Adolescence & Development
Study register · detail Prospektive Kohortenstudie · Adolescence & Development · 2021

Adolescent cannabis use, depression and anxiety disorders in the Northern Finland Birth Cohort 1986

Clear benefit GRADE Low 16 citations
Samplen = 6.325 Pat.
Durationup to 33 years
EndpointIncidence of…
Blindingn.a.
DesignProspektive Kohortenstudie
Key finding

Adolescent cannabis use is associated with a significantly increased risk of depression and anxiety disorders in adulthood.

Summary

Birth cohort study (n=6.325, follow-up 15–33 years); adolescent cannabis use (5.6% adolescents) associated with increased risk of anxiety disorders (HR 2.01, 95% CI 1.15–3.82 for ≥5× use) and depression (HR 1.93–2.02) in adulthood; association persists after adjustment for parental psychiatric history and other substances (p-values not explicit, HR-CIs exclude 1.0).

P
PopulationAdolescents from the Northern Finland Birth Cohort 1986, n=6325 (48,8% male), with follow-up to the age of 33
I
InterventionCannabis use in adolescence (up to 15–16 years), categorized by frequency (once, 2–4 times, ≥5 times)
O
OutcomeIncreased risk of depression with one-time use (HR 1,93; 95%-CI 1,30–2,87) and 2–4-time use (HR 2,02; 95%-CI 1,24–3,31); increased risk of anxiety disorders with ≥5-time use (HR 2,01; 95%-CI 1,15–3,82) after adjustment for confounding variables
Confidence in the evidence
Low

The second of four GRADE levels, the effect estimate is of limited reliability.

Quality profile
Sample size
Blinding
Effect size Clear benefit
Citations / year
Authors
Mustonen A, Hielscher E, Miettunen J et al.
DOI 10.1192/bjo.2021.967
Design: Prospektive Kohortenstudie
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Abstract
<h4>Background</h4>Cannabis use has been associated with increased risk of psychiatric disorders. However, associations between adolescent cannabis use, depression and anxiety disorders are inconsistently reported in longitudinal samples.<h4>Aims</h4>To study associations of adolescent cannabis use with depression and anxiety disorders.<h4>Method</h4>We used data from the Northern Finland Birth Cohort 1986, linked to nationwide registers, to study the association between adolescent cannabis use and depression and anxiety disorders until 33 years of age (until 2018).<h4>Results</h4>We included 6325 participants (48.8% male) in the analyses; 352 (5.6%) participants reported cannabis use until 15-16 years of age. By the end of the follow-up, 583 (9.2%) participants were diagnosed with unipolar depression and 688 (10.9%) were diagnosed with anxiety disorder. Cannabis use in adolescence was associated with an increased risk of depression and anxiety disorders in crude models. After adjusting for parental psychiatric disorder, baseline emotional and behavioural problems, demographic factors and other substance use, using cannabis five or more times was associated with increased risk of anxiety disorders (hazard ratio 2.01, 95% CI 1.15-3.82), and using cannabis once (hazard ratio 1.93, 95% CI 1.30-2.87) or two to four times (hazard ratio 2.02, 95% CI 1.24-3.31) was associated with increased risk of depression.<h4>Conclusions</h4>Cannabis use in adolescence was associated with an increased risk of future depression and anxiety disorders. Further research is needed to clarify if this is a causal association, which could then inform public health messages about the use of cannabis in adolescence.

The impediment to action advances action. — Marcus Aurelius