Cannabis use is elevated in youth with depression and attention-deficit/hyperactivity disorder (ADHD), but drivers of this increase remain underexplored. The self-medication hypothesis suggests cannabis is used by patients for mood regulation, a common difficulty in ADHD and depression. This study aimed to examine associations between mood instability and cannabis use in a large, representative clinical cohort of adolescents diagnosed with ADHD and/or depression.

Natural language processing (NLP) approaches were utilised to identify references to mood instability and cannabis use in the electronic health records of adolescents (aged 11–18 years) with primary diagnoses of ADHD (n = 7,985) or depression (n = 5,738). Logistic regression was used to examine mood instability as the main exposure for cannabis use in models stratified by ADHD and depression.

Mood instability was associated with a 25% higher probability of cannabis use in adolescents with ADHD compared to those with depression. Following adjustment for available sociodemographic and clinical covariates, mood instability was associated with increased cannabis use in both ADHD (aOR: 1.61 [95% CI: 1.41–1.84]) and depression (aOR: 1.38 [95% CI: 1.21–1.57]) groups.

This was the first study to explore the differential impact of mood instability on adolescent cannabis use across distinct diagnostic profiles. NLP analysis proved an efficient tool for examining large populations of adolescents accessing psychiatric services and provided preliminary evidence of a link between mood instability and cannabis use in ADHD and depression. Longitudinal studies using direct measures or tailored NLP techniques can further establish the directionality of these associations.

Eustachian tube balloon dilatation performed for obstructive Eustachian tube dysfunction can lead to improvements in symptoms and a reduction in Eustachian Tube Dysfunction Questionnaire-7 scores. While historically performed under general anaesthetic, studies have demonstrated that Eustachian tube balloon dilatation can be performed under local anaesthetic with equivalent efficacy. We describe our local anaesthetic protocol used to perform Eustachian tube balloon dilatation in the out-patient setting and report outcomes from our case series.

Prospective analysis of all patients undergoing Eustachian tube balloon dilatation between October 2019 and July 2024.

Thirty-one patients underwent 40 dilatations under local anaesthetic. All were well tolerated, with no adverse events. There was a statistically significant decrease in the average total Eustachian Tube Dilatation Questionnaire-7 score of -6.75 points (p = 0.0029) at short-term follow-up and of -7.58 points (p = 0.034) at long-term follow-up.

Our study provides further evidence that Eustachian tube balloon dilatation for obstructive Eustachian tube dysfunction can improve Eustachian Tube Dilatation Questionnaire-7 scores, and can be performed successfully under local anaesthetic in the out-patient setting.