Background: Age at onset (AAO) in affective disorders is of significant prognostic value. Substances like alcohol, cannabis may affect the onset, course and outcome of Bipolar Affective Disorder (BPAD). Cannabis, already has an established role as a risk factor for psychosis, specifically Schizophrenia. However, there is scarcity of research all over the world to assess its association with onset of BPAD, and none has been performed in India yet, which calls for the need of study in this regard.
Aim: To compare the age at onset of BPAD among subjects with prior history of cannabis use and those without cannabis use.
Methodology: An observational comparative study of individuals aged 18-45 years comprising two groups with BPAD based on presence or absence of cannabis use was done using purposive sampling technique. A proforma was administered with details pertaining to socio-demographic data, family and past history of psychiatric disorders, age at onset of cannabis use and first episode of mood disorder, frequency of cannabis use. Retrospective chart review using ICD-10 Criteria for the diagnosis of BPAD was done. Written informed consents were taken after institutional ethical committee clearance.
Results: Patients with Cannabis use prior to the onset of affective episode (Group 1) had a significantly earlier onset as compared to patients without prior cannabis use (Group 2).
Mean age at onset of first affective episode among Group 1 was found to be 20.3 ± 3.74 while it was 23.5 ± 5.84 among Group 2 with a p-value of 0.0142 (statistically significant). Also, those with prior cannabis use had a longer duration of first affective episode.
Conclusion: We found clear differences among other clinical variables also in both the groups. In addition to earlier onset, the cannabis users tend to have longer duration of illness with poor adherence to medications, which can be attributed to continuous cannabis use after being diagnosed with mood disorder.
Impact Factor
2022: 6.012
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