803 – Correlates of Cannabis use Disorders among Bipolar Outpatients Enrolled in the Bipolar Expert Centers French Network

Abstract

Introduction:

Bipolar disorder (BIPD) is a chronic and disabling illness with frequent comorbid addictive disorders (ADD). Little is known about the prevalence and correlates of cannabis use disorders (CUD) in that population.

Objectives:

We sought to characterize clinical, sociodemographic, childhood trauma and psychological correlates associated with CUD in bipolar patients.

Aims:

Our main hypothesis was that BIPD + CUD patients would be more impulsive and affectively unstable than those without.

Methods:

Patients enrolled in a French national network underwent a thorough assessment including lifetime diagnoses using the SCID-IV questionnaire and measures of current symptomatology (Altman and MADRS), impulsivity (BIS-10), emotional instability (AIM and ALS), hostility (BDHI) and history of childhood trauma (CTQ). Univariate and multivariate analyses were used to identify specific associations between several correlates and CUD status.

Results:

Among the 718 patients included, 414 (57.7%) were women, with a mean age of 43 years, and 546 (76.4%) were diagnosed with type I bipolar disorder and 190 (26.9%) had at least one lifetime substance use disorder. CUD were associated with lifetime history of suicidal behavior, psychotic symptoms during an affective episode, rapid cycling and CTQ sub-scores, clinical and psychological dimensions. Parts of these associations remained after controlling for comorbid alcohol use disorders.

Conclusions:

These results suggest a high prevalence of CUD in BIPD, which was associated with a higher severity and worse outcomes of illness. Although the retrospective nature of this study prevents causal interpretations, our results suggest that at-risk traits among CUD+BIPD patients may induce these clinical features.