psychosis by applying it to qualitative longitudinal data. Adding a systemic perspective may help develop future interventions addressing cannabis use in psychosis, which has long been considered a “hard problem” in dual diagnosis treatment.
Keywords
Acknowledgements
This paper has benefited from valuable feedback on earlier versions provided by Sanneke de Haan, PhD, Tilburg University, and Sidsel Busch, PhD, Competence Center for Dual Diagnosis, Capital Region, Denmark. The article has also benefitted from constructive critique from two anonymous reviewers.
Funding: A.P. Møller og Hustru Chastine Mc-Kinney Møllers Fond til almene Formaal > Fonden til Lægevidenskabens Fremme 17-L-0292.Helsefonden.17-B-0284.
Citation
Larsen, J.L., Johansen, K.S., Nordgaard, J. and Mehlsen, M.Y. (2022), "Dual case study of continued use vs cessation of cannabis in psychosis: a theoretically informed approach to a hard problem", Advances in Dual Diagnosis, Vol. 15 No. 1, pp. 22-36. https://doi.org/10.1108/ADD-11-2021-0013
Publisher
:Emerald Publishing Limited
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