Subthreshold

There is increasing evidence that cannabis use can act as a risk factor for the development of bipolar as well as psychotic disorders. A recent systematic review by Gibbs and colleagues identified several studies supporting a link between cannabis use and subsequent relapse of manic symptoms. This review also included a meta-analysis of two large prospective cohort studies, which found that cannabis use almost trebled the risk of new-onset subthreshold manic symptoms after adjusting for potential confounding factors.

For the ICD-11, there is a scale of the severity of personality pathology that ranges from “personality difficulty” to “mild,” “moderate,” and “severe” personality disorder, which represent the only personality disorder “diagnoses” in the system. The designation of “personality difficulty” (subthreshold for a personality disorder), as well as the three levels of personality disorder, can all be amplified by these trait specifiers: negative affectivity, detachment, dissociality, disinhibition, or anankastia.