Psychiatry Investig.
2015 Jul;12(3):349-355. 10.4306/pi.2015.12.3.349.
Impact of Cannabis Use on Long-Term Remission in Bipolar I and Schizoaffective Disorder
- Affiliations
-
- 1Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea.
- 2IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, Australia. MIKEBE@BarwonHealth.org.au
- 3Department of Psychiatry, University of Melbourne, Melbourne, Australia.
- 4Centre for Mental Health and Wellbeing Research, School of Psychology, Faculty of Health Deakin University, Geelong, Australia.
- 5Monash Alfred Psychiatry Research Centre, The Alfred Hospital and Monash University, Melbourne, Australia.
- 6Orygen Youth Health Research Centre, Melbourne, Australia.
- 7Florey Institute for Neuroscience and Mental Health, Melbourne, Australia.
- KMID: 2316495
- DOI: http://doi.org/10.4306/pi.2015.12.3.349
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.
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