Cannabis and Anxiety and Depression in Young Adults: A Large Prospective Study

doi:10.1097/chi.0b013e31802dc54d

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 46, Issue 3, March 2007, Pages 408-417

https://doi.org/10.1097/chi.0b013e31802dc54d Get rights and content

ABSTRACT

Objective

To examine whether age of first use or frequency of use of cannabis is associated with anxiety and depression (AD) in young adults, independent of known potential confounders, including the use of other illicit drugs.

Method

A cohort of 3,239 Australian young adults was followed from birth to the age of 21 when data on AD were obtained from sample members along with information on their use of cannabis at 21 years. Potential confounding factors were prospectively measured when the child was born and at 14 years.

Results

After controlling for confounding factors, those who started using cannabis before age 15 years and used it frequently at 21 years were more likely to report symptoms of AD in early adulthood (odds ratio 3.4; 95% CI 1.9-6.1). This association was of similar magnitude for those who had only used cannabis and those who reported having used cannabis and other illicit drugs.

Conclusion

The relationship between early-onset and frequent use of cannabis and symptoms of AD is independent of individual and family backgrounds. Frequent cannabis use is associated with increased AD in young adults independently of whether the person also uses other illicit drugs.

Section snippets

Participants

The data we used were taken from the 21-year Mater University Study of Pregnancy (MUSP; Najman et al., 2005). After piloting, it was clear that the cost and effort required to recruit privately insured patients were prohibitive (many obstetricians at varied sites). Consequently, privately insured pregnant women (39%) and emergencies transferred to this specialist obstetric service were excluded and 8,556 consecutive patients (at an average of 18 weeks of gestation) were invited to participate

RESULTS

Overall, 3,239 young adults provided information about age at onset and frequency of use of cannabis and about AD. Some 49.0% had used cannabis, comprising 36.8% who reported use of cannabis once in the past month or no use in the past month (occasional users) and 12.2% who had used cannabis at least every few days in the past month (frequent users). Age at initiation to use of cannabis ranged between 7 and 21 years (mean 15.8, SD 1.9 years). Of 1,586 participants who had ever used cannabis,

DISCUSSION

Using data from a birth cohort study, we examined three models of association between use of cannabis and AD. We found that the association between cannabis and AD is not explained by measured individual and social factors at baseline. Furthermore, symptoms of AD in early adolescence do not appear to predict a child's use of cannabis. However, age at onset and frequency of use of cannabis (both reported at 21 years) are significantly associated with symptoms of AD in young adults; MUSP

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We based our analyses on cross-sectional data from the 2019 Ontario Student Drug Use and Health Survey, a provincially representative sample of students in grades 7 through 12 (aged 11–20 years or older) across Ontario, Canada (n= 7097; mean age: 15.2 ± 1.2 years). Logistic regression analyses were adjusted for important covariates.
We found that 20.5% reported cannabis use only, 5.8% reported opioid use only, and 5% reported both cannabis and opioid use. Cannabis use only (odds ratio [OR]:1.91; 95% confidence interval [CI]:1.53–2.37), opioid use only (OR: 2.21; 95% CI: 1.63–3.00), and both cannabis and opioid use (OR: 3.24; 95% CI: 2.25–4.66) were associated with greater odds of serious psychological distress after adjustment for covariates. Associations were similar for males and females.
The use of both cannabis and opioids is significantly associated with serious psychological distress among adolescents. Adolescents who use both cannabis and opioids represent a small and vulnerable group that should be targeted in future interventions against mental health problems. Health professionals should consider screening for polysubstance use, especially when working with adolescents who use cannabis.
Parallel trajectories of vaping and smoking cannabis and their associations with mental and physical well-being among young adults
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Vaping and smoking are common modes of using cannabis (THC) among young adults, but little is known about how patterns of cannabis vaping and smoking unfold over time or how using one or both types of products may differently affect mental and physical well-being. This study examines parallel processes of cannabis vaping and smoking over 5 years and mental and physical outcomes in a sample of young adults.
Annual surveys were conducted between 2016 and 2022 with a mostly California-based cohort of 2428 young adults. Parallel process growth mixture models examined trajectories of past-month frequency of cannabis vaping and smoking from ages 20 – 25. Classes were extracted based on parallel trajectories of vaped and smoked product use. Models assessed differences in self-reported mental (anxiety, depression) and physical (ailments, subjective overall) well-being outcomes in young adulthood across classes, adjusting for demographic characteristics and mental and physical well-being at pre-baseline (average age 19).
Four cannabis vaping/smoking classes emerged: low use of cannabis (84.7%), decreasing smoking, low-moderate vaping (7.1%), stable moderate smoking, decreasing vaping (4.6%), and rapid increasing dual use (3.4%). Classes were similar on physical well-being indicators in young adulthood. The rapid increasing dual use class showed higher anxiety and depressive symptoms compared to other classes.
Progression to higher frequency of both vaping and smoking cannabis in young adulthood may contribute to poorer mental well-being compared to other use patterns. Targeted efforts to reduce dual vaping and smoking in young people who use cannabis may be needed.
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Collectively, these findings strongly suggest that HU210 activates brain CB1R to induce in vivo LTD at CA3-CA1 synapses, leading to antidepressant effects in response to acute stress. Several studies have shown that cannabis use is associated with an increased risk of developing depression and anxiety, especially when used during adolescence [17]. There appears to be less evidence for a correlation between depression and cannabis use in adulthood [15,25].
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Directional associations between cannabis use and anxiety symptoms from late adolescence through young adulthood
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Two major theories aid in explaining the association between anxiety and cannabis use: a symptom-driven pathway (heightened anxiety precedes greater cannabis use) and a substance-induced pathway (greater use precedes heightened anxiety). Although the co-occurrence of cannabis use and anxiety symptomology is well-established, less is known about the temporal sequence of cannabis use and anxiety symptomology over the course of young adult development
Data are from an ongoing, longitudinal, cohort study. All prospective analyses used data from wave 8, when participants were between the ages of 17 and 20, through wave 13, when participants are between ages 21 and 24 (N = 2995). Data were set up in accelerated longitudinal design in which we estimated a series of latent difference score models between anxiety and cannabis use from 17 to 24 years old. Models were estimated for men and women, separately.
For the overall sample and men, greater cannabis use predicted greater subsequent increases in anxiety; however, greater anxiety symptoms were associated with decreasing cannabis use. For women, results were more complex. A positive association was noted between prior, trait-like levels of anxiety predicting greater change (increasing) in anxiety symptomology. However, when change is predicted by prior change we see that cannabis use decreases among women who have recently experienced an increase in anxiety
The nuanced set of results from this study support a dynamic interplay between anxiety symptoms and cannabis use, with important sex differences observed. Overall, our results pave the way for rethinking our guiding theories to include a more robust, flexible, and dynamic model for understanding associations between substance use and mental health symptomology during a key period of development.
Perceived racial and social class discrimination and cannabis involvement among Black youth and young adults
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The current study examines the association of perceived racial and social class discrimination with cannabis involvement among Black youth and young adults.
This secondary analysis used data from the Missouri Family Study (MOFAM), a high-risk longitudinal family study of alcohol use disorder, oversampled for Black families. Offspring (n = 806) and their mothers were interviewed by telephone. Cox proportional hazards regression analyzes were used to examine associations of racial and social class discrimination (experienced by offspring and their mothers) with offspring cannabis involvement. Two stages of cannabis involvement were analyzed: timing of 1) initiation and 2) transition from initiation to first cannabis use disorder (CUD) symptom.
The study found that offspring report of experiencing racial (HR: 1.28, CI: 1.01–1.62) and social class discrimination (HR: 1.45, CI: 1.14–1.84) were associated with cannabis initiation in our fully adjusted model. Mothers’ report of discrimination predicted a lower hazard of cannabis initiation among offspring (HR: 0.79, CI: 0.64–0.98). Offspring social class discrimination (HR: 2.45, CI: 1.71–3.51) predicted an increased hazard of transition from initiation to first CUD symptom, while offspring racial discrimination (HR: 0.57, CI: 0.39–0.85) was associated with lower hazard of transition in our fully adjusted model.
As rates for cannabis use among Black youth are disproportionately rising, there is a critical need to identify pathways to its use among Black youth. These findings suggest racial and social class discrimination may be important targets in efforts to prevent cannabis involvement among Black youth and emerging adults.
Early substance use and the school environment: A multilevel latent class analysis
2024, Journal of the Canadian Academy of Child and Adolescent Psychiatry

View all citing articles on Scopus

The core study was funded by the National Health and Medical Research Council of Australia, but the views expressed in the article are those of the authors and not necessarily those of any funding body. The authors thank the Mater University Study of Pregnancy (MUSP) participants, MUSP Research Team, Rosemary Aird, and the rest of the MUSP21 data collection team; MUSP Data Manager Greg Shuttlewood; the Mater Misericordiae Hospital; and the Schools of Social Science, Population Health, and Medicine at The University of Queensland for their support.

Disclosure: Professor Jamrozik is a principal investigator in a separate study for which vitamin tablets are provided by Blackmore's. The other authors have no financial relationships to disclose.

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ARTICLESCannabis and Anxiety and Depression in Young Adults: A Large Prospective Study

ABSTRACT

Objective

Method

Results

Conclusion

Section snippets

Participants

RESULTS

DISCUSSION

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Drug Alcohol Depend

Neuroscience

Manual for the Youth Self-Report and 1991 Profile

Manual for the Young Adult Self-Report and Young Adult Behavior Checklist

Manual for the Child Behavior Checklist and Revised Child Behavior Profile

Community studies on adolescent substance use, abuse, or dependence and psychiatric comorbidity

J Consult Clin Psychol

A replication study of Foulds' and Bedford's hierarchical model of depression

Br J Psychiatry

Delusions-Symptoms-States Inventory of Anxiety and Depression

Cannabis abuse as a risk factor for depressive symptoms

Am J Psychiatry

Drug use and the risk of major depressive disorder, alcohol dependence, and substance use disorders

Arch Gen Psychiatry

Cannabis use: consistency and validity of self-report, on-site urine testing and laboratory testing

Addiction

The endocannabinoid system: physiology and pharmacology

Alcohol Alcoholism

The relationship between cannabis use, depression and anxiety among Australian adults: findings from the National Survey of Mental Health and Well-Being

Soc Psychiatry Psychiatr Epidemiol

Exploring the association between cannabis use and depression

Addiction

Cannabis use and psychosocial adjustment in adolescence and young adulthood

Addiction

The short-term consequences of early onset cannabis use

J Abnorm Child Psychol

Family disruption in childhood and risk of adult depression

Am J Psychiatry

ARTICLES
Cannabis and Anxiety and Depression in Young Adults: A Large Prospective Study