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Cannabis use and mania symptoms : a systematic review and meta-analysis

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Gibbs, Melanie, Winsper, Catherine, Marwaha, Steven, Gilbert, Eleanor, Broome, Matthew R. and Singh, Swaran P. (2015) Cannabis use and mania symptoms : a systematic review and meta-analysis. Journal of Affective Disorders, Volume 171 . pp. 39-47. doi:10.1016/j.jad.2014.09.016 ISSN 0165-0327.

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Official URL: http://dx.doi.org/10.1016/j.jad.2014.09.016

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Abstract

Background:
Whilst cannabis use appears to be a causal risk factor for the development of schizophrenia-related psychosis, associations with mania remain relatively unknown. This review aimed to examine the impact of cannabis use on the incidence of manic symptoms and on their occurrence in those with pre-existing bipolar disorder.

Methods:
A systematic review of the scientific literature using the PRISMA guidelines. PsychINFO, Cochrane, Scopus, Embase and MEDLINE databases were searched for prospective studies.

Results:
Six articles met inclusion criteria. These sampled 2391 individuals who had experienced mania symptoms. The mean length of follow up was 3.9 years.

Studies support an association between cannabis use and the exacerbation of manic symptoms in those with previously diagnosed bipolar disorder. Furthermore, a meta-analysis of two studies suggests that cannabis use is associated with an approximately 3-fold (Odds Ratio: 2.97; 95% CI: 1.80–4.90) increased risk for the new onset of manic symptoms.

Limitations:
We were only able to identify a small number of studies of variable quality, thus our conclusions remain preliminary.

Conclusions:
Our findings whilst tentative, suggest that cannabis use may worsen the occurrence of manic symptoms in those diagnosed with bipolar disorder, and may also act as a causal risk factor in the incidence of manic symptoms. This underscores the importance of discouraging cannabis use among youth and those with bipolar disorder to help prevent chronic psychiatric morbidity. More high quality prospective studies are required to fully elucidate how cannabis use may contribute to the development of mania over time.

Item Type: Journal Article
Alternative Title: Can cannabis trigger mania?
Subjects: R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Manic-depressive persons, Marijuana abuse
Journal or Publication Title: Journal of Affective Disorders
Publisher: Elsevier Science BV
ISSN: 0165-0327
Official Date: 14 January 2015
Dates:
DateEvent
14 January 2015Published
23 September 2014Available
16 September 2014Accepted
4 September 2014Submitted
Volume: Volume 171
Number of Pages: 15
Page Range: pp. 39-47
DOI: 10.1016/j.jad.2014.09.016
Status: Peer Reviewed
Publication Status: Published
Date of first compliant deposit: 28 December 2015
Date of first compliant Open Access: 28 December 2015

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