Demographic and clinical characteristics associated with comorbid cannabis use disorders (CUDs) in hospitalized patients with bipolar I disorder
Open accessAbstract
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.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Cannabis use disorder is associated with younger age, manic/mixed episode polarity, presence of psychotic features, and comorbid nicotine dependence, alcohol use disorder, and other substance use disorders.
“Cannabis use disorder is associated with younger age, manic/mixed episode polarity, presence of psychotic features, and comorbid nicotine dependence, alcohol use disorder, and other SUDs.703”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Dufour, M. C., Compton, W., Pickering, R. P., & Kaplan, K. (2004) · Archives of General Psychiatry · doi:10.1001/archpsyc.61.8.807 · Cited by 2,889 · see citing works
Extent of illicit drug use and dependence, and their contribution to the global burden of disease
Degenhardt, L. J., & Hall, W. (2012) · The Lancet · doi:10.1016/s0140-6736(11)61138-0 · Cited by 1,311 · see citing works
Cerdá, M., Wall, M. M., Keyes, K. M., Galea, S., & Hasin, D. S. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.06.011 · Cited by 490 · see citing works
Grant, B. F., Stinson, F. S., Hasin, D. S., Dawson, D. A., Chou, S. P., Ruan, W. J., & Huang, B. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n1001 · Cited by 479 · cited 1× · see citing works
“The elevated prevalence of substance misuse in bipolar disorder (BD) has been well documented [1], with evidence that rates of comorbid substance use disorders (SUDs) are among the highest in BD relative to the other major psychiatric disorders [2,3].”
BackgroundCannabis use disorders in the USA: prevalence, correlates and co-morbidity
STINSON, F. S., RUAN, W. J., PICKERING, R., & GRANT, B. F. (2006) · Psychological Medicine · doi:10.1017/s0033291706008361 · Cited by 422 · see citing works
Being stoned: a review of self‐reported cannabis effects
Green, B., Kavanagh, D. J., & Young, R. M. (2003) · Drug and Alcohol Review · doi:10.1080/09595230310001613976 · Cited by 390 · see citing works
Schaffer, A., Isometsä, E. T., Tondo, L., H Moreno, D., Turecki, G., Reis, C., Cassidy, F., Sinyor, M., Azorin, J., Kessing, L. V., et al. (2015) · Bipolar Disorders · doi:10.1111/bdi.12271 · Cited by 335 · see citing works
A History of Substance Abuse Complicates Remission From Acute Mania in Bipolar Disorder
Goldberg, J. F., Garno, J. L., Leon, A. C., Kocsis, J. H., & Portera, L. (1999) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v60n1103 · Cited by 238 · see citing works
The impact of substance abuse on the course of bipolar disorder
Strakowski, S. M., DelBello, M. P., Fleck, D. E., & Arndt, S. V. (2000) · Biological Psychiatry · doi:10.1016/s0006-3223(00)00900-8 · Cited by 236 · see citing works
Does cannabis use predict the first incidence of mood and anxiety disorders in the adult population?
Van Laar, M., Van Dorsselaer, S., Monshouwer, K., & De Graaf, R. (2007) · Addiction · doi:10.1111/j.1360-0443.2007.01875.x · Cited by 224 · see citing works
Cannabis use and mania symptoms: A systematic review and meta-analysis
Gibbs, M., Winsper, C., Marwaha, S., Gilbert, E., Broome, M. R., & Singh, S. P. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.09.016 · Cited by 216 · see citing works
Cannabis use and expression of mania in the general population
Henquet, C., A, L. K. M., de Graaf, R., ten Have, M., & van Os, J. (2006) · Journal of Affective Disorders · doi:10.1016/j.jad.2006.05.002 · Cited by 176 · see citing works
The association between cannabis use and mood disorders: A longitudinal study
Feingold, D., Weiser, M., Rehm, J. T., & Lev‐Ran, S. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.10.006 · Cited by 166 · see citing works
Strakowski, S. M., DelBello, M. P., Fleck, D. E., Adler, C. M., Anthenelli, R. M., Keck, P. E., Arnold, L. M., & Amicone, J. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.1.57 · Cited by 165 · see citing works
Bipolar disorder and substance abuse
LEVIN, F. R., & Hennessy, G. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.05.008 · Cited by 142 · see citing works
Cannabis use and cannabis use disorders among individuals with mental illness
Lev‐Ran, S., Foll, B. L., McKenzie, K. J., George, T. P., & Rehm, J. T. (2013) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2012.12.021 · Cited by 140 · see citing works
Drug abuse and bipolar disorder: comorbidity or misdiagnosis?
Brown, E. S., Suppes, T. M., Adinoff, B. H., & Thomas, N. R. (2001) · Journal of Affective Disorders · doi:10.1016/s0165-0327(00)00169-5 · Cited by 130 · see citing works
Lev‐Ran, S., Foll, B. L., McKenzie, K. J., George, T. P., & Rehm, J. T. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2012.12.014 · Cited by 112 · see citing works
Does Cannabis Use Affect Treatment Outcome in Bipolar Disorder?
van Rossum, I., Boomsma, M. M., Tenback, D. E., Reed, C. C., & van Os, J. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e31819292a6 · Cited by 107 · see citing works
Sequencing of substance use and affective morbidity in 166 first‐episode bipolar I disorder patients
Baethge, C., Hennen, J. A., Khalsa, H.-M. K., Salvatore, P., Tohen, M. F., & Baldessarini, R. J. (2008) · Bipolar Disorders · doi:10.1111/j.1399-5618.2007.00575.x · Cited by 101 · see citing works
Aripiprazole for the treatment of tic disorders in children: a systematic review and meta-analysis
Yang, C., Huang, H., Zhang, L., Zhu, C., & Guo, Q. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0504-z · Cited by 89 · see citing works
Cannabis involvement in individuals with bipolar disorder
Arpana Agrawal, A., Nürnberger, J. I., & Lynskey, M. T. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2010.07.007 · Cited by 85 · see citing works
Anxiety and Mood Disorders and Cannabis Use
Cheung, J. T. W., Mann, R. E., Ialomiteanu, A., Stoduto, G., Chan, V., Ala‐Leppilampi, K., & Rehm, J. T. (2010) · The American Journal of Drug and Alcohol Abuse · doi:10.3109/00952991003713784 · Cited by 79 · see citing works
Goldstein, B. I., & LEVITT, A. J. (2008) · Bipolar Disorders · doi:10.1111/j.1399-5618.2008.00461.x · Cited by 72 · see citing works
Substance Use Disorders and Overweight/Obesity in Bipolar I Disorder
McIntyre, R. S., McElroy, S. L., Konarski, J. Z., Soczynska, J. K., Bottas, A., Castel, S., Wilkins, K., & Kennedy, S. H. (2007) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v68n0905 · Cited by 71 · see citing works
Medication burden in bipolar disorder: A chart review of patients at psychiatric hospital admission
Weinstock, L. M., Gaudiano, B. A., Epstein-Lubow, G. P., Tezanos, K. M., Hoyos, C. C.-D., & Miller, I. W. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.01.038 · Cited by 63 · see citing works
Self-citationLagerberg, T., Kvitland, L. R., Aminoff, S., Aas, M., Ringen, P. A., Andreassen, O., & Melle, I. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2013.10.029 · Cited by 52 · see citing works
Zorrilla, E. P., Aguado, J., Haro, J. M., Barbeito, S., López-Zurbano, S., Ortiz, A., López, P., & González-Pinto, A. M. (2014) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12366 · Cited by 51 · see citing works
Impact of substance use on the physical health of patients with bipolar disorder
García‐Portilla, M. P., Sáiz, P. A., Benabarre, A., Flórez, G., Bobes-Bascarán, T., Díaz, E. M. F., Bousoño, M., & Bobes, J. (2009) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2009.01498.x · Cited by 47 · see citing works
Cognitive and clinical outcomes associated with cannabis use in patients with bipolar I disorder
Braga, R. J., Burdick, K. E., DeRosse, P., & Malhotra, A. K. (2012) · Psychiatry Research · doi:10.1016/j.psychres.2012.05.025 · Cited by 41 · see citing works
Cannabis use in first‐treatment bipolar I disorder: relations to clinical characteristics
Kvitland, L. R., Melle, I. S., Aminoff, S. R., Lagerberg, T. V., Andreassen, O. A., & Ringen, P. A. (2014) · Early Intervention in Psychiatry · doi:10.1111/eip.12138 · Cited by 31 · see citing works
Anxiety disorders among patients with co-occurring bipolar and substance use disorders
Kolodziej, M. E., Griffin, M. L., Najavits, L. M., Otto, M. W., Greenfield, S. F., & Weiss, R. D. (2005) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2005.04.003 · Cited by 26 · see citing works
Kvitland, L. R., Melle, I. S., Aminoff, S. R., Demmo, C., Lagerberg, T. V., Andreassen, O. A., & Ringen, P. A. (2015) · BMC Psychiatry · doi:10.1186/s12888-015-0389-x · Cited by 24 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Bond, D. J., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., Beaulieu, S., et al. (2018) · Bipolar Disorders · doi:10.1111/bdi.12609 · Cited by 1,852 · see citing works
Cohen, K., & Weinstein, A. M. (2018) · Frontiers in Public Health · doi:10.3389/fpubh.2018.00162 · Cited by 197 · see citing works
Kuhns, L., Kroon, E., Colyer‐Patel, K., & Cousijn, J. (2021) · Psychopharmacology · doi:10.1007/s00213-021-06001-8 · Cited by 73 · see citing works
Cannabis use disorder and suicide attempts in bipolar disorder: A meta-analysis
Bartoli, F., Crocamo, C., & Carrà, G. (2019) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2019.05.017 · Cited by 52 · see citing works
Cannabis use and mood disorders: a systematic review
Sorkhou, M., Dent, E. L., & George, T. P. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1346207 · Cited by 54 · see citing works
Kozak, K., Smith, P. H., Lowe, D. J. E., Weinberger, A. H., Cooper, Z. D., Rabin, R. A., & George, T. P. (2021) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2021.1946071 · Cited by 38 · see citing works
Tourjman, V., Buck, G., Jutras‐Aswad, D., Khullar, A., McInerney, S. J., Saraf, G., Pinto, J. V., Potvin, S., Poulin, M.-J., Frey, B. N., et al. (2022) · The Canadian Journal of Psychiatry · doi:10.1177/07067437221099769 · Cited by 34 · see citing works
Alcohol use disorders are associated with increased affective lability in bipolar disorder
Lagerberg, T. V., Aminoff, S. R., Aas, M., Bjella, T. D., Henry, C., Leboyer, M., Pedersen, G., Bellivier, F., Icick, R., Andreassen, O. A., et al. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2016.09.062 · Cited by 30 · see citing works
Cannabis use and its relationship with bipolar disorder: A systematic review and meta-analysis
Maggu, G., Choudhary, S., Jaishy, R., Chaudhury, S., Saldanha, D., & Borasi, M. (2023) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_43_23 · Cited by 20 · see citing works
Prisciandaro, J. J., Mellick, W. H., Squeglia, L. M., Hix, S., Arnold, L., & Tolliver, B. K. (2021) · Addiction Biology · doi:10.1111/adb.13085 · Cited by 20 · see citing works
Menculini, G., Steardo, L., Verdolini, N., Cirimbilli, F., Moretti, P., & Tortorella, A. A. V. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.01.001 · Cited by 22 · see citing works
AL-Eitan, L. N., Alhusban, A., & Alahmad, S. Z. (2020) · Pharmacological Reports · doi:10.1007/s43440-020-00123-0 · Cited by 14 · see citing works
Das, A., Hendershot, C. S., Husain, M. I., Knyahnytska, Y., Elsaid, S., Foll, B. L., & Kloiber, S. M. (2024) · Pharmacopsychiatry · doi:10.1055/a-2264-1047 · Cited by 11 · see citing works
de la Fuente-Tomás, L., Arranz, B., Velasco, Á., Sierra, P., Sánchez-Autet, M., García‐Blanco, A., Safont, G., & García‐Portilla, M. P. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.01.043 · Cited by 11 · see citing works
Bahji, A., Danilewitz, M., Vazquez, G., & Patten, S. (2021) · Canadian Journal of Addiction · doi:10.1097/cxa.0000000000000123 · Cited by 6 · see citing works
Psychiatric Comorbidity of Cannabis Use Disorder
Gorelick, D. A. (2018) · Springer eBooks · doi:10.1007/978-3-319-90365-1_13 · Cited by 6 · see citing works
Preuss, U. W., Hesselbrock, M. N., & HESSELBROCK, V. M. (2023) · Brain Sciences · doi:10.3390/brainsci13081130 · Cited by 5 · see citing works
Differentiation of Therapeutic and Illicit Drug Use via Metabolite Profiling
Stoeva, S., Hvarchanova, N., Gancheva, S., Eftimov, M., Georgiev, K., & Radeva-Ilieva, M. P. (2025) · Metabolites · doi:10.3390/metabo15110745 · Cited by 4 · see citing works
Reece, A. S., & Hulse, G. K. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1182536 · Cited by 3 · see citing works
TLR4 gene polymorphism associated with lifetime cigarette smoking in bipolar disorder
Zerdazi, E., Oliveira, J., Vorspan, F., Bennabi, M., Jamain, S., Étain, B., Leboyer, M., Tamouza, R., & Bellivier, F. (2017) · Journal of Neuroimmunology · doi:10.1016/j.jneuroim.2017.01.021 · Cited by 3 · see citing works
Clinical Phenomenology of Bipolar Disorder With Substance Use Disorders: A Systematic Review
Garvie, S., Sorkhou, M., & George, T. P. (2026) · Bipolar Disorders · doi:10.1111/bdi.70132 · Cited by 1 · see citing works
Sociodemographic and clinical correlates of cannabis dependence among Israeli combat veterans
Asper, A., Binenfeld, E., Pshitizky, H., & Feingold, D. (2022) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2022.108786 · Cited by 1 · see citing works
Reece, A. S., & Hulse, G. K. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1182535 · Cited by 2 · see citing works
Sentetik Kannabinoidlerin Nöropsikiyatrik Etkileri
Aral, A., Avcı, B., & Usta, M. B. (2020) · Arşiv Kaynak Tarama Dergisi · doi:10.17827/aktd.524931
Repercusiones del consumo de cannabis en la evolución del trastorno bipolar
Arias, R., Alberich, S., Zorrilla, E. P., & González-Pinto, A. M. (2020) · Psiquiatría Biológica · doi:10.1016/j.psiq.2020.03.001
DEMOGRAPHIC VARIABLES ASSOCIATED WITH DRUG USE IN BIPOLAR PATIENTS
Rashid, A., Haroon, M., Bokhari, S. Q., Butt, A., Mazhar, N., & Anjum, A. (2021) · Pakistan Postgraduate Medical Journal · doi:10.51642/ppmj.v30i03.306
Troubles bipolaires et comorbidités addictives
Roméo, B., & Benyamina, A. (2023) · Elsevier eBooks · doi:10.1016/b978-2-294-77180-4.00032-9
Reece, A. S., & Hulse, G. K. (2025) · Elsevier eBooks · doi:10.1016/b978-0-443-13492-0.00002-5
Cho, J. S., Sajatovic, M., Briggs, F. B. S., Fiorelli, N. M., Adeniyi, C., Black, J. J., Weise, C., Krehel-Montgomery, J., & Levin, J. B. (2026) · Annals of Clinical Psychiatry · doi:10.1177/10401237261417736
- Authors
- Weinstock, L. M., Gaudiano, B. A., Wenze, S. J., Epstein-Lubow, G., & Miller, I. W.
- Affiliations
- Brown University (US)
- Lafayette College (US)
- Corresponding author
- Weinstock, Lauren M.
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2016-02
- Volume
- 65
- Pages
- 57-62
- ISSN
- 0010-440X (ISSN-L)
- PMC
- PMC4715863
- OpenAlex
- W2111942674
- Cited by
- 29
- References
- 33
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 5 · 2020: 4 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 1
- FWCI
- 1.35
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (K23MH079907)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- cannabis use disorder, bipolar I disorder, comorbidities, manic episodes, mixed states, psychotic features, nicotine dependence, alcoholism, substance use disorders, anxiety disorder comorbidity, psychiatric inpatients
- MeSH terms
- Adult, Bipolar Disorder, Cannabis, Female, Humans, Inpatients, Male, Marijuana Smoking, Medical Records, Middle Aged, Psychotic Disorders, Retrospective Studies, Comorbidity, Substance-Related Disorders, Alcohol-Related Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
