# Endocannabinoid System and Psychosis Risk: Clinical Evidence > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/cannabis-induced-psychosis-clinical-evidence-psychosis-risk/ > **Published:** 2026-04-25T14:18:04-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T11:54:48-04:00 > **Clinical Summary:** Explore clinical evidence on cannabis induced psychosis and its risk for schizophrenia spectrum and bipolar disorder. Understand diagnosis and management. --- #### Clinical Takeaway Cannabis-induced psychosis increases the risk of subsequently developing schizophrenia spectrum and [bipolar disorder](https://cedclinic.com/cannabis-induced-appetite-satiety-bypass-thc-brain/), with prevalence rates varying significantly across studies. Patients experiencing cannabis-induced psychosis require careful diagnostic evaluation and monitoring to identify those at higher risk for transition to primary psychiatric disorders. Early identification and appropriate management may help prevent or delay progression to schizophrenia spectrum conditions or bipolar disorder in vulnerable populations. ### #25 Prevalence of schizophrenia spectrum and bipolar disorder among patients with cannabis induced psychosis: a systematic review and meta-analysis. **Citation:** Javed Mohammad Saad et al. *Prevalence of schizophrenia spectrum and bipolar disorder among patients with cannabis induced psychosis: a systematic review and meta-analysis.* BMC psychiatry. 2026. PMID: 41664079. **Study type:** Journal Article, Systematic Review, Meta-Analysis  |  **Topic area:** Psychosis  |  **CED Score:** 10 Design: 6 Journal: 0 N: 0 Recency: 3 Pop: 2 Human: 1 Risk: -2 **Quality Gate Alerts:** - Preclinical only **Abstract:** BACKGROUND: Distinguishing cannabis-induced psychosis from primary psychiatric disorders is difficult and has significant clinical and prognostic implications. Current treatment approaches lack standardized guidelines, potentially leading to the development of schizophrenia spectrum and bipolar disorder. This study systematically reviews the literature and provides a pooled prevalence of later developing these disorders following a cannabis-induced psychosis diagnosis. METHODS: We systematically reviewed Medline, Embase, Web of Science, Google Scholar, and PsychInfo for studies reporting on a group of patients with cannabis-induced psychosis and subsequent diagnoses of schizophrenia spectrum disorder, bipolar disorder, or both. The search was conducted until January 1, 2025. A modified version of the Newcastle-Ottawa scale was used to assess study quality. Random-effects meta-analyses were conducted to calculate pooled mean prevalence. Random-effects meta-regressions were used to identify predictors of higher prevalence. RESULTS: Our strategy identified 13 studies eligible for inclusion with a total population size of 7,515 which reported a total of 16 outcomes of interest. Among cannabis induced psychosis patients, 20% (95% CI:15.8-29.5%) later received a schizophrenia spectrum diagnosis, 5% (95% CI:2.7-6.9%) bipolar and 63% (95% CI:26.8-90.5%) unspecified (both). Compared to individuals receiving a later schizophrenia spectrum disorder diagnosis, patients were 76% less likely to develop bipolar disorder. Later diagnosis of an unspecified disorder showed an approximate 3 folds higher risk with an ARR of 2.52 (95% CI: 1.03-6.15) compared to schizophrenia spectrum disorder alone. CONCLUSIONS: Approximately one in five patients diagnosed with cannabis-induced psychosis will develop schizophrenia spectrum disorder, while one in twenty will be later diagnosed with bipolar disorder.  |   |  [View on PubMed ↗](https://pubmed.ncbi.nlm.nih.gov/41664079/)[Full Text ↗](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922385/)[DOI ↗](https://doi.org/10.1186/s12888-025-07382-2) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. 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[Read Key Evidence](https://cedclinic.com/cannabis-induced-psychosis-schizophrenia-progression-insights/) [Cannabis-Induced Psychosis: Schizophrenia & Bipolar Risk](https://cedclinic.com/cannabis-induced-psychosis-schizophrenia-bipolar-progression/) Explore the risks of schizophrenia and bipolar disorder following cannabis-induced psychosis in this comprehensive analysis. [Explore Risks](https://cedclinic.com/cannabis-induced-psychosis-schizophrenia-bipolar-progression/) [Prevalence of Schizophrenia Spectrum and Bipolar Disorder Among Patients with Cannabis Induced Psychosis](https://cedclinic.com/cannabis-induced-psychosis-prevalence-schizophrenia-bipolar/) Systematic review and meta-analysis on the prevalence of schizophrenia spectrum and bipolar disorder in cannabis-induced psychosis patients. [View Meta-Analysis](https://cedclinic.com/cannabis-induced-psychosis-prevalence-schizophrenia-bipolar/) Have thoughts on this? 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