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Sorkhou M, Dent EL, George TP. Cannabis use and mood disorders: a systematic review. Front Public Health 2024; 12:1346207. [PMID: 38655516 PMCID: PMC11035759 DOI: 10.3389/fpubh.2024.1346207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/26/2024] [Indexed: 04/26/2024] Open
Abstract
Background Problematic cannabis use is highly prevalent among people with mood disorders. This underscores the need to understand the effects of cannabis and cannabinoids in this population, especially considering legalization of recreational cannabis use. Objectives We aimed to (1) systematically evaluate cross-sectional and longitudinal studies investigating the interplay between cannabis use, cannabis use disorder (CUD), and the occurrence of mood disorders and symptoms, with a focus on major depressive disorder (MDD) and bipolar disorder (BD) and; (2) examine the effects of cannabis on the prognosis and treatment outcomes of MDD and BD. Methods Following PRISMA guidelines, we conducted an extensive search for English-language studies investigating the potential impact of cannabis on the development and prognosis of mood disorders published from inception through November 2023, using EMBASE, PsycINFO, PubMed, and MEDLINE databases. Results Our literature search identified 3,262 studies, with 78 meeting inclusion criteria. We found that cannabis use is associated with increased depressive and manic symptoms in the general population in addition to an elevated likelihood of developing MDD and BD. Furthermore, we observed that cannabis use is linked to an unfavorable prognosis in both MDD or BD. Discussion Our findings suggest that cannabis use may negatively influence the development, course, and prognosis of MDD and BD. Future well-designed studies, considering type, amount, and frequency of cannabis use while addressing confounding factors, are imperative for a comprehensive understanding of this relationship. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023481634.
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Affiliation(s)
- Maryam Sorkhou
- Institute for Mental Health Policy and Research at CAMH, Toronto, ON, Canada
- Department of Psychiatry, Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Eliza L. Dent
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Tony P. George
- Institute for Mental Health Policy and Research at CAMH, Toronto, ON, Canada
- Department of Psychiatry, Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
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Maggu G, Choudhary S, Jaishy R, Chaudhury S, Saldanha D, Borasi M. Cannabis use and its relationship with bipolar disorder: A systematic review and meta-analysis. Ind Psychiatry J 2023; 32:202-214. [PMID: 38161465 PMCID: PMC10756590 DOI: 10.4103/ipj.ipj_43_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/06/2023] [Accepted: 03/15/2023] [Indexed: 01/03/2024] Open
Abstract
Cannabis use has been stated as a causal risk factor for the occurrence of schizophrenia and other psychotic disorders. There is a dearth of literature stating the association of cannabis with bipolar disorder. This review aimed to find the repercussion of cannabis use on the onset of the first episode of bipolar disorder and the worsening of the symptoms in pre-existing illness. A thorough systematic review of the existing literature was carried out using the PRISMA guidelines. PubMed, Medline, EMBASE, SCOPUS, and Google-scholar databases were searched for studies fitting our study's inclusion and exclusion criteria. A total of 25 studies were included in the systematic review and out of these 25 studies, five prospective studies met the inclusion criteria for the primary outcome meta-analysis. A total sample of 13,624 individuals was included in these five studies. A fixed effect model was used in the meta-analysis of these five studies and it revealed an association between cannabis and bipolar disorder with an effect size of 2.63 (95% CI: 1.95-3.53) (heterogeneity: chi² = 3.01, df = 3 (P = 0.39); I² = 0%). Our findings propose that cannabis use may precipitate or worsen bipolar disorder. This highlights the importance of the detrimental effect of cannabis use on bipolar disorder and the need to discourage cannabis use in the youth culture. High-quality prospective studies are required to delineate the effect of cannabis use on bipolar disorder.
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Affiliation(s)
- Gaurav Maggu
- Department of Psychiatry, Jaipur National University Institute for Medical Sciences and Research Centre, Jagatpura, Jaipur, Rajasthan, India
| | - Swati Choudhary
- Department of Psychiatry, Jaipur National University Institute for Medical Sciences and Research Centre, Jagatpura, Jaipur, Rajasthan, India
| | - Rajon Jaishy
- Department of Psychiatry, Jaipur National University Institute for Medical Sciences and Research Centre, Jagatpura, Jaipur, Rajasthan, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D Y Patil Medical College, Dr. D Y Patil University, Pimpri, Pune, Maharashtra, India
| | - Daniel Saldanha
- Department of Psychiatry, Dr. D Y Patil Medical College, Dr. D Y Patil University, Pimpri, Pune, Maharashtra, India
| | - Manish Borasi
- Department of Psychiatry, Chirayu Medical College and Hospital, Bairagarh, Bhopal, Madhya Pradesh, India
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Tourjman SV, Buck G, Jutras-Aswad D, Khullar A, McInerney S, Saraf G, Pinto JV, Potvin S, Poulin MJ, Frey BN, Kennedy SH, Lam RW, MacQueen G, Milev R, Parikh SV, Ravindran A, McIntyre RS, Schaffer A, Taylor VH, van Ameringen M, Yatham LN, Beaulieu S. Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: A Systematic Review and Recommendations of Cannabis use in Bipolar Disorder and Major Depressive Disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:299-311. [PMID: 35711159 PMCID: PMC10192829 DOI: 10.1177/07067437221099769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Given the increasing acceptability and legalization of cannabis in some jurisdictions, clinicians need to improve their understanding of the effect of cannabis use on mood disorders. OBJECTIVE The purpose of this task force report is to examine the association between cannabis use and incidence, presentation, course and treatment of bipolar disorder and major depressive disorder, and the treatment of comorbid cannabis use disorder. METHODS We conducted a systematic literature review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials from inception to October 2020 focusing on cannabis use and bipolar disorder or major depressive disorder, and treatment of comorbid cannabis use disorder. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was used to evaluate the quality of evidence and clinical considerations were integrated to generate Canadian Network for Mood and Anxiety Treatments recommendations. RESULTS Of 12,691 publications, 56 met the criteria: 23 on bipolar disorder, 21 on major depressive disorder, 11 on both diagnoses and 1 on treatment of comorbid cannabis use disorder and major depressive disorder. Of 2,479,640 participants, 12,502 were comparison participants, 73,891 had bipolar disorder and 408,223 major depressive disorder without cannabis use. Of those with cannabis use, 2,761 had bipolar disorder and 5,044 major depressive disorder. The lifetime prevalence of cannabis use was 52%-71% and 6%-50% in bipolar disorder and major depressive disorder, respectively. Cannabis use was associated with worsening course and symptoms of both mood disorders, with more consistent associations in bipolar disorder than major depressive disorder: increased severity of depressive, manic and psychotic symptoms in bipolar disorder and depressive symptoms in major depressive disorder. Cannabis use was associated with increased suicidality and decreased functioning in both bipolar disorder and major depressive disorder. Treatment of comorbid cannabis use disorder and major depressive disorder did not show significant results. CONCLUSION The data indicate that cannabis use is associated with worsened course and functioning of bipolar disorder and major depressive disorder. Future studies should include more accurate determinations of type, amount and frequency of cannabis use and select comparison groups which allow to control for underlying common factors.
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Affiliation(s)
- Smadar V. Tourjman
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, Quebec, Canada
- Research Center, Institut Universitaire en Santé Mentale de Montréal, Montreal, Quebec, Canada
| | - Gabriella Buck
- Bipolar Disorders Clinic, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Didier Jutras-Aswad
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, Quebec, Canada
| | - Atul Khullar
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Shane McInerney
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Gayatri Saraf
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jairo V. Pinto
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephane Potvin
- Department of Psychiatry and Addiction, Université de Montréal, Montreal, Quebec, Canada
| | | | - Benicio N. Frey
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Raymond W. Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Glenda MacQueen
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Roumen Milev
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
| | - Sagar V. Parikh
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Arun Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Roger S. McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Valerie H. Taylor
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Michael van Ameringen
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Lakshmi N. Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Serge Beaulieu
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Winder GS, Andrews SR, Banerjee AG, Hussain F, Ivkovic A, Kuntz K, Omary L, Shenoy A, Thant T, VandenBerg A, Zimbrean P. Cannabinoids and solid organ transplantation: Psychiatric perspectives and recommendations. Transplant Rev (Orlando) 2022; 36:100715. [PMID: 35853383 DOI: 10.1016/j.trre.2022.100715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/10/2022] [Indexed: 01/01/2023]
Abstract
Cannabinoid use in patients seeking solid organ transplantation (SOT) is an important and unsettled matter which all transplantation clinicians regularly encounter. It is also a multifaceted, interprofessional issue, difficult for any specialty alone to adequately address in a research article or during clinical care. Such uncertainty lends itself to bias for or against cannabinoid use accompanied by inconsistent policies and procedures. Scientific literature in SOT regarding cannabinoids often narrowly examines the issue and exists mostly in liver and kidney transplantation. Published recommendations from professional societies are mosaics of vagueness and specificity mirroring the ongoing dilemma. The cannabinoid information SOT clinicians need for clinical care may require data and perspectives from diverse medical literature which are rarely synthesized. SOT teams may not be adequately staffed or trained to address various neuropsychiatric cannabinoid effects and risks in patients. In this article, authors from US transplantation centers conduct a systematized review of the few existing studies regarding clinician perceptions, use rates, and clinical impact of cannabinoid use in SOT patients; collate representative professional society guidance on the topic; draw from diverse medical literature bases to detail facets of cannabinoid use in psychiatry and addiction pertinent to all transplantation clinicians; provide basic clinical and policy recommendations; and indicate areas of future study.
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Affiliation(s)
| | - Sarah R Andrews
- Johns Hopkins Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, USA
| | | | - Filza Hussain
- Stanford University Department of Psychiatry and Behavioral Sciences, Palo Alto, California, USA
| | - Ana Ivkovic
- Massachusetts General Hospital Department of Psychiatry, Boston, Massachusetts, USA
| | - Kristin Kuntz
- Ohio State University Department of Psychiatry and Behavioral Health, Columbus, Ohio, USA
| | - Lesley Omary
- Vanderbilt University Department of Psychiatry and Behavioral Sciences, Nashville, Tennessee, USA
| | - Akhil Shenoy
- Columbia University Department of Psychiatry, New York City, New York, USA
| | - Thida Thant
- University of Colorado Department of Psychiatry, Aurora, Colorado, USA
| | - Amy VandenBerg
- University of Michigan Department of Psychiatry, Ann Arbor, Michigan, USA
| | - Paula Zimbrean
- Yale University Department of Psychiatry, New Haven, Connecticut, USA
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Kuhns L, Kroon E, Colyer-Patel K, Cousijn J. Associations between cannabis use, cannabis use disorder, and mood disorders: longitudinal, genetic, and neurocognitive evidence. Psychopharmacology (Berl) 2022; 239:1231-1249. [PMID: 34741634 PMCID: PMC9520129 DOI: 10.1007/s00213-021-06001-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 10/11/2021] [Indexed: 12/16/2022]
Abstract
RATIONALE Cannabis use among people with mood disorders increased in recent years. While comorbidity between cannabis use, cannabis use disorder (CUD), and mood disorders is high, the underlying mechanisms remain unclear. OBJECTIVES We aimed to evaluate (1) the epidemiological evidence for an association between cannabis use, CUD, and mood disorders; (2) prospective longitudinal, genetic, and neurocognitive evidence of underlying mechanisms; and (3) prognosis and treatment options for individuals with CUD and mood disorders. METHODS Narrative review of existing literature is identified through PubMed searches, reviews, and meta-analyses. Evidence was reviewed separately for depression, bipolar disorder, and suicide. RESULTS Current evidence is limited and mixed but suggestive of a bidirectional relationship between cannabis use, CUD, and the onset of depression. The evidence more consistently points to cannabis use preceding onset of bipolar disorder. Shared neurocognitive mechanisms and underlying genetic and environmental risk factors appear to explain part of the association. However, cannabis use itself may also influence the development of mood disorders, while others may initiate cannabis use to self-medicate symptoms. Comorbid cannabis use and CUD are associated with worse prognosis for depression and bipolar disorder including increased suicidal behaviors. Evidence for targeted treatments is limited. CONCLUSIONS The current evidence base is limited by the lack of well-controlled prospective longitudinal studies and clinical studies including comorbid individuals. Future studies in humans examining the causal pathways and potential mechanisms of the association between cannabis use, CUD, and mood disorder comorbidity are crucial for optimizing harm reduction and treatment strategies.
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Affiliation(s)
- Lauren Kuhns
- Department of Psychology, Neuroscience of Addiction (NofA, University of Amsterdam, Amsterdam, the Netherlands.
- The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, the Netherlands.
| | - Emese Kroon
- Department of Psychology, Neuroscience of Addiction (NofA, University of Amsterdam, Amsterdam, the Netherlands
- The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, the Netherlands
| | - Karis Colyer-Patel
- Department of Psychology, Neuroscience of Addiction (NofA, University of Amsterdam, Amsterdam, the Netherlands
| | - Janna Cousijn
- Department of Psychology, Neuroscience of Addiction (NofA, University of Amsterdam, Amsterdam, the Netherlands
- The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, the Netherlands
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Selloni A, Bhatia G, Ranganathan M, De Aquino JP. Multimodal Correlates of Cannabis Use among U.S. Veterans with Bipolar Disorder: An Integrated Study of Clinical, Cognitive, and Functional Outcomes. J Dual Diagn 2022; 18:81-91. [PMID: 35430960 PMCID: PMC9794455 DOI: 10.1080/15504263.2022.2053264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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.
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Affiliation(s)
- Alexandria Selloni
- VA Connecticut Healthcare System, 950 Campbell Avenue, Building 36/116A4, West Haven, CT 06516, USA
- Yale University School of Medicine, Department of Psychiatry, 300 George Street, New Haven, CT 06511, USA
| | | | - Mohini Ranganathan
- VA Connecticut Healthcare System, 950 Campbell Avenue, Building 36/116A4, West Haven, CT 06516, USA
- Yale University School of Medicine, Department of Psychiatry, 300 George Street, New Haven, CT 06511, USA
| | - Joao P. De Aquino
- VA Connecticut Healthcare System, 950 Campbell Avenue, Building 36/116A4, West Haven, CT 06516, USA
- Yale University School of Medicine, Department of Psychiatry, 300 George Street, New Haven, CT 06511, USA
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Icick R, Melle I, Etain B, Høegh MC, Gard S, Aminoff SR, Leboyer M, Andreassen OA, Belzeaux R, Henry C, Bjella TD, Kahn JP, Steen NE, Bellivier F, Lagerberg TV. Preventive Medication Patterns in Bipolar Disorder and Their Relationship With Comorbid Substance Use Disorders in a Cross-National Observational Study. Front Psychiatry 2022; 13:813256. [PMID: 35592382 PMCID: PMC9110763 DOI: 10.3389/fpsyt.2022.813256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The potential role of sub-optimal pharmacological treatment in the poorer outcomes observed in bipolar disorder (BD) with vs. without comorbid substance use disorders (SUDs) is not known. Thus, we investigated whether patients with BD and comorbid SUD had different medication regimens than those with BD alone, in samples from France and Norway, focusing on compliance to international guidelines. METHODS Seven hundred and seventy patients from France and Norway with reliably ascertained BD I or II (68% BD-I) were included. Medication information was obtained from patients and hospital records, and preventive treatment was categorized according to compliance to guidelines. We used Bayesian and regression analyses to investigate associations between SUD comorbidity and medication. In the Norwegian subsample, we also investigated association with lack of medication. RESULTS Comorbid SUDs were as follows: current tobacco smoking, 26%, alcohol use disorder (AUD), 16%; cannabis use disorder (CUD), 10%; other SUDs, 5%. Compliance to guidelines for preventive medication was lacking in 8%, partial in 44%, and complete in 48% of the sample. Compliance to guidelines was not different in BD with and without SUD comorbidity, as was supported by Bayesian analyses (highest Bayes Factor = 0.16). Cross national differences in treatment regimens led us to conduct country-specific adjusted regression analyses, showing that (1) CUD was associated with increased antipsychotics use in France (OR = 2.4, 95% CI = 1.4-3.9, p = 0.001), (2) current tobacco smoking was associated with increased anti-epileptics use in Norway (OR = 4.4, 95% CI = 1.9-11, p < 0.001), and (3) AUD was associated with decreased likelihood of being medicated in Norway (OR = 1.2, 95% CI = 1.04-1.3, p = 0.038). CONCLUSION SUD comorbidity in BD was overall not associated with different pharmacological treatment in our sample, and not related to the level of compliance to guidelines. We found country-specific associations between comorbid SUDs and specific medications that warrant further studies.
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Affiliation(s)
- Romain Icick
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,FondaMental Foundation, Créteil, France.,INSERM U1144, Université Paris Cité, Paris, France
| | - Ingrid Melle
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bruno Etain
- FondaMental Foundation, Créteil, France.,INSERM U1144, Université Paris Cité, Paris, France.,Université Paris Cité, Paris, France.,Assistance Publique - Hôpitaux de Paris, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie, Paris, France
| | - Margrethe Collier Høegh
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sébastien Gard
- INSERM U1144, Université Paris Cité, Paris, France.,Hôpital Charles Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire (3/4/7), Bordeaux, France
| | - Sofie R Aminoff
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marion Leboyer
- FondaMental Foundation, Créteil, France.,Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France.,Assistance Publique - Hôpitaux de Paris (AP-HP), HU Henri Mondor, Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Fédération Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), Créteil, France
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Raoul Belzeaux
- Assistance Publique - Hôpitaux de Marseille (AP-HM), Hôpital Sainte-Marguerite, Pôle de Psychiatrie, INT-UMR 7289, CNRS, Aix-Marseille University, Marseille, France
| | - Chantal Henry
- Université Paris Cité, Paris, France.,Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Thomas D Bjella
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jean-Pierre Kahn
- Université de Lorraine, CHRU de Nancy et Pôle de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy, Laxou, France
| | - Nils Eiel Steen
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Frank Bellivier
- FondaMental Foundation, Créteil, France.,INSERM U1144, Université Paris Cité, Paris, France.,Université Paris Cité, Paris, France.,Assistance Publique - Hôpitaux de Paris, GH Saint-Louis - Lariboisière - F. Widal, Département de Psychiatrie, Paris, France
| | - Trine Vik Lagerberg
- Norwegian Centre for Mental Disorders Research (NORMENT), Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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The Prevalence of Cannabis Use Disorder Comorbidity in Individuals With Bipolar Disorder: A Systematic Review and Meta-Analysis. CANADIAN JOURNAL OF ADDICTION 2021. [DOI: 10.1097/cxa.0000000000000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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9
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Icick R, Gard S, M'Bailara K, Biseul I, Samalin L, Brousse G, Flaudias V, Llorca PM, Loftus J, Cussac I, Aubin V, Schwan R, Roux P, Polosan M, Courtet P, Olié E, Henry C, Mazer N, Haffen E, Etain B, Leboyer M, Bellivier F, Belzeaux R, Godin O, Guillaume S. The course of bipolar disorder as a function of the presence and sequence of onset of comorbid alcohol use disorders in outpatients attending the Fondamental Advanced Centres of Expertise. J Affect Disord 2021; 287:196-203. [PMID: 33799038 DOI: 10.1016/j.jad.2021.03.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The comorbidity of alcohol use disorder (AUD) and bipolar disorder (BD) has been repeatedly associated with poorer clinical outcomes than BD without AUD. We aimed to extend these findings by focusing on the characteristics associated with the sequence of onset of BD and AUD. METHODS 3,027 outpatients from the Fondamental Advanced Centres of Expertise were ascertained for BD-1, BD-2 and AUD diagnoses, including their respective ages at onset (AAOs, N =2,804). We selected the variables associated with both the presence and sequence of onset of comorbid AUD using bivariate analyses corrected for multiple testing to enter a binary regression model with the sequence of onset of BD and AUD as the dependent variable (AUD first - which also included 88 same-year onsets, vs. BD first). RESULTS BD patients with comorbid AUD showed more severe clinical profile than those without. Compared to BD-AUD (N =269), AUD-BD (N =276) was independently associated with a higher AAO of BD (OR =1.1, p <0.001), increased prevalence of comorbid cannabis use disorder (OR =2.8, p <0.001) a higher number of (hypo)manic/mixed BD episodes per year of bipolar illness (OR =3, p <0.01). LIMITATIONS The transversal design prevents from drawing causal conclusions. CONCLUSION Increased severity of BD with AUD compared to BD alone did not differ according to the sequence of onset. A few differences, though, could be used to better monitor the trajectory of patients showing either one of these disorders.
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Affiliation(s)
- Romain Icick
- Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de psychiatrie et de Médecine Addictologique, Paris, France. Fédération Hospitalo-Universitaire 'FHU NOR-SUD'.; Université de Paris, UMR-S 1144, Paris, France.
| | - Sébastien Gard
- Fondation Fondamental, Créteil, France; Hôpital Charles Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire (3/4/7), Bordeaux, France
| | - Katia M'Bailara
- Fondation Fondamental, Créteil, France; Hôpital Charles Perrens, Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire (3/4/7), Bordeaux, France
| | - Isabelle Biseul
- Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de psychiatrie et de Médecine Addictologique, Paris, France. Fédération Hospitalo-Universitaire 'FHU NOR-SUD'
| | - Ludovic Samalin
- Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Georges Brousse
- Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Valentin Flaudias
- Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Pierre-Michel Llorca
- Fondation Fondamental, Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
| | - Joséphine Loftus
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Iréna Cussac
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Valérie Aubin
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco
| | - Raymund Schwan
- Université de Lorraine, Inserm U1114, Centre Psychothérapique de Nancy, Nancy, France
| | - Paul Roux
- Fondation Fondamental, Créteil, France; Service Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, Le Chesnay, Université Paris-Saclay, UVSQ, Inserm, CESP, Team "DevPsy", 94807, Villejuif, France
| | - Mircea Polosan
- Fondation Fondamental, Créteil, France; Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U 1216, Grenoble, France
| | - Philippe Courtet
- Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Emilie Olié
- Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
| | - Chantal Henry
- Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, F-75014, Paris, France
| | - Nicolas Mazer
- Fondation Fondamental, Créteil, France; AP-HP, Groupe Hospitalo-universitaire Nord, DMU ESPRIT, service de Psychiatrie et Addictologie. Hopital Louis Mourier, Colombes, Inserm U1266, Faculté de médecine, Université de Paris, France
| | - Emmanuel Haffen
- Fondation Fondamental, Créteil, France; Service de Psychiatrie de l'Adulte, Centres Experts FondaMental, Centre Investigation Clinique 1431-INSERM, EA 481 Neurosciences, Université de Franche Comté, Besançon, France
| | - Bruno Etain
- Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de psychiatrie et de Médecine Addictologique, Paris, France. Fédération Hospitalo-Universitaire 'FHU NOR-SUD'.; Université de Paris, UMR-S 1144, Paris, France
| | - Marion Leboyer
- Fondation Fondamental, Créteil, France; Université Paris Est Créteil, Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, F-94010, Créteil, France - AP-HP, HU Henri Mondor, Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Fédération Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT) F-94010, France
| | - Frank Bellivier
- Fondation Fondamental, Créteil, France; AP-HP, GH Saint-Louis - Lariboisière - Fernand Widal, DMU Neurosciences, Département de psychiatrie et de Médecine Addictologique, Paris, France. Fédération Hospitalo-Universitaire 'FHU NOR-SUD'.; Université de Paris, UMR-S 1144, Paris, France
| | - Raoul Belzeaux
- Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France, INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France
| | - Ophélia Godin
- Fondation Fondamental, Créteil, France; Université Paris Est Créteil, Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie translationnelle, F-94010, Créteil, France - AP-HP, HU Henri Mondor, Département Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Fédération Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT) F-94010, France
| | - Sébastien Guillaume
- Fondation Fondamental, Créteil, France; Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; PSNREC, Univ Montpellier, INSERM, CHU Montpellier, Montpellier, France
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10
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Szabo A, Akkouh IA, Ueland T, Lagerberg TV, Dieset I, Bjella T, Aukrust P, Le Hellard S, Stavrum AK, Melle I, Andreassen OA, Djurovic S. Cannabis Use Is Associated With Increased Levels of Soluble gp130 in Schizophrenia but Not in Bipolar Disorder. Front Psychiatry 2020; 11:642. [PMID: 32714224 PMCID: PMC7343889 DOI: 10.3389/fpsyt.2020.00642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 06/19/2020] [Indexed: 12/17/2022] Open
Abstract
The complex effects of plant cannabinoids on human physiology is not yet fully understood, but include a wide spectrum of effects on immune modulation. The immune system and its inflammatory effector pathways are recently emerging as possible causative factors in psychotic disorders. The present study aimed to investigate whether self-administered Cannabis use was associated with changes in circulating immune and neuroendocrine markers in schizophrenia (SCZ) and bipolar disorder (BD) patients. A screening of 13 plasma markers reflecting different inflammatory pathways was performed in SCZ (n = 401) and BD patients (n = 242) after subdividing each group into Cannabis user and non-user subgroups. We found that i) soluble gp130 (sgp130) concentrations were significantly elevated among Cannabis users in the SCZ group (p = 0.002) after multiple testing correction, but not in BD. ii) Nominally significant differences were observed in the levels of IL-1RA (p = 0.0059), YKL40 (p = 0.0069), CatS (p = 0.013), sTNFR1 (p = 0.031), and BDNF (p = 0.020), where these factors exhibited higher plasma levels in Cannabis user SCZ patients than in non-users. iii) These differences in systemic levels were not reflected by altered mRNA expression of genes encoding sgp130, IL-1RA, YKL40, CatS, sTNFR1, and BDNF in whole blood. Our results show that Cannabis self-administration is associated with markedly higher sgp130 levels in SCZ, but not in BD, and that this phenomenon is independent of the modulation of peripheral immune cells. These findings warrant further investigation into the potential IL-6 trans-signaling modulatory, anti-inflammatory, neuroimmune, and biobehavioral-cognitive effects of Cannabis use in SCZ.
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Affiliation(s)
- Attila Szabo
- NORMENT, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Ibrahim A. Akkouh
- NORMENT, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Thor Ueland
- NORMENT, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Dieset
- NORMENT, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Thomas Bjella
- NORMENT, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Pål Aukrust
- Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
- Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway
- K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway
- K.G. Jebsen Thrombosis Research and Expertise Center, University of Tromsø, Tromsø, Norway
| | - Stephanie Le Hellard
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
- Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Anne-Kristin Stavrum
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
- Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ingrid Melle
- NORMENT, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ole A. Andreassen
- NORMENT, Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
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11
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Sex differences in bipolar disorder: Impact of lifetime cannabis use on clinical course, functioning, and quality of life in bipolar disorder. J Affect Disord 2020; 266:258-262. [PMID: 32056886 DOI: 10.1016/j.jad.2020.01.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/26/2019] [Accepted: 01/12/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Cannabis use is markedly prevalent among patients with bipolar disorder (BD). However, to date, there have been no studies on this issue with a sex-based approach. This study examines if lifetime cannabis use (LCU) is differently associated with clinical course, functioning, and quality of life (QoL) in patients with BD by sex. METHODS Secondary analysis of a cross-sectional, naturalistic, multicentre study. LCU was defined as having had at least one day of use per month for at least 12 consecutive months in a patient's life. RESULTS A total of 224 patients with BD were included (65.2% women). Patients with LCU were younger (p = 0.001) and had their first hospitalization earlier (p<0.005) than those without LCU, regardless of sex. Among women, LCU was associated with being single (p = 0.006), worse sexual functioning (p = 0.006), financial functioning (p = 0.009), QoL [bodily pain (p = 0.009), vitality (p = 0.027), social functioning (p = 0.037), emotional role (p = 0.038), mental health (p = 0.001), and mental summary component (p = 0.012)]. After controlling for confounders, among women, LCU was associated with worse QoL, specifically on bodily pain (p = 0.049) and mental health (p = 0.016) subscales. Among males, no statistically significant differences were found between LCU and no LCU (NLCU) in any of the variables of the study. LIMITATIONS This study was a secondary analysis not powered specifically to analyze cannabis use. CONCLUSIONS LCU was associated with a younger age at first hospitalization in both women and men, while only women reported worse QoL on bodily pain and mental health subscales. Clinicians and public health providers should be aware of this and inform their patients and the general population of these detrimental effects.
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12
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Icick R, Melle I, Etain B, Ringen PA, Aminoff SR, Leboyer M, Aas M, Henry C, Bjella TD, Andreassen OA, Bellivier F, Lagerberg TV. Tobacco smoking and other substance use disorders associated with recurrent suicide attempts in bipolar disorder. J Affect Disord 2019; 256:348-357. [PMID: 31202989 DOI: 10.1016/j.jad.2019.05.075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 04/08/2019] [Accepted: 05/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Suicide attempts (SA) are more frequent in bipolar disorder (BD) than in most other mental disorders. Prevention strategies would benefit from identifying the risk factors of SA recurrence in BD. Substance use disorders (SUD) (including tobacco-related) are strongly associated with both BD and SA, however, their specific role for the recurrence of SA in BD remains inadequately investigated. Thus, we tested if tobacco smoking - with or without other SUDs - was independently associated with recurrent SA in BD. METHODS 916 patients from France and Norway with ascertained diagnoses of BD and reliable data about SA and SUD were classified as having no, single, or recurrent (≥2) SA. Five SUD groups were built according to the presence/absence/combination of tobacco, alcohol (AUD) and cannabis use disorders. Multinomial logistic regression was used to identify the correlates of SA recurrence. RESULTS 338 (37%) individuals reported at least one SA, half of whom (173, 51%) reported recurrence. SUD comorbidity was: tobacco smoking only, 397 (43%), tobacco smoking with at least another SUD, 179 (20%). Regression analysis showed that tobacco smoking, both alone and comorbid with AUD, depressive polarity of BD onset and female gender were independently associated with recurrent SA. LIMITATIONS Lack of data regarding the relative courses of SA and SUD and cross-national differences in main variables. CONCLUSION Tobacco smoking with- or without additional SUD can be important risk factors of SA recurrence in BD, which is likely to inform both research and prevention strategies.
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Affiliation(s)
- R Icick
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France.
| | - I Melle
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - B Etain
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France
| | - P A Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - S R Aminoff
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - M Leboyer
- FondaMental Foundation, Créteil F-94000, France; Inserm U955, Psychiatric Genetics Team, Créteil F-94000, France; Paris Est University, Faculty of medicine, Créteil F-94000, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Henri Mondor, DHU PePsy, Psychiatry Center, Créteil F-94000, France
| | - M Aas
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - C Henry
- FondaMental Foundation, Créteil F-94000, France; Paris Est University, Faculty of medicine, Créteil F-94000, France
| | - T D Bjella
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - O A Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - F Bellivier
- Inserm, U1144, Paris F-75006, France; Paris Diderot University, UMR-S 1144, Paris F-75013, France; Assistance Publique - Hôpitaux de Paris, University Hospitals Saint-Louis - Lariboisière - F. Widal, Departement of Psychiatry and Addiction Medicine, Paris F-75010, France; FondaMental Foundation, Créteil F-94000, France
| | - T V Lagerberg
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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13
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Cannabis use disorder and suicide attempts in bipolar disorder: A meta-analysis. Neurosci Biobehav Rev 2019; 103:14-20. [DOI: 10.1016/j.neubiorev.2019.05.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 12/28/2022]
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14
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Fleiss B, Rivkees SA, Gressens P. Early origins of neuropsychiatric disorders. Pediatr Res 2019; 85:113-114. [PMID: 30367161 DOI: 10.1038/s41390-018-0225-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 08/08/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Bobbi Fleiss
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Scott A Rivkees
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA
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15
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Kiselica AM, Duhig A, Montoya I, Skolnick P, Floyd J, Byars C. A Survey of Payer Perspectives on Cannabis Use Disorder. Subst Use Misuse 2018; 53:2257-2264. [PMID: 29927691 DOI: 10.1080/10826084.2018.1473432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Cannabis use disorder (CUD) as described/defined in DSM 5, is characterized by impaired control of marijuana use and related personal, health, and legal consequences. CUD is a serious public health problem, affecting nearly 6 million individuals in the United States. There are no FDA approved medications to treat this disorder. The lack of available treatment options contributes to uncertainties by drug sponsors about formulary and reimbursement decision-making for CUD pharmacotherapies. OBJECTIVE To addresses this gap by presenting the first findings on managed care payers' perceptions of CUD treatments and clinical trial end points. METHODS An online survey was conducted with 50 payers from managed care organizations. The survey inquired about perceptions of unmet need in CUD treatment, relevant clinical trial end points, disease knowledge, and likelihood of review of new pharmacotherapies. RESULTS The majority of payers (62%) reported that they were at least moderately familiar with CUD treatment end points. Most (80%) rated the unmet need for new pharmacotherapies for CUD as at least moderately important. Payers rated the most important end points for clinical trials as abstinence and decreased resource utilization. Most participants said an FDA approved CUD treatment would be formally reviewed by payers within 6 months (58%) or a year (36%). CONCLUSIONS Based on these findings, payers see an unmet need for CUD treatment. Furthermore, FDA-approved pharmacotherapies for CUD will likely be reviewed quickly by payers, especially if data are provided on the likelihood of achieving abstinence and reduced resource utilization.
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Affiliation(s)
- Andrew M Kiselica
- a Department of Psychology , University of South Florida , Tampa , Florida , USA.,b Xcenda L.L.C., Health Economics and Outcomes Research , Palm Harbor , Florida , USA
| | - Amy Duhig
- b Xcenda L.L.C., Health Economics and Outcomes Research , Palm Harbor , Florida , USA
| | - Ivan Montoya
- c National Institute on Drug Abuse , Division of Therapeutics and Medical Consequences , Bethesda , Maryland , USA
| | - Phil Skolnick
- d Opiant Pharmaceuticals, Inc. , Chief Scientific Officer, Santa Monica , California , USA
| | - Jennifer Floyd
- b Xcenda L.L.C., Health Economics and Outcomes Research , Palm Harbor , Florida , USA
| | - Cigi Byars
- b Xcenda L.L.C., Health Economics and Outcomes Research , Palm Harbor , Florida , USA
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16
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Recherche d’association entre abus de cannabis et bipolarité : étude sur un échantillon de patients hospitalisés pour un trouble bipolaire. Encephale 2018; 44:14-21. [DOI: 10.1016/j.encep.2016.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 07/20/2016] [Accepted: 08/03/2016] [Indexed: 12/22/2022]
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17
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Cortical thickness, cortical surface area and subcortical volumes in schizophrenia and bipolar disorder patients with cannabis use. Eur Neuropsychopharmacol 2018; 28:37-47. [PMID: 29254657 DOI: 10.1016/j.euroneuro.2017.11.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/03/2017] [Accepted: 11/22/2017] [Indexed: 11/20/2022]
Abstract
Cannabis is associated with increased risk for severe mental illness and is commonly used among individuals with schizophrenia or bipolar disorder. In this study we investigated associations between cannabis use and brain structures among patients with schizophrenia or bipolar disorders. Magnetic resonance imaging scans were obtained for 77 schizophrenia and 55 bipolar patients with a history of cannabis use (defined as lifetime use >10 times during one month or abuse/dependence), and 97 schizophrenia, 85 bipolar disorder patients and 277 healthy controls without any previous cannabis use. Cortical thickness, cortical surface area and subcortical volumes were compared between groups. Both hypothesis-driven region-of-interest analyses from 11 preselected brain regions in each hemisphere and exploratory point-by-point analyses were performed. We tested for diagnostic interactions and controlled for potential confounders. After controlling for confounders such as tobacco use and alcohol use disorders we found reduced cortical thickness in the caudal middle frontal gyrus compared to non-user patients and healthy controls. The findings were not significant when patients with co-morbid alcohol and illicit drug use were excluded from the analyses, but onset of cannabis use before illness onset was associated with cortical thinning in the caudal middle frontal gyrus. To conclude, we found no structural brain changes associated with cannabis use among patients with severe mental illness, but the findings indicate excess cortical thinning among those who use cannabis before illness onset. The present findings support the understanding that cannabis use is associated with limited brain effects in schizophrenia as well as bipolar disorder.
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18
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Jia YF, Choi Y, Ayers-Ringler JR, Biernacka JM, Geske JR, Lindberg DR, McElroy SL, Frye MA, Choi DS, Veldic M. Differential SLC1A2 Promoter Methylation in Bipolar Disorder With or Without Addiction. Front Cell Neurosci 2017; 11:217. [PMID: 28785205 PMCID: PMC5520464 DOI: 10.3389/fncel.2017.00217] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 07/06/2017] [Indexed: 12/15/2022] Open
Abstract
While downregulation of excitatory amino acid transporter 2 (EAAT2), the main transporter removing glutamate from the synapse, has been recognized in bipolar disorder (BD), the underlying mechanisms of downregulation have not been elucidated. BD is influenced by environmental factors, which may, via epigenetic modulation of gene expression, differentially affect illness presentation. This study thus focused on epigenetic DNA methylation regulation of SLC1A2, encoding for EAAT2, in BD with variable environmental influences of addiction. High resolution melting PCR (HRM-PCR) and thymine–adenine (TA) cloning with sequence analysis were conducted to examine methylation of the promoter region of the SLC1A2. DNA was isolated from blood samples drawn from BD patients (N = 150) with or without addiction to alcohol, nicotine, or food, defined as binge eating, and matched controls (N = 32). In comparison to controls, the SLC1A2 promoter region was hypermethylated in BD without addiction but was hypomethylated in BD with addiction. After adjusting for age and sex, the association of methylation levels with nicotine addiction (p = 0.0009) and binge eating (p = 0.0002) remained significant. Consistent with HRM-PCR, direct sequencing revealed increased methylation in CpG site 6 in BD, but decreased methylation in three CpG sites (6, 48, 156) in BD with alcohol and nicotine addictions. These results suggest that individual point methylation within the SLC1A2 promoter region may be modified by exogenous addiction and may have a potential for developing clinically valuable epigenetic biomarkers for BD diagnosis and monitoring.
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Affiliation(s)
- Yun-Fang Jia
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, RochesterMN, United States
| | - YuBin Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, RochesterMN, United States
| | | | - Joanna M Biernacka
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, RochesterMN, United States.,Division of Biomedical Statistics and Informatics, Mayo Clinic, RochesterMN, United States
| | - Jennifer R Geske
- Division of Biomedical Statistics and Informatics, Mayo Clinic, RochesterMN, United States
| | - Daniel R Lindberg
- Neurobiology of Disease Program, Mayo Graduate School, Mayo Clinic, RochesterMN, United States
| | - Susan L McElroy
- Lindner Center of HOPE, MasonOH, United States.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, CincinnatiOH, United States
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, RochesterMN, United States
| | - Doo-Sup Choi
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, RochesterMN, United States.,Neurobiology of Disease Program, Mayo Graduate School, Mayo Clinic, RochesterMN, United States.,Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, RochesterMN, United States
| | - Marin Veldic
- Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Mayo Clinic, RochesterMN, United States
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19
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Neural mechanisms of sensitivity to peer information in young adult cannabis users. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2017; 16:646-61. [PMID: 27068178 DOI: 10.3758/s13415-016-0421-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Though social influence is a critical factor in the initiation and maintenance of marijuana use, the neural correlates of influence in those who use marijuana are unknown. In this study, marijuana-using young adults (MJ; n = 20) and controls (CON; n = 23) performed a decision-making task in which they made a perceptual choice after viewing the choices of unknown peers via photographs, while they underwent functional magnetic resonance imaging scans. The MJ and CON groups did not show differences in the overall number of choices that agreed with versus opposed group influence, but only the MJ group showed reaction time slowing when deciding against group choices. Longer reaction times were associated with greater activation of frontal regions. The MJ goup, compared to CON, showed significantly greater activation in the caudate when presented with peer information. Across groups, caudate activation was associated with self-reported susceptibility to influence. These findings indicate that young adults who use MJ may exhibit increased effort when confronted with opposing peer influence, as well as exhibit greater responsivity of the caudate to social information. These results not only better define the neural basis of social decisions, but also suggest that marijuana use is associated with exaggerated neural activity during decision making that involves social information.
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20
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Lagerberg TV, Aminoff SR, Aas M, Bjella T, Henry C, Leboyer M, Pedersen G, Bellivier F, Icick R, Andreassen OA, Etain B, Melle I. Alcohol use disorders are associated with increased affective lability in bipolar disorder. J Affect Disord 2017; 208:316-324. [PMID: 27810713 DOI: 10.1016/j.jad.2016.09.062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/15/2016] [Accepted: 09/05/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Affective dysregulation is a core feature of bipolar disorder (BD), and inter-episodic affect lability is associated with more severe outcomes including comorbidity. Rates of daily tobacco smoking and substance use disorders in BD are high. Knowledge regarding relationships between affective lability and abuse of the most commonly used substances such as tobacco, alcohol and cannabis in BD is limited. METHODS We investigated whether dimensions of inter-episodic affective lability as measured with the Affective Lability Scale - short form (ALS-SF) were associated with lifetime daily tobacco use or alcohol (AUD) or cannabis use disorders (CUD) in a sample of 372 French and Norwegian patients with BD I and II. RESULTS ALS-SF total score and all sub-dimensions (anxiety-depression, depression-elation and anger) were significantly associated with AUD, while only the depression-elation sub-dimension was associated with CUD, after controlling for possible confounders such as gender, age at interview, age at illness onset, BD subtype, duration of illness and other substance use disorders. Daily tobacco smoking was not significantly associated with affective lability. LIMITATIONS Data for recent substance use or psychiatric comorbidities such as personality or hyperkinetic disorders were not available, and could have mediated the relationships. CONCLUSION AUD is associated with several dimensions of inter-episodic affective lability in BD, while CUD is associated with increased oscillations between depression and elation only. Increased affective lability may partly explain the increased illness severity of patients with BD and AUD or CUD. Affective lability should be treated in order to prevent these comorbidities.
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Affiliation(s)
- Trine Vik Lagerberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Sofie Ragnhild Aminoff
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Specialized Inpatient Treatment, Division of Mental Health Services, Akershus University Hospital, Norway
| | - Monica Aas
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thomas Bjella
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Chantal Henry
- AP-HP, Hôpital H. Mondor - A. Chenevier, DHU Pepsy, Pôle de Psychiatry, Créteil 94000, France; Inserm, U955, Créteil 94000, France; Institut Pasteur, Unité Perception et Mémoire, F-75015 Paris, France; ENBREC, European Network of Bipolar Research Expert Centres, Paris, France
| | - Marion Leboyer
- AP-HP, Hôpital H. Mondor - A. Chenevier, DHU Pepsy, Pôle de Psychiatry, Créteil 94000, France; Inserm, U955, Créteil 94000, France; ENBREC, European Network of Bipolar Research Expert Centres, Paris, France; Fondation FondaMental, Créteil, France
| | - Geir Pedersen
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Oslo University Hospital, Department of Personality Psychiatry, Division of Mental Health and Addiction, Oslo, Norway
| | - Frank Bellivier
- ENBREC, European Network of Bipolar Research Expert Centres, Paris, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France; Inserm, U1144, Paris F-75006, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
| | - Romain Icick
- AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France; Inserm, U1144, Paris F-75006, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Fondation FondaMental, Créteil, France
| | - Bruno Etain
- ENBREC, European Network of Bipolar Research Expert Centres, Paris, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France; Inserm, U1144, Paris F-75006, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Biseul I, Icick R, Seguin P, Bellivier F, Scott J. Feasibility and Acceptability of the 'HABIT' Group Programme for Comorbid Bipolar and Alcohol and Substance use Disorders. Clin Psychol Psychother 2016; 24:887-898. [PMID: 27761983 DOI: 10.1002/cpp.2053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/03/2016] [Accepted: 10/04/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVES We investigated the feasibility and acceptability of an integrated group therapy (called HABIT) for comorbid bipolar disorder (BD) and alcohol and substance use disorders (ASUD) (BD-ASUD), a disabling clinical presentation for which no specific treatment has been validated. The 14-session HABIT programme employs psychoeducation-oriented cognitive-behaviour therapy (CBT) followed by mindfulness-based relapse prevention (MBRP) therapy. METHOD Potential group participants were recruited from adult clients with a DSM-IV diagnosis of BD and an ASUD who were referred by their treating clinician. Observer-rated changes in mood symptoms and ASUD, attendance rates and subjective feedback are reported. RESULTS Eight of 12 clients referred to the programme initially agreed to join the group, six attended the first group session and five clients completed the programme. Group mean scores for mood symptoms improved over time, with slightly greater reductions in depression during the first module. About 50% of individuals showed clinically significant improvement (≥30% reduction) in alcohol and substance use. Attendance rates showed some variability between individuals and across sessions, but the average attendance rate of the group was marginally higher for the first module (86%) as compared with the second module (77%). Most clients reported high levels of general satisfaction with a group specifically targeted at individuals with BD-ASUD. CONCLUSION This small pilot study suggests our intensive group therapy is acceptable and feasible. If findings are replicated, we may have identified a therapy that, for the first time, leads to improvement in both mood and substance use outcomes in clients with difficult-to-treat comorbid BD-ASUD. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Comorbidity between bipolar and alcohol and substance use disorders (BD-ASUD) is frequent and highly disabling; Therapeutic research on approaches that can simultaneously help BD and ASUD is lacking; Previous research highlights the need for integrated treatment of both conditions but showed improvements limited to either element of the comorbid disorder; This pilot study supports the feasibility and acceptability of an intensive, 14-session group therapy programme that integrates CBT and mindfulness approaches.
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Affiliation(s)
- Isabelle Biseul
- Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Fondation FondaMental, Créteil, France
| | - Romain Icick
- Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Fondation FondaMental, Créteil, France.,Inserm, U1144, Paris, France.,Université Paris Descartes, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France
| | - Perrine Seguin
- Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Fondation FondaMental, Créteil, France
| | - Frank Bellivier
- Assistance Publique-Hôpitaux de Paris, GH Saint-Louis-Lariboisière-Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, Paris, France.,Fondation FondaMental, Créteil, France.,Inserm, U1144, Paris, France.,Université Paris Descartes, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, France
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK.,Centre for Affective Disorders, IPPN, London, UK
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Halah MP, Zochniak MP, Barr MS, George TP. Cannabis Use and Psychiatric Disorders: Implications for Mental Health and Addiction Treatment. CURRENT ADDICTION REPORTS 2016. [DOI: 10.1007/s40429-016-0128-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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