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Cannabis and bipolar disorder: does quitting cannabis use during manic/mixed episode improve clinical/functional outcomes?
Author(s) -
Zorrilla I.,
Aguado J.,
Haro J. M.,
Barbeito S.,
López Zurbano S.,
Ortiz A.,
López P.,
GonzalezPinto A.
Publication year - 2015
Publication title -
acta psychiatrica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.849
H-Index - 146
eISSN - 1600-0447
pISSN - 0001-690X
DOI - 10.1111/acps.12366
Subject(s) - cannabis , bipolar disorder , mania , psychiatry , observational study , medicine , logistic regression , bipolar i disorder , psychology , clinical psychology , mood
Objective To examine whether bipolar disorder patients who stop cannabis use during a manic/mixed episode have better clinical and functional outcomes than continued use or never use. Method Data from the European Mania in Bipolar Longitudinal Evaluation of Medication ( EMBLEM ), a 2‐year prospective observational study in adults with a manic/mixed episode of bipolar disorder, was used. Three cannabis use groups were: current use (between 12‐week and 24‐month visits); no current but previous use (during first 12 weeks); and never use. Associations between cannabis use and outcomes were analyzed using regression models. Results Of 1922 patients analyzed, 6.9% were current users, 4.6% previous users, and 88.5% never users. Clinical outcomes differed between groups ( P < 0.019): previous users had highest rates of remission (68.1%) and recovery (38.7%), and lowest rates of recurrence (42.1%) and relapse (29.8%). Logistic regression showed previous users had similar outcomes to never users (all P > 0.05), whereas current users had lower recovery ( P = 0.004) and remission ( P = 0.014), higher recurrence ( P = 0.014), greater work impairment ( P = 0.016), and were more likely not to be living with partner ( P = 0.006) than never users. Conclusion Bipolar patients who stop using cannabis during manic/mixed episode have similar clinical and functional outcomes to never users, while continued use is associated with higher risk of recurrence and poorer functioning.