Suicidal Ideation in Medicinal Cannabis Patients: A 12-Month Prospective Study

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Objective

To document the prevalence and correlates of suicidal ideation (SI) among individuals seeking cannabis-based medicinal products (CBMPs); to test whether SI declines or intensifies after three months of CBMP treatment and to document 12-month trajectories of depression in those reporting SI and other patients.

Method

Observational data were available for 3781 patients at entry to treatment, 2112 at three months and 777 for 12 months. Self-reported depressed mood and SI were assessed using items from the PHQ-9. Additional data included sociodemographic characteristics and self-reported well-being.

Results

25% of the sample reported SI at treatment entry and those with SI had higher levels of depressed mood (mean = 17.4 vs. 11.3; F_(1,3533) = 716.5, p < .001) and disturbed sleep (mean = 13.8 vs. 12.2, F_(1,3533) = 125.9, p < .001), poorer general health (mean = 43.6 vs. 52.2, F_(1,3533) = 118.3, p < .001) and lower quality of life (mean = 0.44 vs. 0.56 (F_(1,3533) = 118.3, p < .001). The prevalence of SI reduced from 23.6% to 17.6% (z = 6.5, p < .001) at 3 months. Twelve-month follow-up indicated a substantial reduction in depressed mood with this reduction being more pronounced in those reporting SI (mean _(baseline) = 17.7 vs. mean (12 months) = 10.3) than in other patients (mean _(baseline) = 11.1 vs. mean _{(12 months)} = 7.0).

Conclusions

SI is common among individuals seeking CBMPs to treat a range of chronic conditions and is associated with higher levels of depressed mood and poorer quality of life. Treatment with CBMPs reduced the prevalence and intensity of suicidal ideation.