Cannabis use disorder (CUD) is associated with increased risk of psychotic and nonpsychotic bipolar disorder and unipolar depression, according to a study published online May 24 in JAMA Psychiatry.

Oskar Hougaard Jefsen, M.D., from Aarhus University Hospital-Psychiatry in Denmark, and colleagues examined whether CUD is associated with increased risk of psychotic and nonpsychotic unipolar depression and bipolar disorder in a prospective, population-based cohort study involving 6,651,765 individuals with 119,526,786 person-years of follow-up.

The researchers found that CUD was associated with increased risk of unipolar depression, psychotic unipolar depression, and nonpsychotic unipolar depression (hazard ratios, 1.84, 1.97, and 1.83, respectively). Cannabis use was associated with increased risk of bipolar disorder in men and women (hazard ratios, 2.96 and 2.54, respectively), psychotic bipolar disorder (hazard ratio, 4.05), and nonpsychotic bipolar disorder in men and women (hazard ratios, 2.96 and 2.60). Higher risk for psychotic versus nonpsychotic subtypes of bipolar disorder was seen in association with CUD, but this was not seen for unipolar depression.

“These findings have implications regarding the legalization and control of cannabis use,” the authors write.

More information:
Oskar Hougaard Jefsen et al, Cannabis Use Disorder and Subsequent Risk of Psychotic and Nonpsychotic Unipolar Depression and Bipolar Disorder, JAMA Psychiatry (2023). DOI: 10.1001/jamapsychiatry.2023.1256

Journal information:
JAMA Psychiatry

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