Cannabinoid use and self-injurious behaviours: A systematic review and meta-analysis

Andrea Escelsior, Martino Belvederi Murri, Giovanni Pietro Corsini, Gianluca Serafini, Andrea Aguglia, Domenico Zampogna, Simone Cattedra, Jacopo Nebbia, Alice Trabucco, Davide Prestia, Martina Olcese, Elena Barletta, Beatriz Pereira da Silva, Mario Amore

Research output: Contribution to journalReview articlepeer-review


Background: The increasing availability of high-potency cannabis-derived compounds and the use of synthetic cannabinoids may be responsible for severe side effects like cognitive impairment, psychosis or self-injurious behaviours (SIB). In particular, SIB like non-suicidal self-injury (NSSI) and deliberate self-harm (DSH) raise growing concern as a possible consequence of cannabis use. However, the research to date has not addressed the relationship between cannabinoid use and SIB systematically. Methods: We conducted a systematic review on PubMed up to March 2020, using search terms related to cannabinoids and SIB. Results: The search yielded a total of 440 abstracts. Of those, 37 studies published between 1995 and 2020 were eligible for inclusion. Cannabinoid use was significantly associated with SIB at the cross-sectional (OR=1.569, 95%CI [1.167–2.108]) and longitudinal (OR=2.569, 95%CI [2.207–3.256]) level. Chronic use, presence of mental disorders, depressive symptoms, emotional dysregulation and impulsive traits might further increase the likelihood of self-harm in cannabis users. Synthetic cannabinoids may trigger highly destructive SIB mainly through the psychotomimetic properties of these compounds. Conclusion: Cannabinoid use was associated with an increased prevalence of self-injury and may act as a causative factor with a duration-dependent manner. Emotional regulation and behavioural impulsivity functions might crucially moderate this association. Future studies should further investigate the mechanisms underlying this association, while exploring potential therapeutic applications of substances modulating the endocannabinoid system.

Original languageEnglish
Pages (from-to)85-98
Number of pages14
JournalJournal of Affective Disorders
Publication statusPublished - Jan 1 2021


  • Cannabis
  • Deliberate self-harm
  • Marijuana
  • Non-suicidal self injury
  • Novel psychoactive substances
  • Synthetic cannabinoid

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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