Excessive cannabis use is associated with earlier age at onset in bipolar disorder
Open Access
- 26 January 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in Archiv Fur Psychiatrie Und Nervenkrankheiten
- Vol. 261 (6), 397-405
- https://doi.org/10.1007/s00406-011-0188-4
Abstract
The aim of the study was to investigate which factors are associated with age at onset in bipolar disorder with a specific focus on excessive alcohol and cannabis use, and the sequence of the onsets of excessive substance use and bipolar disorder. We investigated a naturalistic sample of 151 patients with bipolar I and II disorder receiving psychiatric treatment. Whether the presence of excessive substance use prior to bipolar disorder onset or the type of substance used (alcohol or cannabis) was associated with differences in age at onset was investigated using hierarchical and multiple linear regression analyses, adjusting for potential confounders. Patients with excessive alcohol use had a significantly later onset compared with patients with excessive cannabis use. Excessive general substance use prior to bipolar disorder onset was associated with a later onset. However, excessive cannabis use was associated with an earlier onset whether it preceded or followed bipolar disorder onset, also after adjusting for possible confounders. Excessive use of alcohol or other substances was not independently associated with age at onset in multivariate analyses. Alcohol use was associated with a later onset compared with cannabis use, suggesting different relationships to the onset of bipolar disorder. Lifetime use of cannabis predicted an earlier onset, independent of the sequence of onsets. This indicates that an early onset may increase the risk of cannabis use and that cannabis use may trigger bipolar disorder in vulnerable individuals.Keywords
This publication has 54 references indexed in Scilit:
- Onset-age of bipolar disorders at six international sitesJournal of Affective Disorders, 2010
- Excessive substance use in bipolar disorder is associated with impaired functioning rather than clinical characteristics, a descriptive studyBMC Psychiatry, 2010
- Cannabis and psychosis/schizophrenia: human studiesArchiv Fur Psychiatrie Und Nervenkrankheiten, 2009
- Psychosis Genetics: Modeling the Relationship Between Schizophrenia, Bipolar Disorder, and Mixed (or "Schizoaffective") PsychosesSchizophrenia Bulletin, 2009
- Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based studyThe Lancet, 2009
- Age of onset and temporal sequencing of lifetime DSM-IV alcohol use disorders relative to comorbid mood and anxiety disordersDrug and Alcohol Dependence, 2008
- Incidence of childhood-onset bipolar illness in the USA and EuropeThe British Journal of Psychiatry, 2008
- Factors Associated With Temporal Priority in Comorbid Bipolar I Disorder and Alcohol Use DisordersBritish Journal of Psychology, 2006
- Clinical features related to age at onset in bipolar disorderJournal of Affective Disorders, 2004
- The effects of antecedent substance abuse on the development of first-episode psychotic maniaJournal of Psychiatric Research, 1996