The bidirectional relationships between alcohol, cannabis, co-occurring alcohol and cannabis use disorders with major depressive disorder: results from a national sample
Open accessAbstract
Introduction Alcohol use disorders (AUD) and cannabis use disorders (CUD) are common in the United States (US), and are associated with major depressive disorder (MDD). Co-occurring alcohol and cannabis use/use disorders (AUD+CUD), though understudied, have been found to be associated with greater adverse outcomes than alcohol or cannabis use/use disorders alone. There is a paucity of research on the co-occurring relationships of the two disorders with depression.Methods Data came from Waves 1 and 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a population-based longitudinal survey of the adult non-institutionalized, civilian population in the US. Logistic regression analyses were used to assess the associations between: 1) baseline AUD, CUD, and co-occurring AUD+CUD with incident MDD at follow-up and 2) baseline MDD with incident AUD, CUD, and co-occurring AUD+CUD at follow-up, adjusted for potential confounding variables.Results For Aim 1, most of the AUD and CUD were positively associated with MDD. The strongest associations with incident MDD were observed for cannabis dependence (OR=6.61, CI=1.67-26.21) and co-occurring alcohol and cannabis dependence (OR=2.34, CI=1.23-4.48). For Aim 2, baseline MDD was significantly associated with comparatively fewer cases of incident AUD and CUD but the strongest association was observed for new onset co-occurring alcohol and cannabis dependence (OR=4.51, CI=1.31-15.60).Limitations The present study is limited by the potential for social desirability and recall biases.Discussion Positive associations between AUD, CUD and MDD were observed bidirectionally. Findings have implications for preventive and treatment programs and initiatives.
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Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Diagnostic and Statistical Manual of Mental Disorders
Siegel, L. J., & Fletcher‐Janzen, E. (2008) · Wiley eBooks · doi:10.1002/9780470373699.speced0655 · Cited by 8,468 · see citing works
Summary health statistics for U.S. adults: national health interview survey, 2012.
Blackwell, D. L., Lucas, J. W., & Clarke, T. C. (2014) · PubMed · Cited by 1,889 · see citing works
Allostasis and Allostatic Load Implications for Neuropsychopharmacology
McEwen, B. (2000) · Neuropsychopharmacology · doi:10.1016/s0893-133x(99)00129-3 · Cited by 1,833 · see citing works
Psychiatric disorders in America
Robins, L. N. (1991) · Medical Entomology and Zoology · Cited by 1,567 · see citing works
Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, S. P., Dufour, M. C., & Pickering, R. P. (2004) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2004.02.004 · Cited by 1,509 · see citing works
Anthony, J. C., Warner, L. A., & Kessler, R. C. (1994) · Experimental and Clinical Psychopharmacology · doi:10.1037/1064-1297.2.3.244 · Cited by 1,341 · see citing works
Results from the 2003 National Survey on Drug Use and Health: National Findings
(2004) · PsycEXTRA Dataset · doi:10.1037/e400442005-001 · Cited by 1,245 · see citing works
Results From the 2008 National Survey on Drug Use and Health: National Findings
(2009) · PsycEXTRA Dataset · doi:10.1037/e592592009-001 · Cited by 1,178 · see citing works
Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, P. S., Kay, W., & Pickering, R. (2003) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(03)00070-x · Cited by 1,110 · see citing works
Comorbidity in Child Psychopathology: Concepts, Issues and Research Strategies
Caron, C., & Rutter, M. (1991) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1991.tb00350.x · Cited by 1,051 · see citing works
Alcoholism: theory, problem and challenge. II. Reinforcement theory and the dynamics of alcoholism.
Conger, J. J. (1956) · PubMed · Cited by 810 · see citing works
Neurobiological similarities in depression and drug dependence: a self-medication hypothesis
Markou, A. (1998) · Neuropsychopharmacology · doi:10.1016/s0893-133x(97)00113-9 · Cited by 767 · see citing works
Comorbidity between DSM-IV alcohol use disorders and major depression: results of a national survey
Grant, B. F., & Harford, T. C. (1995) · Drug and Alcohol Dependence · doi:10.1016/0376-8716(95)01160-4 · Cited by 637 · see citing works
II. Reinforcement Theory and the Dynamics of Alcoholism
Conger, J. J. (1956) · Quarterly Journal of Studies on Alcohol · doi:10.15288/qjsa.1956.17.296 · Cited by 617 · see citing works
Exploring the association between cannabis use and depression.
Degenhardt, L., Hall, W., & Lynskey, M. (2003) · Addiction · doi:10.1046/j.1360-0443.2003.00437.x · Cited by 587 · see citing works
Grant, B. F., Goldstein, R. B., Chou, S. P., Huang, B., Stinson, F. S., Dawson, D. A., Saha, T. D., Smith, S. M., Pulay, A. J., Pickering, R. P., et al. (2008) · Molecular Psychiatry · doi:10.1038/mp.2008.41 · Cited by 568 · see citing works
Ruan, W. J., Goldstein, R. B., Chou, S. P., Smith, S. M., Saha, T. D., Pickering, R. P., Dawson, D. A., Huang, B., Stinson, F. S., & Grant, B. F. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.06.001 · Cited by 557 · see citing works
Co-Occurring Mental and Substance Use Disorders: The Neurobiological Effects of Chronic Stress
Brady, K. T., & Sinha, R. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.8.1483 · Cited by 551 · see citing works
Prevalence of Marijuana Use Disorders in the United States: 1991-1992 and 2001-2002
Compton, W. M., Grant, B. F., Colliver, J. D., Glantz, M. D., & Stinson, F. S. (2004) · JAMA · doi:10.1001/jama.291.17.2114 · Cited by 537 · see citing works
Tests of Causal Links Between Alcohol Abuse or Dependence and Major Depression
Fergusson, D. M., Boden, J. M., & Horwood, L. J. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2008.543 · Cited by 475 · see citing works
Concurrent and simultaneous drug and alcohol use: Results of the 2000 National Alcohol Survey
Midanik, L. T., Tam, T. W., & Weisner, C. M. (2007) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.02.024 · Cited by 342 · see citing works
Grant, B. F., Hasin, D. S., Stinson, F. S., Dawson, D. A., Patricia Chou, S., June Ruan, W., & Huang, B. (2005) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2004.05.004 · Cited by 335 · see citing works
A longitudinal study of the order of onset of alcohol dependence and major depression
Gilman, S. E., & Abraham, H. D. (2001) · Drug and Alcohol Dependence · doi:10.1016/s0376-8716(00)00216-7 · Cited by 293 · see citing works
Major Depression in 6050 Former Drinkers
Hasin, D. S., & Grant, B. F. (2002) · Archives of General Psychiatry · doi:10.1001/archpsyc.59.9.794 · Cited by 266 · see citing works
Phobic Anxiety Syndrome Complicated by Drug Dependence and Addiction
Quitkin, F. M. (1972) · Archives of General Psychiatry · doi:10.1001/archpsyc.1972.01750260013002 · Cited by 227 · see citing works
Summary health statistics for U.S. adults: National Health Interview Survey, 2008.
Pleis, J. R., Lucas, J. W., & Ward, B. W. (2009) · PubMed · Cited by 218 · see citing works
Dawson, D. A., Grant, B. F., Stinson, F. S., & Chou, P. S. (2004) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2004.07.012 · Cited by 179 · see citing works
Pacek, L. R., Malcolm, R. J., & Martins, S. S. (2012) · American Journal on Addictions · doi:10.1111/j.1521-0391.2012.00249.x · Cited by 121 · see citing works
Self-citationDepression and substance use in minority middle-school students
Kelder, S. H., Murray, N. G., Orpinas, P., Prokhorov, A. V., McReynolds, L. S., Zhang, Q., & ROBERTS, R. E. (2001) · American Journal of Public Health · doi:10.2105/ajph.91.5.761 · Cited by 107 · see citing works
Aharonovich, E., Liu, X., Samet, S., Nunes, E. V., Waxman, R., & Hasin, D. S. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.8.1507 · Cited by 97 · see citing works
Shillington, A. M., & Clapp, J. D. (2001) · Substance Use & Misuse · doi:10.1081/ja-100103566 · Cited by 93 · see citing works
Harder, V. S., Stuart, E. A., & Anthony, J. C. (2008) · American Journal of Epidemiology · doi:10.1093/aje/kwn184 · Cited by 76 · see citing works
de Graaf, R., Radovanovic, M., van Laar, M., Fairman, B. J., Degenhardt, L. J., Aguilar‐Gaxiola, S., Bruffaerts, R., de Girolamo, G., Fayyad, J. A., Gureje, O., et al. (2010) · American Journal of Epidemiology · doi:10.1093/aje/kwq096 · Cited by 75 · see citing works
LADER, M. H. (1972) · The British Journal of Psychiatry · doi:10.1192/bjp.121.5.481 · Cited by 73 · see citing works
Are early-onset cannabis smokers at an increased risk of depression spells?
Fairman, B. J., & Anthony, J. C. (2012) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.12.031 · Cited by 30 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Klein D Riso L Costello G 1994 Psychiatric disorders: problems of boundaries and comorbidity Basic Issues in Psychopathology 19 66 New York Guilford Press
Cited by
Sorted by citations
Hasin, D. S., & Grant, B. F. (2015) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-015-1088-0 · Cited by 452 · see citing works
Childhood Psychiatric Disorders as Risk Factor for Subsequent Substance Abuse: A Meta-Analysis.
Groenman, A. P., Janssen, T. W. P., & Oosterlaan, J. (2017) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2017.05.004 · Cited by 335 · see citing works
Danzo, S., Connell, A. M., & Stormshak, E. A. (2017) · Journal of Adolescence · doi:10.1016/j.adolescence.2017.01.007 · Cited by 56 · see citing works
A meta-analysis of the effect of substance use interventions on emotion outcomes.
Kang, D., Fairbairn, C. E., & Ariss, T. A. (2019) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000450 · Cited by 25 · see citing works
- Authors
- Pacek, L. R., Martins, S. S., & Crum, R. M.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Pacek, Lauren R.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 148
- Issue
- 2-3
- Pages
- 188-195
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC3608823
- OpenAlex
- W2069722293
- Cited by
- 164
- References
- 36
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 14 · 2023: 20 · 2022: 14 · 2021: 15 · 2020: 15 · 2019: 7 · 2018: 15 · 2017: 13 · 2016: 12 · 2015: 8 · 2014: 3 · 2013: 4
- FWCI
- 3.58
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Alcohol Abuse and Alcoholism (NIAAA)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Keywords
- alcoholism, cannabis use disorder, co-occurring substance use disorders, major depressive disorder, bidirectional relationship, incident depression, NESARC
- MeSH terms
- Adolescent, Adult, Marijuana Abuse, Major Depressive Disorder, Female, Health Surveys, Humans, Longitudinal Studies, Male, Middle Aged, United States, Comorbidity, Alcohol-Related Disorders, Young Adult
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