Abstract

Objective: Cannabis use (CU) is common among persons with bipolar disorder (BD). Evidence suggests that CU is associated with poorer outcomes among persons with BD; however, these findings remain inconsistent. The present exploratory study aims to examine clinical, functional, and cognitive correlates of CU among persons with BD. Methods: U.S. veterans with BD type I who participated in a large-scale, nationwide study were categorized into four groups: current CU, past CU, past other drug use, and no drug use. Bivariate analyses, univariate analyses of covariance, and Levene’s Test for Equality of Variance were used to compare groups on clinical, cognitive, and functional measures. Results: Of 254 (84.6% male) veterans with BD type I included in the analyses, 13 (5.1%) had current CU, 37 (14.5%) past CU, 77 (30.3%) past other drug use, and 127 (50%) reported no drug use. BD with CU was associated with post-traumatic stress disorder (PTSD) and experiencing lifetime suicidal ideation. Notably, current CU was associated with higher working memory performance, compared to both past CU and no drug use. Likewise, current CU was associated with higher functional capacity, compared to past CU as well as no drug use. Conclusions: These findings contribute to the growing literature on the complex effects of cannabis on BD. As the commercialization and legalization of cannabis increases, further research in this area is warranted to quantify posed risks to this population, and thereby guide clinical decision-making.

摘要

目的：大麻使用（CU）在躁郁症（BD）患者中很常见。有证据表明，CU 与 BD 患者的较差预后相关；然而，这些研究结果仍然不一致。本探索性研究旨在检查 BD 患者 CU 的临床、功能和认知相关性。方法：参与一项大规模全国性研究的患有 I 型 BD 的美国退伍军人被分为四组：当前 CU、过去 CU、过去使用其他药物和未使用药物。使用双变量分析、单变量协方差分析和 Levene 方差齐性检验来比较各组的临床、认知和功能测量。结果：分析中包括 254 名患有 I 型 BD 的退伍军人（84.6% 男性），其中 13 名（5.1%）目前患有 CU，37 名（14.5%）过去患有 CU，77 名（30.3%）过去曾使用过其他药物，127 名（50 %) 报告没有吸毒。BD 合并 CU 与创伤后应激障碍 (PTSD) 和经历终生自杀意念有关。值得注意的是，与过去的 CU 和未使用药物相比，当前的 CU 与更高的工作记忆性能相关。同样，与过去的 CU 以及不使用药物相比，当前的 CU 与更高的功能能力相关。结论：这些发现有助于越来越多关于大麻对双相情感障碍复杂影响的文献。随着大麻商业化和合法化的增加，有必要在这一领域进行进一步的研究，以量化对该人群造成的风险，从而指导临床决策。