Nearly half of first-episode mania patients tested positive for cannabis

In a retrospective study of 20 patients admitted for a first manic episode, 47% of those screened tested positive for cannabis on urine drug screening.

Etyemez, Semra et al.·Journal of affective disorders·2020·Preliminary EvidenceRetrospective Cohort
RTHC-02541Retrospective CohortPreliminary Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Retrospective Cohort
Evidence
Preliminary Evidence
Sample
N=20

What This Study Found

Of 15 patients who received urine drug screening, 7 (47%) tested positive for cannabinoids, a rate substantially higher than the general population. Only two patients tested positive for other substances.

Key Numbers

20 patients identified from 15,969 records. 15 received UDS. 7 of 15 (47%) positive for cannabis. Mean age: 28.65 years. 50% female. Mean hospital stay: 7.15 days.

How They Did This

Retrospective cohort study examining 15,969 inpatient psychiatric records from 2012-2013 at a single center to identify patients admitted with a first manic episode (single episode mania per ICD-9 criteria).

Why This Research Matters

The high prevalence of cannabis use among first-episode mania patients adds to evidence linking cannabis use to the onset of bipolar disorder, though the direction of this association remains unclear.

The Bigger Picture

The 47% cannabis positivity rate in first-episode mania is consistent with prior literature reporting 30-70% co-occurrence, raising questions about whether cannabis triggers mania in vulnerable individuals or whether both share common risk factors.

What This Study Doesn't Tell Us

Very small sample of 20 patients, making statistical analysis limited. Single center, retrospective design. Urine drug screening was not performed on all patients. The study cannot determine whether cannabis use preceded or followed mood symptoms.

Questions This Raises

  • ?Does cannabis trigger first manic episodes, or do people experiencing prodromal mania self-medicate with cannabis?
  • ?Would routine cannabis screening in psychiatric emergencies improve diagnostic accuracy?

Trust & Context

Key Stat:
47% of screened first-episode mania patients tested positive for cannabis
Evidence Grade:
Preliminary: very small retrospective sample (20 patients) from a single center.
Study Age:
Published in 2020 in Journal of Affective Disorders.
Original Title:
Cannabis use: A co-existing condition in first-episode bipolar mania patients.
Published In:
Journal of affective disorders, 263, 289-291 (2020)
Database ID:
RTHC-02541

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Looks back at existing records to find patterns.

What do these levels mean? →

Frequently Asked Questions

Does cannabis cause bipolar mania?

This study cannot answer that question. It found a high rate of cannabis use among first-episode mania patients but could not determine whether cannabis preceded the manic episode or vice versa.

How does 47% compare to the general population?

General population cannabis use rates are substantially lower (around 12-15% among adults in the US at the time of the study), making the 47% rate in first-episode mania patients notably elevated.

Read More on RethinkTHC

Cite This Study

RTHC-02541·https://rethinkthc.com/research/RTHC-02541

APA

Etyemez, Semra; Currie, Terrence T; Hamilton, Jane E; Weaver, Michael F; Findley, J Chase; Soares, Jair; Selek, Salih. (2020). Cannabis use: A co-existing condition in first-episode bipolar mania patients.. Journal of affective disorders, 263, 289-291. https://doi.org/10.1016/j.jad.2019.11.097

MLA

Etyemez, Semra, et al. "Cannabis use: A co-existing condition in first-episode bipolar mania patients.." Journal of affective disorders, 2020. https://doi.org/10.1016/j.jad.2019.11.097

RethinkTHC

RethinkTHC Research Database. "Cannabis use: A co-existing condition in first-episode bipol..." RTHC-02541. Retrieved from https://rethinkthc.com/research/etyemez-2020-cannabis-use-a-coexisting

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.