Impact of Cannabis Use on Long-Term Remission in Bipolar I and Schizoaffective Disorder.
- Author:
Sung Wan KIM
1
;
Seetal DODD
;
Lesley BERK
;
Jayashri KULKARNI
;
Anthony DE CASTELLA
;
Paul B FITZGERALD
;
Jae Min KIM
;
Jin Sang YOON
;
Michael BERK
Author Information
- Publication Type:Original Article
- Keywords: Cannabis; Bipolar disorder; Schizoaffective disorder; Observational study; Substance; Remission
- MeSH: Bipolar Disorder; Cannabis*; Depression; Female; Follow-Up Studies; Humans; Male; Observational Study; Outcome Assessment (Health Care); Prospective Studies; Psychotic Disorders*; Smoking
- From:Psychiatry Investigation 2015;12(3):349-355
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To investigate the impact of regular cannabis use on long-term remission of mood symptoms in bipolar spectrum disorders. METHODS: The 24-month prospective observational study included patients (n=239) with bipolar I disorder and schizoaffective disorder, bipolar type. Participants were classified as regular cannabis users (three times or more per week) or non-users. The primary outcome measure was the achievement of remission on the evaluations during the 24 months. RESULTS: Of the 234 participants for whom data was available, 25 (10.7%) were regular cannabis users, and the group comprised significantly more males than females. In the total population, cannabis use was significantly associated with decreased likelihood of remission during the 24-month follow-up period. Subgroup analyses showed that cannabis use was significantly associated with lower remission rates on the Hamilton Depression Rating Scale in females (n=139) and patients prescribed mood stabilizers alone (n=151), whereas in males (n=95) and patients prescribed olanzapine and/or a mood stabilizer (n=83), cannabis use was significantly associated with lower remission rates on the Young Mania Rating Scale. Remission rates were lowest in the concurrent cannabis and tobacco smoking group (n=22) followed by the tobacco smoking only group (n=97), and the non-smoker group (n=116). The post-hoc analysis revealed that all remission rates were significantly lower in the concurrent cannabis and the tobacco smoking group compared to the non-smoker group. CONCLUSION: Cannabis use negatively affects the long-term clinical outcome in patients with bipolar spectrum disorders. A comprehensive assessment and integrated management of cannabis use are required to achieve better treatment outcomes for bipolar spectrum disorders.
