Researchers from the University of Warwick have found evidence to suggest a significant relationship between cannabis use and the onset and exacerbation of mania symptoms.

In a paper published in the Journal of Affective Disorders, mental health researchers from Warwick Medical School carried out a review of scientific literature examining the effect of cannabis use. The literature sampled 2,391 individuals who had experienced mania symptoms.

Mania symptoms are part of bipolar disorder and can include feelings of persistent elation, heightened energy and hyperactivity and a reduced need for sleep. Mania can also make people feel angry and aggressive with extreme symptoms including becoming delusional or hearing voices.

Lead author Dr Steven Marwaha said: "Previously it has been unclear whether cannabis use predates manic episodes. We wanted to answer two questions -- does cannabis use lead to increased occurrence of mania symptoms or manic episodes in individuals with pre-existing bipolar disorder? But also, does cannabis use increase the risk of onset of mania symptoms in those without pre-existing bipolar disorder?"

The researchers looked at a number of previous studies and concluded that cannabis use preceded the onset of mania symptoms.

Dr Marwaha said: "The observed tendency for cannabis use to precede or coincide with rather than follow mania symptoms, and the more specific association between cannabis use and new onset manic symptoms, suggests potential causal influences from cannabis use to the development of mania. It is a significant link."

Dr Marwaha also said the review suggested that cannabis use significantly worsened mania symptoms in people who had previously been diagnosed with bipolar disorder.

He added: "There are limited studies addressing the association of cannabis use and manic symptoms, which suggests this is a relatively neglected clinical issue. However our review suggests that cannabis use is a major clinical problem occurring early in the evolving course of bipolar disorder.

More research is needed to consider specific pathways from cannabis use to mania and how these may be effected by genetic vulnerability and environmental risk factors.

"Cannabis is the most prevalent drug used by the under-18s and during this critical period of development services should be especially aware of and responsive to the problems that cannabis use can cause for adolescent populations.