Cited by 311Cannabis and Cannabinoid ResearchSubstance Abuse Treatment and OutcomesMental Health Treatment and Access

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Cannabis use and cannabis use disorders and their relationship to mental disorders: A 10-year prospective-longitudinal community study in adolescents

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Wittchen, Hans-Ulrich, Fröhlich, Christine, Behrendt, Silke, Günther, Agnes, Rehm, Jürgen, Zimmermann, Petra, Lieb, Roselind, Perkonigg, Axel·2007·Drug and Alcohol Dependence

DOI 10.1016/j.drugalcdep.2006.12.013

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Abstract

Background Whereas the role of externalizing disorders is relatively well established in predicting the onset of cannabis use (CU) or cannabis use disorder (CUD), the status of anxiety and mood disorders in predicting CU and CUD remains controversial.Objective (1) To examine cross-sectional and prospective associations of CU and CUD with a range of mental disorders and whether anxiety and mood disorders are associated with CU/CUD after adjusting for externalizing disorders.Methods N=1395 community subjects aged 14-17 at baseline were followed-up at three waves prospectively over 10 years. Substance use, substance disorders and mental disorders were assessed using the DSM-IV/M-CIDI.Results (1) The baseline prevalence rates where 19.3% at t(0) for CU and 2.6% for CUD. Cumulative incidence rates at t(3) were 54.3% for CU and 13.7% for CUD. (2) In cross-sectional and prospective analyses other substance use disorders, mood and anxiety disorders were associated with CU and CUD. (3) Associations of panic-anxiety with CU and of depressive and bipolar disorders with CU and CUD were significant after controlling for externalizing disorders.Conclusion A range of psychopathological conditions, including depressive, bipolar and less consistently anxiety disorders as well as the degree of their comorbidity are significantly associated with incident CU and progression to CUD, even when controlling for externalising disorders. A better understanding of this complex interplay may result in better aetiological models and intervention strategies.

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Self-citation
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Background
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BackgroundInfluential
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BackgroundInfluential
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BackgroundResult
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BackgroundSelf-citation
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“Patients with bipolar disorder show a high prevalence of cannabis use (14), however longitudinal studies on cannabis use and the risk of bipolar disorder have yielded mixed results (15-19).”
Result
Genome-wide DNA methylation association study of recent and cumulative marijuana use in middle aged adults
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Background
Cannabis Use is a Better Indicator of Poor Mental Health in Women Than in Men: A Cross-Sectional Study in Young Adults from the General Population
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“[21] The investigators used the Munich CIDI to explore outcomes including suicidality, the course of post traumatic stress disorder, the influence of cannabis use on psychotic symptoms, the role of trauma and PTSD on premenstrual disorders, and the predictive significance of anxiety disorders on first onset of major d…”
Method
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Background
Effects of Cannabis Use on Psychotic and Mood Symptoms: A Systematic Review
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Two Sides of the Same Coin: Cannabis Dependence and Mental Health Problems in Help-Seeking Adolescent and Young Adult Outpatients
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“An age span of 14 to 29 years was chosen given that epidemiological studies have found this group to be at greatest risk for developing comorbid mental health and substance use disorders (Wittchen et al. 2007; Wittchen, et al. 1998).”
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Prevalence and Mental Health Correlates of Illegal Cannabis Use Among Bisexual Women
Robinson, M., Sanches, M., & MacLeod, M. A. (2016) · Journal of Bisexuality · doi:10.1080/15299716.2016.1147402 · Cited by 20
“Cross-sectional and longitudinal studies have found cannabis use to be associated with anxiety (Van Gastel, Rossegger, Ropssler, Bisson, & Endrass, 2014; Wittchen et al., 2007), cross-sectional studies have associated cannabis use with posttraumatic stress disorder (PTSD) (Cougle, Bonn-Miller, Vujanovic, Zvolensky, &…”
Background
The association between health conditions and cannabis use in patients with opioid use disorder receiving methadone maintenance treatment
Shams, I., Sanger, N., Bhatt, M., Rosic, T., Luo, C., Shahid, H., Mouravska, N., Tam, S. L., Hillmer, A., Chawar, C., et al. (2019) · BJPsych Open · doi:10.1192/bjo.2019.78 · Cited by 15
The association between cannabis use and depression: a review of the evidence
Degenhardt, L. J., Hall, W., Lynskey, M. T., Coffey, C., & Patton, G. C. (2011) · Cambridge University Press eBooks · doi:10.1017/cbo9780511706080.011 · Cited by 15
Cannabis use, addiction risk and functional impairment in youth seeking treatment for primary mood or anxiety concerns
Osuch, E. A., Vingilis, E. R., Ross, E., Forster, C. I., & Summerhurst, C. (2013) · International Journal of Adolescent Medicine and Health · doi:10.1515/ijamh-2013-0067 · Cited by 15
Prolonged cannabis withdrawal in young adults with lifetime psychiatric illness
Schuster, R. M., Fontaine, M., Nip, E., Zhang, H., Hanly, A. M., & Evins, A. E. (2017) · Preventive Medicine · doi:10.1016/j.ypmed.2017.02.019 · Cited by 15
Adverse Reactions Associated With Cannabis Consumption as Evident From Search Engine Queries
Yom‐Tov, E., & Lev‐Ran, S. (2017) · JMIR Public Health and Surveillance · doi:10.2196/publichealth.8391 · Cited by 14
“Our findings on common reports of anxiety and depression-related symptoms are in line with previous reports based on conventional data collection [21].”
Result
Alcohol and Cannabis Consumption Does Not Diminish Cure Rates in a Real-World Cohort of Chronic Hepatitis C Virus Infected Patients on Opioid Substitution Therapy—Data From the German Hepatitis C-Registry (DHC-R)
Christensen, S., Buggisch, P., Mauss, S., Böker, K. H. W., Müller, T., Klinker, H., Zimmermann, T., Serfert, Y., Weber, B., Reimer, J., et al. (2019) · Substance Abuse Research and Treatment · doi:10.1177/1178221819835847 · Cited by 15
Comorbidity of addictive problems: Assessment and treatment implications
Essau, C. A. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-818626-8.00011-6 · Cited by 15
Portability of a screener for pediatric bipolar disorder to a diverse setting.
Freeman, A. J., Youngstrom, E. A., Frazier, T. W., Youngstrom, J. K., Demeter, C., & Findling, R. L. (2011) · Psychological Assessment · doi:10.1037/a0025617 · Cited by 15
Cannabis for Cognitive Enhancement as a New Coping Strategy? Results From a Survey of Students at Four Universities in Germany
Franke, A. G., Roser, P., Lieb, K., Vollmann, J., & Schildmann, J. (2016) · Substance Use & Misuse · doi:10.1080/10826084.2016.1200619 · Cited by 14
“Chronic use of CAN has been found to increase the risk of developing persistent mood and anxiety disorders (Wittchen et al., 2007), as well as schizophrenia (Kuepper et al., 2011).”
Background
Public Health Impact of Substance Use on Adolescent: A Snapshot of Yenagoa in Bayelsa State. Nigeria
Raimi, M. O. (2019) · American Journal of Biomedical Science & Research · doi:10.34297/ajbsr.2019.04.000796 · Cited by 14
Vulnerability Factors for the Psychiatric and Behavioral Effects of Cannabis
Bortolato, M., Bini, V., & Tambaro, S. (2010) · Pharmaceuticals · doi:10.3390/ph3092799 · Cited by 17
“In support of this last notion, anxiety disorders have been shown to predict later cannabis use disorder [74,134,135].”
Background
Unique Functional Abnormalities in Youth with Combined Marijuana Use and Depression: An fMRI Study
Ford, K. A., Wammes, M., Neufeld, R. W. J., Mitchell, D. G. V., Théberge, J., Williamson, P., & Osuch, E. A. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2014.00130 · Cited by 14
Long-Term Effects of Adolescent Marijuana Use Prevention on Adult Mental Health Services Utilization: The Midwestern Prevention Project
Riggs, N. R., & Pentz, M. A. (2009) · Substance Use & Misuse · doi:10.1080/10826080902809691 · Cited by 13
“One study demonstrated associations with marijuana use and progression to marijuana use disorder with depressive, bipolar, and anxiety disorders, while controlling for confounding variables including externalizing disorders (Wittchen et al., 2007).”
Background
Neurostructural Correlates of Cannabis Use in Adolescent Bipolar Disorder
Sultan, A. A., Kennedy, K. G., Fıksenbaum, L., MacIntosh, B. J., & Goldstein, B. I. (2020) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyaa077 · Cited by 13
Molecular Targets of Cannabinoids Associated with Depression
Paudel, P., Ross, S. A., & Li, X. (2021) · Current Medicinal Chemistry · doi:10.2174/0929867328666210623144658 · Cited by 14
Associations between marijuana use and anxious mood lability during adolescence
Rusby, J. C., Westling, E. H., Crowley, R. N., Mills, K. L., & Light, J. M. (2018) · Addictive Behaviors · doi:10.1016/j.addbeh.2018.12.029 · Cited by 13
“Longitudinal studies that follow adolescents into adulthood have found that marijuana use during adolescence predicted adult anxiety disorders (Wittchen et al., 2007), and that chronic users (those who used marijuana throughout adolescence) had significantly greater anxiety symptoms in adulthood than those who did not…”
Background
Trastornos mentales y afectación neuropsicológica relacionados con el uso crónico de cannabis
Tziraki, S. (2012) · Revista de Neurología · doi:10.33588/rn.5412.2011427 · Cited by 12
Comorbidity and Coaggregation of Major Depressive Disorder and Bipolar Disorder and Cannabis Use Disorder in a Controlled Family Study
Quick, C. R., Conway, K. P., Swendsen, J. D., Stapp, E. K., Cui, L., & Merikangas, K. R. (2022) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2022.1338 · Cited by 14
Cannabis Use and Its Association to Mental Illness: A Focus on Mood and Anxiety Disorders
Lev‐Ran, S., & Feingold, D. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-800756-3.00035-1 · Cited by 13
Risky decision‐making as an antecedent or consequence of adolescent cannabis use: findings from a 2‐year longitudinal study
Pacheco‐Colón, I., Lopez‐Quintero, C., Coxe, S. J., Limia, J. M., Pulido, W. J., Granja, K., Paula, D. C., González, I., Ross, J. M., Duperrouzel, J. C., et al. (2021) · Addiction · doi:10.1111/add.15626 · Cited by 12
Clinical correlates of cannabis use among adolescent psychiatric inpatients
Lev‐Ran, S., Aviram, A., Braw, Y., Nitzan, U., Ratzoni, G., & Fennig, S. (2012) · European Psychiatry · doi:10.1016/j.eurpsy.2011.11.002 · Cited by 13
“Though there is a high overlap of disruptive behaviors and ADHD, a growing body of evidence shows that adolescent cannabis use is mainly driven by behavioral disorders; ADHD seems to have little or no independent effect [18,21,67].”
Background
The role of anxiety in bisexual women’s use of cannabis in Canada.
Robinson, M. (2015) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000100 · Cited by 13
Association between cannabis use and treatment outcomes in patients receiving methadone maintenance treatment: a systematic review protocol
Zielinski, L., Bhatt, M., Eisen, R. B., Perera, S., Bhatnagar, N., MacKillop, J. M., Steiner, M. S., Vaz, S. M., Thabane, L., & Samaan, Z. (2016) · Systematic Reviews · doi:10.1186/s13643-016-0317-2 · Cited by 12
Epidemiology and Natural Course
Beesdo‐Baum, K., & Knappe, S. (2014) · Wiley eBooks · doi:10.1002/9781118775349.ch3 · Cited by 12
Emotion regulation in emerging adults with major depressive disorder and frequent cannabis use
Nichols, E. S., Penner, J., Ford, K. A., Wammes, M., Neufeld, R. W. J., Mitchell, D. G. V., Greening, S. G., Théberge, J., Williamson, P., & Osuch, E. A. (2021) · NeuroImage Clinical · doi:10.1016/j.nicl.2021.102575 · Cited by 12
Prevalence and associated factors of cannabis consumption in medical students: the BOURBON nationwide study
Fond, G. B., Picot, A., Bourbon, A., Boucékine, M., Auquier, P., Lançon, C., & Boyer, L. (2020) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-020-01131-0 · Cited by 11
Treating depression with cannabinoids
Blaas, K. (2008) · Cited by 11
Association of comorbid psychopathology with the duration of cannabis use disorders.
Farmer, R. F., Kosty, D. B., Seeley, J. R., Gau, J. M., Duncan, S. C., Walker, D. D., & Lewinsohn, P. M. (2016) · Psychology of Addictive Behaviors · doi:10.1037/adb0000151 · Cited by 12
“Others, however, have variously found that internalizing features or disorders represent a significant risk for CUD onset (Wittchen et al., 2007) or act a modest protective factor against substance use (Colder et al., 2013).”
Background
Does cannabis use increase anxiety disorders? A literature review
Shalit, N., & Lev‐Ran, S. (2019) · Current Opinion in Psychiatry · doi:10.1097/yco.0000000000000560 · Cited by 11
Doppeldiagnose Psychose und Sucht - Grundlagen und Therapie
Gouzoulis‐Mayfrank, E. (2008) · Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie · doi:10.1024/1422-4917.36.4.245 · Cited by 10
Challenges in minimizing the adverse effects of cannabis use after legalization
Hall, W. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1067-5 · Cited by 11
Persistent increased severity of cannabis use disorder symptoms in adolescents compared to adults: a one-year longitudinal study
Lees, R., Lawn, W., Petrilli, K., Brown, A., Trinci, K., Borissova, A., Ofori, S., Mokrysz, C., Curran, H. V., Hines, L. A., et al. (2024) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01806-y · Cited by 10
“For example, CUD often co-occurs with other mental health disorders and other substance use disorders [31, 35].”
Psychoactive substance use and associated factors among Mohammed first university students, Oujda, Morocco: a cross-sectional study
Essadi, A., Aissaoui, H., Yeznasni, A., Lekfif, A., Sebbar, S., Atassi, M., & Abda, N. (2024) · BMC Public Health · doi:10.1186/s12889-024-19507-5 · Cited by 10
Implementation fidelity of a Brazilian drug use prevention program and its effect among adolescents: a mixed-methods study
Gusmões, J. D., García-Cerde, R., Valente, J. Y., Pinsky, I., & Sanchez, Z. M. (2022) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/s13011-022-00496-w · Cited by 13
“Introduction Adolescence is the typical period during which initial alcohol and drug use occurs [1], impacting mental health [2] and facilitating the development of drug-related issues [3], as well as drug dependence in adulthood [4].”
Background
La entrevista Cannabis Abuse Screening Test (CAST) para el diagnóstico de trastornos psiquiátricos en jóvenes consumidores de cannabis
Cuenca‐Royo, A., Niubo, A. S., Torrens, M., Suelves, J. M., & Domingo‐Salvany, A. (2013) · Adicciones · doi:10.20882/adicciones.75 · Cited by 10
Relationship between drug use and psychopathological variables of risk in university students
García‐Montes, J. M., Basurto, F. Z., Moreno, M., & Cubos, P. F. (2013) · Psicothema · doi:10.7334/psicothema2013.20 · Cited by 10
Effects of Co‐occurring marijuana use and anxiety on brain structure and functioning: A systematic review of adolescent studies
Cancilliere, M. K., Yusufov, M., & Weyandt, L. L. (2018) · Journal of Adolescence · doi:10.1016/j.adolescence.2018.03.013 · Cited by 10

Authors: Wittchen, H.-U., Fröhlich, C., Behrendt, S., Günther, A., Rehm, J., Zimmermann, P., Lieb, R., & Perkonigg, A.
Affiliations: Technische Universität Dresden (DE)
Centre for Addiction and Mental Health (CA)
Max Planck Society (DE)
ORCID: Behrendt, Silke
Rehm, Jürgen
Zimmermann, Petra
Lieb, Roselind
Perkonigg, Axel
Venue: Drug and Alcohol Dependence
Publisher: Elsevier BV
Published: 2007-04
Volume: 88
Pages: S60-S70
ISSN: 0376-8716 (ISSN-L)
DOI: 10.1016/j.drugalcdep.2006.12.013
OpenAlex: W2103849723
Cited by: 311
References: 50
Citations by year: 2026: 7 · 2025: 5 · 2024: 12 · 2023: 13 · 2022: 10 · 2021: 16 · 2020: 20 · 2019: 22 · 2018: 14 · 2017: 23 · 2016: 18 · 2015: 15 · 2014: 17 · 2013: 24 · 2012: 21
FWCI: 11.96
Type: journal article
Language: en
Open access: green
tud.qucosa.de
Licence: other-oa
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Drug and Alcohol Dependence (publishedVersion)
PubMed (publishedVersion)
Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
Max Planck Institute for Plasma Physics (submittedVersion)
Funders: Deutsche Forschungsgemeinschaft (WI 709/8-1, WI 709/7-1, WI2246/1‐1, LA1148/1‐1)
Bundesministerium für Bildung und Forschung (LA1148/1-1, 01EB9901/6, EB 0142, WI2246/1-1, WI 709/7-1, 01EB0140, WI 709/8-1, 01EB9405/6, EB01016200, 01EB0440)
National Institutes of Health
U.S. Public Health Service (303-7028)
National Institute of Mental Health
Topics: Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: cannabis use, cannabis use disorder, adolescents, anxiety disorders, mood disorders, depressive disorders, bipolar disorder, externalizing disorders, substance use disorders, comorbidities, substance use onset, substance use progression
MeSH terms: Adolescent, Mental Disorders, Cannabis, Marijuana Abuse, Humans, Internal-External Control, Prospective Studies, Residence Characteristics

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Cannabis use and cannabis use disorders and their relationship to mental disorders: A 10-year prospective-longitudinal community study in adolescents

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