Impulsivity and hostility are often thought to be interrelated among depressed patients with suicidal behavior, but few studies have examined this relationship empirically. In this study, we assessed trait impulsivity and hostility among 52 DSM-IV bipolar subjects with and without histories of suicide attempts. Impulsivity and hostility were correlated among attempters (r = .41, p = .03) but not non-attempters (r = .22, p = .28). As compared to non-attempters, attempters had significantly higher levels of overall hostility, more extensive subcomponents of hostility, and a trend toward higher overall impulsivity. Associations between lifetime suicide attempts and overall hostility were significant while controlling for current depression severity and lifetime illness duration. Aggression and impulsivity appear linked among bipolar patients with lifetime suicide attempts but may be independent constructs among non-attempters. The presence of both factors may elevate risk for suicidal behavior.

Background Studies to date showing an association between cannabis use and schizophrenia-spectrum disorders are of relatively small sample sizes with limitations in generalizability. The present study addresses this gap by examining the relationship between cannabis use and psychotic-like symptoms in a large representative community sample. Method Data were derived from the 2004 – 2005 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, Wave 2), a large, nationally representative sample of 34 653 adults from the United States population. We evaluated the association between lifetime cannabis use, psychosis, and schizotypal personality features. Results The prevalence of psychosis and schizotypal personality disorder increased significantly with greater cannabis use in a dose-dependent manner. The association between cannabis use and psychosis was 1.27 (95% CI 1.03–1.57) for lifetime cannabis use, 1.79 (95% CI 1.35–2.38) for lifetime cannabis abuse, and 3.69 (95% CI 2.49–5.47) for lifetime cannabis dependence. There was a similar dose-response relationship between the extent of cannabis use and schizotypal personality disorder (OR = 2.02 for lifetime cannabis use, 95% CI 1.69–2.42; OR = 2.83 for lifetime cannabis abuse, 95% CI 2.33–2.43; OR = 7.32 for lifetime cannabis dependence, 95% CI 5.51–9.72). Likelihood of individual schizotypal features increased significantly with increased extent of cannabis use in a dose-dependent manner. Conclusion This is the first population-based study to examine the association between lifetime cannabis use, psychosis, and schizotypal personality traits. These results add to evidence that cannabis use may be a risk factor for psychosis liability.

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