Association of Cannabis With Long-Term Clinical Symptoms in Anxiety and Mood Disorders: A Systematic Review of Prospective Studies
Abstract
OBJECTIVE: To systematically review studies examining the longitudinal associations between cannabis use and symptomatic outcomes among individuals with an anxiety or mood disorder at baseline. DATA SOURCES: A search of the literature up to May 2017 was conducted using several databases. Search terms related to the exposure (ie, cannabis) and outcome (ie, symptoms) variables of interest. There were no search restrictions. STUDY SELECTION: In total, 10,191 citations were screened. Key inclusion criteria related to (1) cohort-based longitudinal study design using adults who met criteria for a mood or anxiety disorder at baseline, (2) an independent variable focusing on at least baseline cannabis use, and (3) a dependent variable focusing on the symptomatic course and/or outcomes in anxiety and mood disorders (AMD). DATA EXTRACTION: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Methodological characteristics and key findings were extracted from each study, and quality assessments were conducted for each study. RESULTS: Twelve studies (with a total of 11,959 individuals) met inclusion criteria related to posttraumatic stress disorder (n = 4), panic disorder (n = 1), bipolar disorder (n = 5), and depressive disorder (n = 2). Across 11 studies, "recent" cannabis use (ie, any/greater frequency of use during the last 6 months) was associated with higher symptomatic levels over time relative to comparison groups (ie, no/lesser frequency of use). Ten of these studies further suggested that cannabis use was associated with less symptomatic improvement from treatment (eg, medication, psychotherapy for AMD). CONCLUSIONS: Recent cannabis use was associated with negative long-term symptomatic and treatment outcomes across AMD. The findings should be interpreted with caution, considering the observational designs across studies and the biases associated with the samples (eg, inpatients) and sources of cannabis consumed (ie, unregulated sources). Nonetheless, clinicians can use the insight gained to inform their own and their patients' knowledge concerning potential risks of cannabis with regard to symptoms of AMD.
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Cannabis use did not impede recovery from panic disorder when treated with other medications or treatments.
“another study showed that cannabis use did not impede recovery from panic disorder’ when treated with other medications or treatments [46].”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [46]
There is strong early evidence that recent cannabis use is associated with negative long-term symptomatic and treatment outcomes across anxiety or mood disorders.
“There is strong early evidence that recent cannabis use is associated with negative long-term symptomatic and treatment outcomes across anxiety or mood disorders [46].”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [46]
Cannabis use itself can increase the risk for the onset of anxiety disorders, with greater symptom severity and with poorer treatment outcome.
“However, cannabis use itself can increase the risk for the onset of anxiety disorders, with greater symptom severity and with poorer treatment outcome [ (Grunberg, Cordova, Bidwell, & Ito, 2015;Mammen et al., 2018;Zvolensky et al., 2006), but see (Feingold, Rehm, Factor, Redler, & Lev-Ran, 2018)].”
From Novel pharmacological targets in drug development for the treatment of anxiety and anxiety-related disorders (2019) · cites this paper as Mammen et al., 2018
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“…of other longitudinal studies that have associated cannabis use with depressive symptoms and development of mood disorders, especially with frequent use (two or more days per week) or long-term use (six or more months) (Leadbeater et al., 2019; Lev-Ran et al., 2014; Mammen et al., 2018).”
A perspective review of cannabis use and sexual offenses
Erickson, S. K., & Vorwerk, M. L. (2022) · Behavioral Sciences & the Law · doi:10.1002/bsl.2571 · Cited by 2 · see citing works
Penney, S. R., Jones, R. M., Wilkie, T., Gerritsen, C. J., Chatterjee, S., Chaimowitz, G. A., & Simpson, A. I. F. (2024) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2024.104622 · Cited by 1 · see citing works
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Cannabinoid Drugs in Mental Health Disorders
Kloiber, S. M., Matheson, J., Kim, H. K., & Foll, B. L. (2021) · Springer eBooks · doi:10.1007/978-3-319-56015-1_465-1 · Cited by 3 · see citing works
The Differences between THC and CBD
Groh, C. (2022) · Home Healthcare Now · doi:10.1097/nhh.0000000000001048 · Cited by 1 · see citing works
Cannabinoids and Mental Health Risks
MacCallum, C. A., de Freitas, L., & Lu, S. (2021) · Springer eBooks · doi:10.1007/978-3-030-69186-8_33 · Cited by 1 · see citing works
Cannabis para el dolor neuropático crónico
Cuestas, E. (2019) · Revista de la Facultad de Ciencias Médicas de Córdoba · doi:10.31053/1853.0605.v76.n1.23669 · Cited by 1 · see citing works
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“Accumulating evidence also shows that marijuana use can precipitate or worsen existing mental health symptoms [14,15].”
Troubles anxieux, troubles dépressifs, conduites suicidaires et cannabis
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Is your patient’s cannabis use problematic?
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Cannabinoid Drugs in Mental Health Disorders
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“While many individuals report that acute use of cannabis is associated with anxiolytic properties, our findings and other evidence on mental health and cannabis use (Mammen et al., 2018) suggest that use of cannabis may be associated with worse anxiety symptoms.”
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“While cannabis provides immediate relief from some depressive symptoms, its effects are transient and long-term use actually worsens the course of depressive disorders [27,28].”
BackgroundDie Rolle von Cannabis für die Behandlung chronischer Schmerzen
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Kim, K., Kim, J., & Yoon, D. H. (2024) · Exercise Science · doi:10.15857/ksep.2024.00234
“Another meta-analysis by the same group in 2017 involving 2,901 patients with depression showed a substantial reduction in physical activity levels and increased sedentary time per day, suggesting an association between physical activity and depression [19].”
Background
- Authors
- Mammen, G., Rueda, S., Roerecke, M., Bonato, S., Lev-Ran, S., & Rehm, J.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2018-06-05
- Volume
- 79
- Issue
- 4
- ISSN
- 0160-6689 (ISSN-L)
- 1555-2101
- OpenAlex
- W2807041317
- Cited by
- 118
- References
- 0
- Citations by year
- 2026: 12 · 2025: 10 · 2024: 13 · 2023: 10 · 2022: 15 · 2021: 22 · 2020: 20 · 2019: 14 · 2018: 2
- FWCI
- 9.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- cannabis use, anxiety disorders, mood disorders, post-traumatic stress disorder, panic disorder, bipolar disorder, depressive disorders, symptom course, treatment response, drug response, psychotherapy response, longitudinal outcomes
- MeSH terms
- Anxiety, Marijuana Abuse, Humans, Marijuana Smoking, Treatment Outcome, Mood Disorders
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