Our study was carried out to identify distinct sociodemographic and clinical features of cannabis-induced psychosis and schizophrenia. In the present study, it was seen that cannabis intake was high in the male; in our study, no female cannabis user could be taken due to the unavailability. These findings are also supported by the previous studies.[36] It was seen that gender has no role in schizophrenia; it is equally prevalent in men and women. In a comparative study it was found that total number of acute schizophrenia were 35 in which 54.3% were male and rest were female.[3] It is also seen in our study, where in the schizophrenia patients the distribution of male and female patients was 66% and 34% respectively.

In India, the use of cannabis was widely disseminated, both as a medicine and as a recreational drug. Such a broad use may be due to the fact that cannabis maintained a straight association with religion, which sighed sacred virtues to the plant. The Atharva Veda mentions cannabis as one of five sacred plants, referring to it as a source of happiness, donator of joy, and bringer of freedom. Hence, cannabis use became part of numerous religious rituals in that religion.[7] Our study comprised 90% of Hindu males as it is supported in the study by Basu et al.[8] In India, because of its association with religious rituals, cannabis has got social acceptance. It is regarded as a stimulant of religious fervor and used to propitiate Lord by Hindu people.[89] Whereas in the control group, 66% were Hindu and 34% were Sikh. It showed that in schizophrenia religion has no effect.

Literature suggests[3] that family history of psychosis was higher in acute schizophrenia group than in cannabis psychosis and differences between the groups reached statistical significant level. The few studies that have examined family history in cannabis-related psychosis have reported that subjects gave a family history of substance dependence disorders, mental illness, and personality difficulties.[210111213] In all these studies, it was noted that family history of substance abuse was most frequently reported. Family history of drug disorders is regarded as one of the risk factors for developing a drug dependence disorder, including cannabis dependence;[14] whether it also results in increased vulnerability to cannabis psychosis is not clear. In the present study, experimental group had 40% family history of mental illness, while it was 64% in the control group. In the control group, 56% of patients had a family history of schizophrenia; whereas, in the experimental group, only 10% had a family history of schizophrenia while majority of the patients had a family history of substance dependence (22%). The finding of our study is similar with the findings of the previous studies.[313]

In a study,[3] it was found that premorbid schizoid personality traits were significantly more frequent among acute schizophrenia patients (P = 0.0010, Fisher's two-tailed exact test); these subjects were rated as having premorbid antisocial personality traits less frequently than the members of the cannabis psychosis group (P = 0.0300, Fisher's two-tailed exact test). In the present study, it was found that 80% of patients of the experimental group have antisocial premorbid personality, whereas the patients of the control group have 38% schizoid premorbid personality. Thus, the results of our study are similar with the previous study.

In India, the number of drug addicts are increasing day by day. Every year, about 55,000 children take up to smoking generally hailing from low socioeconomic strata with poor social support, broken homes, and victims of deprivation and discrimination. This risky behavior is often initiated during childhood and adolescence, as more than 70% of adult smokers report that they started smoking on a daily basis prior to the age of 18 years.[15] Similarly, in the present study it was seen that smoking (40%) was high in the patients of cannabis psychosis and 96% of patients of the experimental group belonged to the lower socioeconomic status. 96% of patients belonged to the nuclear families, 66% of patients of the experimental group have broken home, and 60% have parental lack before the age of 18 years. 40% of patients have childhood disorder and 66% have disciplinary problems. 40% of patients started taking cannabis before the age of 18 years, while 60% of patients started taking cannabis after the age of 18 years.

Peer smoking also predicts continued smoking among young people who have already begun to smoke.[16] Cannabis abuse in school-going population has been associated with poor scholastic performance, school dropout, and reinforcement of conduct symptoms. In the present study, majority of the patients described that they started taking cannabis due to the enhanced peer relationship. In the present study, 52% of patients of the experimental group have good peer relationship.

In earlier studies it was seen that heavy cannabis smokers reported significantly lower educational attainment and lower income than did control. When asked to the subjective effects of cannabis on career, social life, physical and mental health, and various quality of life measures, a large majority of heavy cannabis smokers reported negative effects of their drug use.[1718] Similar findings are reported by our study, where 60% of patients had poor academic record.

Mental and behavioral effects of marijuana include a state of well-being (euphoria), a feeling of relaxation, perception alterations (changes in shape, color and brightness, time seems slower), loquacity, and an increase in sociability within a specific social environment.[19]

The same kind of findings have found in the present study, where 74% of patients of the experimental group have shown enhanced interaction with people, 72% of patients' self-confidence was high, and 76% of patients were optimistic for future and they were feeling pleasure. Thus, the findings of the previous studies are in favor of the present study.

Another side, inverse finding is found in the control group. They have shown 100% lack of interest in mixing with people and 96% of patients showed lack of interest in work. 88% of patients showed decreased self-confidence and 96% of patients of the control group have shown reduced optimism and feeling pleasures. Poor peer relationship is also noticed in the patients of the control group (52%) because in the patients with schizophrenia, isolated behavior is more prominent. Thus, the findings of the present study confirm that both the groups have shown opposite behavioral patterns.

In a study, Bebbington et al.[20] assessed life events in 97 psychotic patients (52 with schizophrenia) and general population controls. There was a significant relationship between life events and onset of relapse of schizophrenia, although it was not as strong as for depressive psychosis. One possibility is that certain types of schizophrenic patients are particularly vulnerable to relapse following adverse life events. In our study, it was seen that precipitating factor was higher in the control group (22%) compared to the experimental group (4%) and a significant difference between both the groups was at 0.05 level. Similar findings were seen in the area of predisposing factors; it was 62% in the control group and only 18% in the experimental group and the difference between both the groups was at 0.01 level.

In a study,[21] it was seen that majority of patients (59%) of the schizophrenia belonged to the urban domicile. Similar findings were seen in the present study, where 40% of patients of the control group belonged to the urban background. On the other hand, 92% of patients of the experimental group belonged to the rural background.

When we talk about symptomatology and psychopathology, it was seen that few symptoms were prominent in the experimental group compared to the control group such as visual hallucination, grandiose delusion, and religious delusion. Few other symptoms were also seen frequently in the experimental group in comparison to the control group such as pressure of speech, distractible speech, and clanging.