title: The Use of Cannabis as a Predictor of Early Onset of Bipolar Disorder and Suicide Attempts.
abstract: Introduction. Bipolar disorder (BD) implies risk of suicide. The age at onset (AAO) of BD carries prognostic significance. Substance abuse may precede the onset of BD and cannabis is the most common illicit drug used. The main goal of this study is to review the association of cannabis use as a risk factor for early onset of BD and for suicide attempts. Materials and Methods. PubMed database was searched for articles using key words "bipolar disorder," "suicide attempts," "cannabis," "marijuana," "early age at onset," and "early onset." Results. The following percentages in bipolar patients were found: suicide attempts 3.6-42%; suicide attempts and substance use 5-60%; suicide attempts and cannabis use 15-42%. An early AAO was associated with cannabis misuse. The mean age of the first manic episode in individuals with and without BD and cannabis use disorder (CUD) was 19.5 and 25.1 years, respectively. The first depressive episode was at 18.5 and 24.4 years, respectively. Individuals misusing cannabis showed increased risk of suicide. Discussion. Cannabis use is associated with increased risk of suicide attempts and with early AAO. However, the effect of cannabis at the AAO and suicide attempts is not clear.
authors.affiliation: Faculty of Medicine, University of Fortaleza, 221 Desembargador Floriano Benevides Street, 60811-905 Fortaleza, CE, Brazil.
authors.forename: Rafaela Torres Portugal
authors.initials: RT
authors.lastname: Leite
authors.affiliation: Department of Psychology, Federal University of Ceará, 2762 Universidade Avenida, 60020-181 Fortaleza, CE, Brazil.
authors.forename: Sarah de Oliveira
authors.initials: Sde O
authors.lastname: Nogueira
authors.affiliation: Faculty of Medicine, Christus University Center, 133 João Adolfo Gurgel Street, Fortaleza, CE, Brazil.
authors.forename: João Paulo Rodrigues
authors.initials: JP
authors.lastname: do Nascimento
authors.affiliation: Department of Psychology, Federal University of Ceará, 2762 Universidade Avenida, 60020-181 Fortaleza, CE, Brazil.
authors.forename: Laisa Soares
authors.initials: LS
authors.lastname: de Lima
authors.affiliation: Department of Psychology, Federal University of Ceará, 2762 Universidade Avenida, 60020-181 Fortaleza, CE, Brazil.
authors.forename: Taís Bastos
authors.initials: TB
authors.lastname: da Nóbrega
authors.affiliation: Department of Psychology, Federal University of Ceará, 2762 Universidade Avenida, 60020-181 Fortaleza, CE, Brazil.
authors.forename: Mariana da Silva
authors.initials: Mda S
authors.lastname: Virgínio
authors.affiliation: Faculty of Medicine, Federal University of Ceará, 949 Alexandre Baraúna Street, 60430-160 Fortaleza, CE, Brazil.
authors.forename: Lucas Monte da Costa
authors.initials: LM
authors.lastname: Moreno
authors.affiliation: Department of Psychology, Federal University of Ceará, 2762 Universidade Avenida, 60020-181 Fortaleza, CE, Brazil.
authors.forename: Bruno Henrique Barbosa
authors.initials: BH
authors.lastname: Sampaio
authors.affiliation: Department of Clinical Medicine, Federal University of Ceará, 1290 Capitão Francisco Pedro Street, 60430-140 Fortaleza, CE, Brazil.
authors.forename: Fábio Gomes
authors.initials: FG
authors.lastname: de Matos E Souza
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000523:psychology; D011379:Prognosis; D012307:Risk Factors; D013406:Suicide, Attempted; D055815:Young Adult