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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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“Risk factors for both using drugs and suffering from poor mental health can be concurrent (Bergen et al. 2008; Degenhardt et al. 2013; Stilo et al. 2016) and these may be individual as well as contextual.”
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Tadonio, L., Giudice, A., Infantino, C., Pilloni, S., Verdesca, M., Patianna, V. D., Gerra, G., & Esposito, S. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14207177 · Cited by 3
“Substance-use habits formed in adolescence often persist into adulthood, highlighting the need for early detection [32].”
Comorbid Anxiety and Alcohol or Substance Use Disorders: An Overview
Bartoli, F., Carretta, D., & Carrà, G. (2020) · Springer eBooks · doi:10.1007/978-3-030-36391-8_92 · Cited by 3
Hämmig, R., Preuss, U. W., & Soyka, M. (2018) · Elsevier eBooks · doi:10.1016/b978-3-437-23021-9.00009-6 · Cited by 3
Huizink, A. C. (2012) · Addiction · doi:10.1111/add.12046 · Cited by 3
“Commentary on Degenhardt et al. (2013): Specific effect of adolescent cannabis use on anxiety – tentative explanations Considerable attention has been paid to the hypothesized increase in incidence of psychotic disorders as a result of repeated (adolescent) cannabis use [1,2].”
BackgroundCannabis and mental health in adolescents: changes in associations over 15 years
Valter, R., Nézet, O. L., Obradović, I., Spilka, S., Falissard, B., Josseran, L., Gautier, S., & Airagnes, G. (2025) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-025-02859-7 · Cited by 2
Berny, L. M., Nichols, L. M., Schweer‐Collins, M. L., & Tanner‐Smith, E. E. (2025) · Prevention Science · doi:10.1007/s11121-025-01826-7 · Cited by 2
“…and psychosocial outcomes (Hall & Degenhardt, 2009), including reduced educational attainment, increased risk of cannabis dependence, other illicit drug use, criminal activity, internalizing disorder symptoms, and suicidality (Degenhardt et al., 2013; Fergusson et al., 2002; Silins et al., 2014).”
Differentiating Cannabis Use: Associations Between Product Type and Mental Health Outcomes
Leal, W. E., Boccio, C. M., & Moscrop-Blake, K. (2026) · Crime & Delinquency · doi:10.1177/00111287261441245 · Cited by 2
Whiteley, L., Warner, J. L., Ahuja, M., Curtis, V., Kessimian, M., Ryoo, H.-J., & Brown, L. K. (2017) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-017-9815-2 · Cited by 2
La mariguana en México: implicaciones biológicas y sociales en su legalización y regulación
Arellanes, F. J. V., & Mendívil, E. A. S. (2018) · Revista Internacional de Investigación en Adicciones · doi:10.28931/riiad.2018.1.05 · Cited by 2
“Otros trastornos como la depresión y la ansiedad también fueron analizados para evaluar si se presentan por el uso del cannabis; Degenhardt et al. (2013) indicaron que si bien no hay asociación consistente entre el consumo de cannabis y la depresión en adultos jóvenes, la utilización regular de…”
BackgroundCannabiskonsum zum Freizeitgebrauch
Schneider, M., Friemel, C. M., von Keller, R., Adorjan, K., Bonnet, U., Hasan, A., Hermann, D., Kambeitz, J., Koethe, D., Kraus, L., et al. (2018) · Springer eBooks · doi:10.1007/978-3-662-57291-7_3 · Cited by 2
Diabetes and Cannabis: Myth or Reality
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“including anxiety [3], schizophrenia [4,5], depression, dependence”
Malischnig, D., Baumgärtner, C., & Schaub, M. P. (2020) · Suchttherapie · doi:10.1055/a-1257-9681 · Cited by 2
“[11] Degenhardt L, Coffey C, Romaniuk H et al.”
BackgroundThe Psychiatric Disorders and Cannabis Use
Ouazzani, K. E., Karroumi, S., Elattar, A., Adali, I., & Manoudi, F. (2024) · SAS Journal of Medicine · doi:10.36347/sasjm.2024.v10i04.013 · Cited by 2
PSYCHIATRIC COMORBIDITY IN PATIENTS WITH OPIOID DEPENDENCE
Kattukulathil, S., Cholakottil, A., Kazhungil, F., Kottelassal, A., Thovarayi, R., & Narippatta, M. S. (2018) · Journal of Evidence Based Medicine and Healthcare · doi:10.18410/jebmh/2018/145 · Cited by 2
Heavy and Chronic Cannabis Addiction does not Impact Motor Function: A BOLD-fMRI Study
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Cannabis and Neuropsychiatric Effects
Rettew, D. C., Gundersen, D. C., Rapp, E. K., Riggs, P., Miller, C. L., Jackson, M., Sabet, K. A., Cort, B., & Bader, L. L. (2020) · Springer eBooks · doi:10.1007/978-3-030-45968-0_4 · Cited by 1
The Role of Sex and Coping Styles on the Relationship Between Depression and Cannabis Use
Villanueva‐Blasco, V. J., Mateu-Mollá, J., Vázquez‐Martínez, A., Boubeta, A. R., de Fonseca, F. R., & Folgar, M. I. (2024) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-024-01275-3 · Cited by 2
“However, other studies (Degenhardt et al., 2013; Georgiades & Boyle, 2007) suggest that cannabis consumers, including heavy users, were not more likely to be diagnosed with depression compared to non-users.”
Rabinow, L., Dries, E., & Hoffman, N. D. (2025) · Pediatrics in Review · doi:10.1542/pir.2024-006514 · Cited by 1
Comorbid Anxiety and Alcohol or Substance Use Disorders: An Overview
Bartoli, F., Carretta, D., Clerici, M., & Carrà, G. (2014) · Springer eBooks · doi:10.1007/978-88-470-5322-9_91 · Cited by 1
Predictive Modeling of Adolescent Cannabis Use From Multimodal Data
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Engaging Cannabis Users in Treatment
KAY‐LAMBKIN, F. J., Healey, A., Baker, A., Swift, W., Thornton, L. K., & Turner, A. (2017) · Elsevier eBooks · doi:10.1016/b978-0-12-800756-3.00134-4 · Cited by 1
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“However, a nine-wave, 15-year representative longitudinal cohort study that followed adolescents into young adulthood reported that regular (particularly daily) adolescent cannabis use was not associated with depressive disorder (Degenhardt et al., 2013).”
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Turner, S. D., Spithoff, S. M., & Kahan, M. (2014) · PubMed Central
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“co-exist with drug and alcohol problems, with problems in one domain perpetuating those in the other [6, 7].”
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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