The Use of Cannabis as a Predictor of Early Onset of Bipolar Disorder and Suicide Attempts

Table 3

Frequency of use of cannabis in bipolar disorder.

Study	Design	Sample ()	Follow-up (in years)	Measures	Comparisons	Frequency of cannabis use
Henquet et al., 2006 [24]	Cohort	4,815 individuals^a; 18–64 years	3	Composite; International; Diagnostic; Interview; (CIDI)	The baseline cannabis use was assessed with the occurrence of mania in the follow-up	Less than once a month; 1–3 days/month; 1-2 days/week; 3-4 days/week and nearly every day.
Tijssen et al., 2010 [25]	Cohort	705 patients; 14–24 years	8	Munich-Compo; site; International; Diagnostic; Interview; (M-CIDI)	The onset of manic/depressive symptoms was assessed with the following risk factors (a family history of mood disorders, trauma, substance use, attention-deficit/hyperactivity disorder (ADHD), and temperamental/personality traits)	Lifetime cannabis use was considered in case they reported at baseline that they had used cannabis five times or more
de Hert et al., 2011 [7]	Cross-; sectional	766 patients (676 with schizophrenia and 90 with bipolar disorder); 16–65 years	—	Composite International Diagnostic Interview (CIDI), Clinical Global; Impression (CGI), and Global Assessment of Functioning (GAF)	A linear regression between the age at onset was done considering the following variables: cannabis use, diagnosis, and gender	Used CIDI (Composite International Diagnostic Interview) for lifetime substance use and classified patients as “heavy users” when consumption was several times a day.
Lagerberg et al., 2011 [26]	Cross-sectional	151 bipolar patients (91 BD I and 60 BD II)	—	Clinical assessments carried out by trained clinical psychologists and psychiatrists	The bivariate analyses revealed significant correlations between age at onset and gender, age, BD type, excessive cannabis use, and sequencing	Patients who met DSM-IV criteria for substance use disorder or had predominant weekly use of cannabis for a period of 4 years from 11–15 years, 16–20 years, 21–27 years, 28–44 years, 45–60 years, and 60 years and more were considered “excessive cannabis use”
LevRan et al., 2013 [9]	Cross-sectional	1,905 bipolar individuals	—	Alcohol use disorder and associated disabilities interview schedule	Rates of CUD in the past 12 months were 7.2%, compared to 1.2% in the general population. Logistic regression models adjusting for sociodemographic variables indicated that cooccurring CUD was at increased risk for nicotine dependence, alcohol and drug use disorders, and antisocial personality; disorder compared to those without CUD.	Number of joints consumed with the number of days when cannabis was used in the last 12 months. Frequency was defined as ranging from “almost daily” to “once a year.”

The sample was found to be representative of the Dutch population in terms of gender, marital status and level of urbanisation, with the exception of a slight under-representation of individuals in the age group 18–24 years.