Evidence map›Paper›PMID 40843511›Full record

ArticleEuropean psychiatry : the journal of the Association of European Psychiatrists2025

Mood instability as a transdiagnostic predictor of cannabis use in attention-deficit/hyperactivity disorder and depression: A natural language processing analysis of electronic health records from 13,025 adolescents.

Asilay Seker, Edward Bullock, Susie Chandler, Rashmi Patel, Diego Quattrone, Craig Colling, Edmund J S Sonuga-Barke, Johnny Downs

Abstract read
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In one paragraph

Article in European psychiatry : the journal of the Association of European Psychiatrists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
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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

8 authors.

Asilay SekerCAMHS Digital Lab, King's Maudsley Partnership, https://ror.org/0220mzb33King's College London and South London and the Maudsley NHS Foundation Trust, London, UK.ORCID 0000-0002-6229-3924
Edward BullockDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Susie ChandlerCAMHS Digital Lab, King's Maudsley Partnership, https://ror.org/0220mzb33King's College London and South London and the Maudsley NHS Foundation Trust, London, UK.ORCID 0000-0002-5543-8638
Rashmi PatelDepartment of Psychiatry, https://ror.org/013meh722University of Cambridge, CambridgeUK.ORCID 0000-0002-9259-8788
Diego QuattroneNational Institute for Health Research (NIHR) Biomedical Research Centre, https://ror.org/015803449South London and Maudsley NHS Foundation Trust, London, UK.ORCID 0000-0002-6051-8309
Craig CollingCAMHS Digital Lab, King's Maudsley Partnership, https://ror.org/0220mzb33King's College London and South London and the Maudsley NHS Foundation Trust, London, UK.
Edmund J S Sonuga-BarkeDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Johnny DownsCAMHS Digital Lab, King's Maudsley Partnership, https://ror.org/0220mzb33King's College London and South London and the Maudsley NHS Foundation Trust, London, UK.ORCID 0000-0002-8061-295X

Funding

Institute of Psychiatry, Psychology and Neuroscience, King's College London
6 · The paper itself

Abstract

backgroundCannabis use is elevated in youth with depression and attention-deficit/hyperactivity disorder (ADHD), but drivers of this increase remain underexplored. The self-medication hypothesis suggests cannabis is used by patients for mood regulation, a common difficulty in ADHD and depression. This study aimed to examine associations between mood instability and cannabis use in a large, representative clinical cohort of adolescents diagnosed with ADHD and/or depression.

methodsNatural language processing (NLP) approaches were utilised to identify references to mood instability and cannabis use in the electronic health records of adolescents (aged 11-18 years) with primary diagnoses of ADHD (

resultsMood instability was associated with a 25% higher probability of cannabis use in adolescents with ADHD compared to those with depression. Following adjustment for available sociodemographic and clinical covariates, mood instability was associated with increased cannabis use in both ADHD (aOR: 1.61 [95% CI: 1.41-1.84]) and depression (aOR: 1.38 [95% CI: 1.21-1.57]) groups.

conclusionsThis was the first study to explore the differential impact of mood instability on adolescent cannabis use across distinct diagnostic profiles. NLP analysis proved an efficient tool for examining large populations of adolescents accessing psychiatric services and provided preliminary evidence of a link between mood instability and cannabis use in ADHD and depression. Longitudinal studies using direct measures or tailored NLP techniques can further establish the directionality of these associations.

Indexed as

Attention Deficit Disorder with HyperactivityDepressionDepressive DisorderElectronic Health RecordsMarijuana UseNatural Language ProcessingAdolescentChildComorbidityFemaleHumansMaleADHDadolescentcannabisdepressionemotion dysregulationmood instabilitynatural language processing

Identifiers

PMID40843511
PMCPMC12538179

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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.