Evidence map›Paper›PMID 35315149›Full record

Observational studyAddiction (Abingdon, England)2022

Is early exposure to cannabis associated with bipolar disorder? Results from a Finnish birth cohort study.

Alexander Denissoff, Antti Mustonen, Anni-Emilia Alakokkare, James G Scott, Musa B Sami, Jouko Miettunen, Solja Niemelä

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Addiction (Abingdon, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Article
  6. Article
  7. Observational
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Alexander DenissoffFaculty of Medicine, Department of Psychiatry, University of Turku, Turku, Finland.ORCID 0000-0001-5019-2600
Antti MustonenFaculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
Anni-Emilia AlakokkareFaculty of Medicine, Department of Psychiatry, University of Turku, Turku, Finland.
James G ScottQIMR Berghofer Medical Research Institute, Herston, Qld, Australia.
Musa B SamiInstitute of Mental Health, University of Nottingham, Nottingham, UK.
Jouko MiettunenMedical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Solja NiemeläFaculty of Medicine, Department of Psychiatry, University of Turku, Turku, Finland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThere are few longitudinal studies assessing the association of cannabis use and subsequent onset of bipolar disorder. We aimed to measure the association between early cannabis exposure and subsequent bipolar disorder. DESIGN, SETTING AND

participantsObservational study linking a sample from the northern Finland birth cohort 1986 (n = 6325) to nation-wide register data to examine the association of life-time cannabis exposure at age 15/16 years and subsequent bipolar disorder until age 33 (until the end of 2018); 6325 individuals (48.8% males) were included in the analysis. MEASUREMENTS: Cannabis exposure was measured via self-report. Bipolar disorder was measured via bipolar disorder-related diagnostic codes (ICD-10: F30.xx, F31.xx) collected from the Care Register for Health Care 2001-18, the Register of Primary Health Care Visits 2011-18, the medication reimbursement register of the Social Insurance Institution of Finland 2001-05 and the disability pensions of the Finnish Center for Pensions 2001-16. Potential confounders included demographic characteristics, parental psychiatric disorders, emotional and behavioral problems and other substance use.

findingsThree hundred and fifty-two adolescents (5.6%) reported any cannabis use until the age of 15-16 years. Of the whole sample, 66 (1.0%) were diagnosed with bipolar disorder. Adolescent cannabis use was associated with bipolar disorder [hazard ratio (HR) = 3.46; 95% confidence interval (CI) = 1.81-6.61]. This association remained statistically significant after adjusting for sex, family structure and parental psychiatric disorders (HR = 3.00; 95% CI = 1.47-6.13) and after further adjusting for adolescent emotional and behavioral problems (HR = 2.34; 95% CI = 1.11-4.94). Further adjustments for frequent alcohol intoxications, daily smoking and lifetime illicit drug use attenuated the associations to statistically non-significant.

conclusionsIn Finland, the positive association between early cannabis exposure and subsequent development of bipolar disorder appears to be confounded by other substance use.

Indexed as

Bipolar DisorderCannabisSubstance-Related DisordersAdolescentAdultBirth CohortCannabinoid Receptor AgonistsCohort StudiesFemaleFinlandHumansMaleCannabinoid Receptor AgonistsAdolescentbipolar disordersbirth cohortcannabismood disorderssubstance use

Identifiers

PMID35315149
PMCPMC9545505

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.