Characteristics of cannabis-related behaviors in individuals with BD are presented in Table 1. Fifty seven percent of users reported using cannabis 21 or more times in a single year. Rates of DSM-IV abuse/dependence were high – 30% of individuals with BD (72% of those reporting lifetime use of 21 or more times in a single year) met criteria for DSM-IV cannabis use disorders. Fifty-three percent of the cases reported onset of a mood episode (depression, mania or hypomania) prior to their onset of cannabis use – the onset of a manic/hypomanic episode prior to onset of cannabis use was more common (43%) than onset of a depressive episode prior to cannabis use (21%). Of those who had used cannabis 21 or more times in a single year, 45% met criteria for cannabis use disorders prior to, or concurrent with the onset of BD – manic/hypomanic episodes were more likely than depressive episodes to precede onset of cannabis use disorders.
