Demographic and clinical characteristics associated with comorbid cannabis use disorders (CUDs) in hospitalized patients with bipolar I disorder

Compr Psychiatry. 2016 Feb:65:57-62. doi: 10.1016/j.comppsych.2015.10.003. Epub 2015 Oct 23.

Abstract

Background: Published data suggest that cannabis use is associated with several negative consequences for individuals with bipolar disorder (BD), including new manic episode onset, psychosis, and functional disability. Yet much less is known about cannabis use disorders (CUDs) in this population, especially in more acutely symptomatic groups.

Methods: To evaluate correlates of CUD comorbidity in BD, a retrospective chart review was conducted for 230 adult patients with bipolar I disorder (BDI) who were admitted to a university-affiliated private psychiatric hospital. Using a computer algorithm, a hospital administrator extracted relevant demographic and clinical data from the electronic medical record for analysis.

Results: Thirty-six (16%) had a comorbid CUD. CUD comorbidity was significantly associated with younger age, manic/mixed episode polarity, presence of psychotic features, and comorbid nicotine dependence, alcohol use disorder (AUD), and other substance use disorders, but was associated with decreased likelihood of anxiety disorder comorbidity. With the exception of manic/mixed polarity and AUD comorbidity, results from multivariate analyses controlling for the presence of other SUDs were consistent with univariate findings.

Conclusion: Patients with BD and comorbid CUDs appear to be a complex population with need for enhanced clinical monitoring. Given increasing public acceptance of cannabis use, and the limited availability of evidenced-based interventions targeted toward CUDs in BD, psychoeducation and other treatment development efforts appear to be warranted.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alcohol-Related Disorders / epidemiology
  • Bipolar Disorder / epidemiology
  • Cannabis
  • Comorbidity
  • Female
  • Humans
  • Inpatients* / psychology
  • Inpatients* / statistics & numerical data
  • Male
  • Marijuana Smoking / epidemiology*
  • Marijuana Smoking / psychology*
  • Medical Records
  • Middle Aged
  • Psychotic Disorders / epidemiology
  • Retrospective Studies
  • Substance-Related Disorders / epidemiology*