MedicalResearch.com Interview with:
Leen Naji, BHSc, MD
Family Medicine Resident
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Cannabis use has consistently been linked to suicide attempt in the general population, but little data exists linking the association between cannabis use and suicide attempt amongst patients with psychiatric disorders. This is important data as we know that patients with psychiatric disorders are both more likely to use cannabis and to attempt suicide. Therefore, our goal was to study the association between cannabis use and suicide attempt amongst patients with psychiatric disorders. Additionally, since we know that women are more likely to suffer from mental health disorders, are more likely to attempt suicide and are more likely to incur the deleterious consequences of drug use at lower doses, we sought to compare the association between cannabis use and suicide attempt in men and women amongst our study population.
We conducted our analysis on a large sample of over 900 adults with psychiatric disorders (465 men, 444 women), of whom 112 men and 158 women had attempted suicide. The average age of our study sample was 40 years.
We found that cannabis use is not associated with an increased risk of suicide in patients with psychiatric disorders, though this association may vary when looking at specific subpopulations and/or amount of cannabis use. For instance, we found that heavier cannabis use is associated with an increased risk of suicide attempt amongst men with psychiatric disorders. Specifically, there was a 3% increased risk of suicide attempt for every day of cannabis use per month in men with psychiatric disorders. We also found that amongst those with psychiatric conditions, women, unemployed individuals and those with a mood disorder were at increased risk of suicide attempt.
MedicalResearch.com: What should readers take away from your report?
Response: While cannabis use was not directly associated with an increased risk of suicide attempt amongst patients with psychiatric disorders, it has been associated with other high risk psychopathology that may indirectly increase the risk of suicide (e.g., psychotic symptoms) and these potential risks should not be overlooked. Additionally, we found that heavier cannabis use was associated with suicide in men with psychiatric disorders (3% increased risk of suicide attempt for every day of cannabis use per month). Our findings are both timely and relevant, given that the impending legalization of recreational cannabis use in Canada amongst other jurisdictions is expected to lead to an increased prevalence of cannabis use. Our findings suggest that more aggressive management of mood disorders in primary care as well as providing more social assistance to those with psychiatric disorders to obtain and maintain jobs may be worthwhile investments for lowering suicide rates and working towards the WHO’s plan to reduce suicide rates by 10% by 2020.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Given the WHO’s plan to reduce the rate of suicide by 10% by 2020, it is important that we have a clearer understanding of risk factors for suicide so as to properly allocate our efforts and resources. Given that patients with psychiatric disorders are amongst the most likely to both use cannabis and attempt suicide, it is important that we gain a clearer understanding of the risk factors for suicide amongst this population. Further studies may investigate the impact of the amount and frequency of cannabis use on suicide attempt in this patient population, as well as investigate specific subpopulations of psychiatric patients.
Leen Naji, Tea Rosic, Brittany Dennis, Meha Bhatt, Nitika Sanger, Jackie Hudson, Natalia Mouravska, Lehana Thabane, Zainab Samaan. The association between cannabis use and suicidal behavior in patients with psychiatric disorders: an analysis of sex differences. Biology of Sex Differences, 2018; 9 (1) DOI: 10.1186/s13293-018-0182-x
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