Objective: Cannabis use disorder (CUD) is increasingly prevalent and often co-occurs with psychiatric and legal complications. While cross-sectional associations between CUD and mental illness are well-documented, longitudinal data on the clinical and forensic trajectories of affected individuals remain limited, particularly in real-world settings.
Methods: This naturalistic follow-up study tracked 51 male patients diagnosed with CUD over a five-year period. Data were collected via structured telephone interviews and hospital records, assessing substance use patterns, psychiatric diagnoses, Alcohol and Substance Addiction Treatment Center (AMATEM) admissions, and legal outcomes. Psychiatric comorbidities were evaluated using medical records, and substance use severity was assessed using the Addiction Profile Index (API).
Results: Over five years, 82.4% of participants continued substance use, with synthetic cannabinoids being the most frequently used substance (76.5%). More than half (64.7%) developed a psychiatric diagnosis, most commonly depression and anxiety. Synthetic cannabinoid use was significantly different in individuals with psychiatric comorbidity (p = .033). AMATEM admissions declined over time but remained higher in patients with psychiatric diagnoses (Year × Diagnosis interaction: F = 2.600, p = .037). Nearly half experienced judicial psychiatric evaluations, and 23.5% had a history of incarceration.
Conclusion: CUD is associated with persistent substance use, high rates of psychiatric comorbidity, and substantial legal-system involvement. Synthetic cannabinoids appear to exacerbate psychiatric outcomes. Long-term, integrated interventions are needed to address dual-diagnosis and reduce forensic burden.
Cannabis use disorder Synthetic cannabinoids Psychiatric comorbidity Substance use Longitudinal study
The study was approved by the Scientific Research Ethics Committee of Sakarya University Faculty of Health Sciences on June 27, 2024 (Approval No: 2024/193).
| Primary Language | English |
|---|---|
| Subjects | Psychiatry |
| Journal Section | Research Article |
| Authors | |
| Submission Date | September 13, 2025 |
| Acceptance Date | November 17, 2025 |
| Early Pub Date | January 28, 2026 |
| Publication Date | January 28, 2026 |
| Published in Issue | Year 2026 Issue: Advanced Online Publication |
Sakarya Medical Journal aims to develop medical science and its members with an open, free, and accessible publishing approach. It presents original and current medical articles to its readers.
Sakarya Medical Journal is a scientific journal that aims to reach all national and international medical institutions and personnel, publishing retrospective, prospective, or experimental research, reviews, case reports, editorial comments/discussion, letters to the editor, and current issues that determine the medical agenda that may be related to every branch of medicine. The journal is published four times a year in March, June, September, and December.
General Information
Sakarya Medical Journal, all national and international medical institutions that publish retrospective, prospective, or experimental research, compilations, case reports, editorial comments/discussions, letters to the editor, surgical techniques, and current issues that determine the medical agenda, which may be related to every field of medicine. It is a scientific journal that aims to reach people and staff.
The journal publishes four issues a year in March, June, September, and December. The official journal publication languages is English. All transactions and applications regarding the journal can be made at http://dergipark.org.tr/smj Studies published in previous issues can be accessed from this address.
Article writing templates:
Click here for the article writing template with 2 or more authors written in English.
Click for sample reference illustrations.
Information for Authors:
Copyright Agreement and Author Acceptance Form must be attached.
Scientific Policies and Ethical Responsibility
The scientific responsibility of the articles belongs to the authors. All authors must actively participate in the study. In order for the submitted articles to be published in the journal, they must not have been previously published in another scientific publication. If the submitted article has been presented at any meeting before, the meeting name, date, and city where it is held must be stated. The protocol of clinical trials must be approved by the ethics committee of the relevant institution. For all studies conducted on humans, the “Methods and Materials” section must include a sentence stating that the study was approved by the relevant committee or that the study was conducted in accordance with the Declaration of Helsinki Principles. (Ethics committee date and protocol number) It should be stated in the text that all people included in the study signed the informed consent form. If the "Animal" element is used in the study, the authors must state in the Materials and Methods section of the article that they protect animal rights in their studies in line with the principles of the Guide for the Care and Use of Laboratory Animals and that they have received approval from the ethics committees of their institutions. Studies based on data older than ten (10) years are not accepted.
Publication Policy and Evaluation Process
All research published in the journal is open-access. The evaluation of the articles submitted to the journal is conducted in three stages. In the first stage, articles are examined in terms of journal standards, and articles that do not comply with the spelling rules are rejected. After the article is edited according to the writing rules, it can be re-uploaded to the journal with the same name. In the second stage, the article is evaluated by the editorial board in terms of content and method. Articles that complete the first two stages go to the third stage and are sent to referees for review. Editorial evaluation and correction are applied to all articles. When necessary, authors may be asked to answer some questions and fill in the gaps. As a result of the evaluation, a decision may be made to accept, request a minor revision, a major revision, or a rewrite, or reject the submission. The article was decided to be published in the journal and taken into the printing process. At this stage, all information is subjected to detailed control and audit for accuracy. It is brought into pre-publication form and submitted to the authors' control and approval. Although the evaluation process takes at least 1.5 months, it can take up to 3-4 months due to the change in the author's response time and referee evaluation periods.
Publication Rights
According to the 1976 Copyright Act, all publishing rights of articles accepted for publication belong to the institution that publishes the journal. Authors must fill out the "Publication Rights Transfer Form" (signed by all authors in blue pen and with wet signatures), which can be accessed from the website http://dergipark.gov.tr/smj, and send it via the DergiPark website.
Preparation of the Article
Statistical Information Note
• The statistical method used should be stated in such detail that a knowledgeable reader with access to the original data can confirm the reported results. Statistical terms, abbreviations and symbols should be defined. An explanation of the computer program and statistical method used should be given. Sources regarding the study design and statistical method should be stated if possible.
• In presenting the results, especially when giving averages and percentages, 2 decimal places should be used after the decimal point (instead of 112.2, such as 112.20 or 112.21). p, t, Z values are exceptions, and 3 digits should be given after the comma (full value p=0.001 instead of p<0.05). Presenting two digits after the comma in representations other than integers, presenting statistical values (such as p, t, z, F, Chi-Square) with three digits after the comma, and presenting p values with test statistics instead of p<0.05 or p>0.05. However, the exact p-value (in case this value is less than one thousandth, p<0.001) must be shown.
Keywords
References
The arrangement of the sources and punctuation must comply with the following examples (Please pay attention to punctuation): For the article, The surname(s) and initial(s) of the author(s), article name, journal name, year, volume, issue, page number must be stated. Example: Dilek ON, Yilmaz S, Degirmenci B, Ali Sahin D, Akbulut G, Dilek FH. The use of a vessel sealing system in thyroid surgery. Acta Chir Belg 2005;105:369-372. For the book, The surname(s) of the author(s) and initial(s) of their name(s), chapter title, name(s) of the editor(s), book title, edition number, city, publishing house, year and pages should be stated. Example: • For books published in foreign languages; Vissers RJ, Abu-Laban RB. Acute and Chronic Pancreatitis. In: Tintinalli JE, Kelen GD, Stapczynski JS (eds.), Emergency Medicine: A Comprehensive Study Guide. 6st ed. New York: McGraw-Hill Co.; 2005. p.573-577. • For Turkish books: Gokce O. Peptic ulcer. Dilek ON, editor. Stomach and Duedon. 1st Edition. Ankara: Anit Printing House; 2001. pp:265- 276. • Format for online publications: DOI is the only acceptable online reference.
Figures, Pictures, Tables, and Graphs
Conflict of interest: If the authors have any conflict of interest, this should be disclosed.
Acknowledgments: This section should include people or institutions that are not mentioned as authors but need to be thanked.
Contribution Rate Statement: In this section, what each researcher contributed to the research should be stated.
• Sakarya Medical Journal does not request any fees for article submission, reviewing and editing processes, page layout, and publication (page or color fees).
• Sakarya Medical Journal does not pay any fees to authors, reviewers, editors, and editorial board members.
• All papers in Sakarya Medical Journal are free to read and download.
• Sakarya Medical Journal signed on to the Budapest Open Access Initiative (BOAI), which promotes free access to research literature and has adopted the Open Access Principles that are clarified in this initiative.
• All papers in Sakarya Medical Journal are archived with the LOCKSS (Lots Of Copies Keep Stuff Safe) system through TUBITAK ULAKBİM DergiPark.
• Sakarya Medical Journal does not accept announcements, advertisements, sponsorships, etc. due to its publication policy.
• All expenses of Sakarya Medical Journal are covered by Sakarya University.