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The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood
Abstract
AIMS: Debate continues about whether the association between cannabis use in adolescence and common mental disorders is causal. Most reports have focused on associations in adolescence, with few studies extending into adulthood. We examine the association from adolescence until the age of 29 years in a representative prospective cohort of young Australians. DESIGN: Nine-wave, 15-year representative longitudinal cohort study, with six waves of data collection in adolescence (mean age 14.9-17.4 years) and three in young adulthood (mean age 20.7, 24.1 and 29.1 years). PARTICIPANTS: Participants were a cohort of 1943 recruited in secondary school and surveyed at each wave when possible from mid-teen age to their late 20s. SETTING: Victoria, Australia. MEASUREMENTS: Psychiatric morbidity was assessed with the Revised Clinical Interview Schedule (CIS-R) at each adolescent wave, and as Composite International Diagnostic Interview (CIDI)-defined ICD-10 major depressive episode and anxiety disorder at 29 years. Frequency of cannabis use was measured in the past 6 months in adolescence. Cannabis use frequency in the last year and DSM-IV cannabis dependence were assessed at 29 years. Cross-sectional and prospective associations of these outcomes with cannabis use and dependence were estimated as odds ratios (OR), using multivariable logistic regression models, with the outcomes of interest, major depressive episode (MDE) and anxiety disorder (AD) at 29 years. FINDINGS: There were no consistent associations between adolescent cannabis use and depression at age 29 years. Daily cannabis use was associated with anxiety disorder at 29 years [adjusted OR 2.5, 95% confidence interval (CI):< 1.2-5.2], as was cannabis dependence (adjusted OR 2.2, 95% CI: 1.1-4.4). Among weekly+ adolescent cannabis users, those who continued to use cannabis use daily at 29 years remained at significantly increased odds of anxiety disorder (adjusted OR 3.2, 95% CI: 1.1-9.2). CONCLUSIONS: Regular (particularly daily) adolescent cannabis use is associated consistently with anxiety, but not depressive disorder, in adolescence and late young adulthood, even among regular users who then cease using the drug. It is possible that early cannabis exposure causes enduring mental health risks in the general cannabis-using adolescent population.
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“Interestingly, the higher risk for depression and anxiety in adolescents that continue to smoke until age 29 years was also confirmed by Degenhardt et al, 38 suggesting that even the chronic use in young age is detrimental for mental health.”
From Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood (2019) · cites this paper as [38]
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“CU was associated with increased emergence of MDD in some studies,(49,50,56,57) but not in others.(27,55,58) Further, in a prospective study, both high and low frequency of CU before the age of 18 years were associated with an increased risk of developing MDD,(57) while cross-sectional studies identified an increased…”
BackgroundMokwena, K. (2019) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v11i1.2136 · Cited by 36
Juvenile cannabinoid treatment induces frontostriatal gliogenesis in Lewis rats
Bortolato, M., Bini, V., Frau, R., Devoto, P., Pardu, A., Fan, Y., & Solbrig, M. V. (2014) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2013.12.011 · Cited by 32
“Whereas only a minority of young marijuana smokers develop schizophrenia, other individuals may exhibit different psychopathological sequelae, such as mood and personality disorders, anxiety or attention impairments (Degenhardt et al., 2012; for a general overview, see Jager and Ramsey, 2008).”
BackgroundBaggio, S., N'Goran, A. A., Deline, S., Studer, J., Dupuis, M., Henchoz, Y., Mohler-Kuo, M., Daeppen, J.-B., & Gmel, G. (2014) · Addiction · doi:10.1111/add.12490 · Cited by 31
Cannabis use, harms and the management of cannabis use disorder
Copeland, J., Clement, N., & Swift, W. (2014) · Neuropsychiatry · doi:10.2217/npy.13.90 · Cited by 33
Self-citationPrevalence and Correlates of Medicinal Cannabis Use Among Adolescents
Wardell, J. D., Rueda, S., Elton‐Marshall, T., Mann, R. E., & Hamilton, H. A. (2020) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2020.07.032 · Cited by 31
Bataineh, B. S., Wilkinson, A. V., Sumbe, A., Clendennen, S. L., Chen, B., Messiah, S. E., & Harrell, M. B. (2023) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntad058 · Cited by 33
Danielsson, A., Lundin, A., Allebeck, P., & Agardh, E. E. (2016) · Addictive Behaviors · doi:10.1016/j.addbeh.2016.03.005 · Cited by 31
Cannabis Use and Risk for Substance Use Disorders and Mood or Anxiety Disorders
Hill, K. P. (2017) · JAMA · doi:10.1001/jama.2016.19706 · Cited by 30
Hirjak, D., Schmitgen, M. M., Werler, F., Wittemann, M., Kubera, K. M., Wolf, N. D., Sambataro, F., Calhoun, V. D., Reith, W., & Wolf, R. C. (2021) · Addiction Biology · doi:10.1111/adb.13113 · Cited by 31
“In 2010, there were 2 million disability-adjusted life years (DALYs) attributable to cannabis dependence.(3,8) According to recent scientific evidence, there is a causal link between cannabis use and long-lasting common mental disorders (e.”
BackgroundOtten, R., Huizink, A. C., Monshouwer, K., Creemers, H. E., & Onrust, S. A. (2016) · Addiction Biology · doi:10.1111/adb.12372 · Cited by 29
Cannabis Use as a Risk Factor for Depression, Anxiety, and Suicidality
Halladay, J. E., MacKillop, J. M., Munn, C., Jack, S. M., & Georgiades, K. (2020) · Journal of Addictions Nursing · doi:10.1097/jan.0000000000000334 · Cited by 36
Brook, J. S., Zhang, C., Rubenstone, E., Primack, B. A., & Brook, D. W. (2016) · Addictive Behaviors · doi:10.1016/j.addbeh.2016.06.003 · Cited by 36
Lowe, D. J. E., Sorkhou, M., & George, T. P. (2024) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990.2023.2299922 · Cited by 36
“Six prospective studies following adolescents until young or middle adulthood observed a significant relationship between adolescent cannabis use and elevated levels of anxiety (20–22 , 41– 47).”
BackgroundInfluentialLiebregts, N., van der Pol, P., van Laar, M., de Graaf, R., van den Brink, W., & Korf, D. J. (2013) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2013.00085 · Cited by 26
“event experienced (n) Cannabis use NNN (12) NDN (7) NDD (4) DNN (10) DND (2) DDN (5) DDD (7) Total (47)”
BackgroundShi, Y. (2013) · Addictive Behaviors · doi:10.1016/j.addbeh.2013.12.013 · Cited by 25
“Previous studies have proposed a few biological, social, and psychological factors to explain the disparity in marijuana use between adults with and without mental health problems (Buckner, Ecker, & Cohen, 2010; Cooper & Haney, 2008; Degenhardt et al., 2013; Degenhardt, Hall, & Lynskey, 2003; Gorzalka, Hill, & Hillard…”
BackgroundMeier, M. H., Beardslee, J., & Pardini, D. A. (2020) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-020-00641-8 · Cited by 26
Longitudinal associations of cannabis, depression, and anxiety in heterosexual and LGB adolescents.
London-Nadeau, K., Rioux, C., Parent, S., Vitaro, F., Côté, S. M., Boivin, M., Tremblay, R. E., Séguin, J. R., & Ryan, N. C. (2021) · Journal of Abnormal Psychology · doi:10.1037/abn0000542 · Cited by 36
The Impact of Adolescent Substance Use on Family Functioning
Russell, B. S., Simpson, E. G., Flannery, K. M., & Ohannessian, C. M. (2017) · Youth & Society · doi:10.1177/0044118x16688708 · Cited by 25
Feingold, D., Rehm, J., Factor, H., Redler, A., & Lev‐Ran, S. (2018) · Depression and Anxiety · doi:10.1002/da.22735 · Cited by 24
“For example, participants under the age of 18 were not included in the NESARC (Stetser, Shepherd, & Moore, 2002); thus, our study did not take into consideration the high co-occurrence of cannabis use and anxiety disorders during adolescence (Degenhardt et al., 2013).”
BackgroundResultCo-Occurrence of Substance-Related and Other Mental Health Disorders Among Adolescent Cannabis Users
Zaman, T., Malowney, M., Knight, J. R., & Boyd, J. W. (2015) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000138 · Cited by 25
“Given recent increases in diagnoses of ADHD and controversies surrounding the risks/benefits of treatment, including the potential risk for addiction to stimulants, this may prove an important clinical consideration (Degenhardt et al., 2013).”
BackgroundInfluentialRisk Factors for Pediatric Anxiety Disorders
Warner, E. N., & Strawn, J. R. (2023) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2022.10.001 · Cited by 26
The association between cannabis and depression: an updated Systematic Review and Meta-analysis
Churchill, V., Chubb, C. S., Popova, L., Spears, C. A., & Pigott, T. (2025) · Psychological Medicine · doi:10.1017/s0033291724003143 · Cited by 22
“…et al., 2021) that we added to the original studies from the Lev-Ran et al. analysis (Bovasso, 2001; Brook et al., 2002; Brook et al., 2011; Degenhardt et al., 2013; Fergusson & Horwood, 1997; Georgiades & Boyle, 2007; Harder et al., 2008; Manrique-Garcia et al., 2012; Marmorstein &…”
Intrinsic Frontolimbic Connectivity and Mood Symptoms in Young Adult Cannabis Users
Shollenbarger, S. G., Thomas, A. M., Wade, N. E., Gruber, S. A., Tapert, S. F., Filbey, F. M., & Lisdahl, K. M. (2019) · Frontiers in Public Health · doi:10.3389/fpubh.2019.00311 · Cited by 24
Adult Psychiatric, Substance, and Functional Outcomes of Different Definitions of Early Cannabis Use
Copeland, W., Hill, S., & Shanahan, L. (2021) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2021.07.824 · Cited by 23
Metadata
- Authors
- Degenhardt, L., Coffey, C., Romaniuk, H., Swift, W., Carlin, J. B., Hall, W. D., & Patton, G. C.
- Affiliations
- The University of Melbourne (AU)
- Royal Children's Hospital (AU)
- UNSW Sydney (AU)
- The University of Queensland (AU)
- Corresponding author
- Degenhardt, Louisa
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2012-10-18
- Volume
- 108
- Issue
- 1
- Pages
- 124-133
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W2111932815
- Cited by
- 237
- References
- 49
- Citations by year
- 2026: 8 · 2025: 11 · 2024: 12 · 2023: 8 · 2022: 20 · 2021: 15 · 2020: 22 · 2019: 17 · 2018: 25 · 2017: 22 · 2016: 18 · 2015: 22 · 2014: 25 · 2013: 9 · 2012: 3
- FWCI
- 13.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- 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
- adolescent cannabis use, cannabis use disorder, anxiety disorders, major depressive episode, common mental disorders, early adulthood, daily cannabis use, long-term mental health outcomes, causal relationship
- MeSH terms
- Adolescent, Adult, Anxiety Disorders, Marijuana Abuse, Major Depressive Disorder, Depressive Disorder, Major, Female, Humans, Longitudinal Studies, Male, Marijuana Smoking, Young Adult
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