In these data, those who initiated using cannabis prior to their first manic/hypomanic/depressive episode had a significantly lower mean age at first use (15.1 vs. 17.7 yrs) while those who used cannabis after (or in tandem with) their onset of a manic/hypomanic/depressive episode had a lower age at onset of BD (17.5 vs. 21.5 yrs). Those who used cannabis prior to onset of a BD episode were 1.75 [95% C.I. 1.05-2.91] times more likely to report disability attributable to BD. Thus, earlier onset of cannabis use was associated with BD-related disability.
