Dataset Information

Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood: A Systematic Review and Meta-analysis.

ABSTRACT:

Importance

Cannabis is the most commonly used drug of abuse by adolescents in the world. While the impact of adolescent cannabis use on the development of psychosis has been investigated in depth, little is known about the impact of cannabis use on mood and suicidality in young adulthood.

Objective

To provide a summary estimate of the extent to which cannabis use during adolescence is associated with the risk of developing subsequent major depression, anxiety, and suicidal behavior.

Data sources

Medline, Embase, CINAHL, PsycInfo, and Proquest Dissertations and Theses were searched from inception to January 2017.

Study selection

Longitudinal and prospective studies, assessing cannabis use in adolescents younger than 18 years (at least 1 assessment point) and then ascertaining development of depression in young adulthood (age 18 to 32 years) were selected, and odds ratios (OR) adjusted for the presence of baseline depression and/or anxiety and/or suicidality were extracted.

Data extraction and synthesis

Study quality was assessed using the Research Triangle Institute item bank on risk of bias and precision of observational studies. Two reviewers conducted all review stages independently. Selected data were pooled using random-effects meta-analysis.

Main outcomes and measures

The studies assessing cannabis use and depression at different points from adolescence to young adulthood and reporting the corresponding OR were included. In the studies selected, depression was diagnosed according to the third or fourth editions of Diagnostic and Statistical Manual of Mental Disorders or by using scales with predetermined cutoff points.

Results

After screening 3142 articles, 269 articles were selected for full-text review, 35 were selected for further review, and 11 studies comprising 23 317 individuals were included in the quantitative analysis. The OR of developing depression for cannabis users in young adulthood compared with nonusers was 1.37 (95% CI, 1.16-1.62; I2 = 0%). The pooled OR for anxiety was not statistically significant: 1.18 (95% CI, 0.84-1.67; I2 = 42%). The pooled OR for suicidal ideation was 1.50 (95% CI, 1.11-2.03; I2 = 0%), and for suicidal attempt was 3.46 (95% CI, 1.53-7.84, I2 = 61.3%).

Conclusions and relevance

Although individual-level risk remains moderate to low and results from this study should be confirmed in future adequately powered prospective studies, the high prevalence of adolescents consuming cannabis generates a large number of young people who could develop depression and suicidality attributable to cannabis. This is an important public health problem and concern, which should be properly addressed by health care policy.

SUBMITTER: Gobbi G

PROVIDER: S-EPMC6450286 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:ImportanceLittle is known about cannabis vaping trajectories across adolescence and young adulthood or the co-occurrence with nicotine vaping.ObjectiveTo evaluate nicotine vaping and cannabis vaping trajectories from late adolescence to young adulthood (≥18 years of age) and the extent of polysubstance vaping.Design, setting, and participantsIn this prospective cohort study, 5 surveys (including information on substance vaped) were completed at 10 high schools in the Los Angeles, California, metro area. Students were surveyed at 6-month intervals from fall of 11th grade (October to December 2015; wave 5) through spring of 12th grade (March to June 2017; wave 8) and again approximately 1 to 2 years after high school (October 2018 to October 2019; wave 9).ExposuresPast 30-day nicotine and cannabis vaping frequency across 5 waves.Main outcomes and measuresSelf-reported frequency of nicotine vaping and cannabis vaping within the past 30 days across 5 time points from late adolescence to young adulthood. Trajectories were measured with these past 30-day use frequencies at each wave. Parallel growth mixture modeling estimated conditional probabilities of polysubstance vaping.ResultsThe analytic sample included 3322 participants with at least 1 time point of data (mean [SD] age, 16.50 [0.42] years at baseline; 1777 [53.5%] female; 1573 [47.4%] Hispanic or Latino). Growth mixture modeling identified the 5-trajectory model as optimal for both nicotine vaping and cannabis vaping. Trajectories for nicotine and cannabis vaping were similar (nonusers: 2246 [67.6%] nicotine, 2157 [64.9%] cannabis; infrequent users: 566 [17.0%] nicotine, 608 [18.3%] cannabis; moderate users: 167 [5.0%] nicotine, 233 [7.0%] cannabis; young adult-onset frequent users: 213 [6.4%] nicotine, 190 [5.7%] cannabis; adolescent-onset escalating frequent users: 131 [3.9%] nicotine, 134 [4.0%] cannabis). Males had greater odds of belonging to the adolescent-onset escalating frequent users nicotine (adjusted odds ratio, 2.88; 95% CI, 1.58-5.23; P < .01) and cannabis (adjusted odds ratio, 1.95; 95% CI,1.03-3.66; P < .05) vaping trajectories compared with nonusers. Polysubstance vaping was common, with those in trajectories reflecting more frequent nicotine vaping (adolescent-onset escalating frequent users and young adult-onset frequent users) having a high probability of membership (85% and 93%, respectively) in a cannabis-use trajectory.Conclusions and relevanceIn this cohort study, the prevalence and type of nicotine vaping and cannabis vaping developmental trajectories from late adolescence to young adulthood were similar. Polysubstance vaping was common from late adolescence to young adulthood, particularly among those reporting more frequent vaping use. The findings suggest that public health policy and clinical interventions should address polysubstance vaping in both adolescence and young adulthood.

Project description:ImportanceMental health problems are common during the transition from adolescence to young adulthood. Although perceived social support and mental health problems have been shown to be concurrently associated, longitudinal studies are lacking to document the directionality of this association, especially in emerging adulthood (late teens to late 20s).ObjectiveTo test whether social support in emerging adulthood protects against later depression, anxiety, and suicidal ideation and suicide attempts after adjusting for a range of confounders, including prior mental health problems and family characteristics.Design, setting, and participantsThis population-based cohort study included 1174 participants from the Quebec Longitudinal Study of Child Development. Participants underwent yearly or biennial assessment (starting from age 5 months to age 20 years). Data were collected from March 16, 1998, through June 1, 2018.Main outcomes and measuresSelf-reported perceived social support was measured at age 19 years using the 10-item Social Provision Scale. Mental health problems, including depressive and anxiety symptoms as well as suicidal ideation and attempts, were measured at age 20 years. Social support and mental health problem raw scores were converted to z-scores to ease interpretation. Depressive and anxiety symptoms were categorized using validated cutoffs to determine clinical significance.ResultsThe study consisted of 1174 participants (574 female [48.89%] and 600 male [51.11%] individuals). Emerging adults with higher levels of perceived social support at age 19 years reported fewer mental health problems 1 year later, even after adjusting for a range of mental health problems in adolescence at ages 15 and 17 years (eg, depressive and anxiety symptoms and suicidal ideation and attempts) and family characteristics (eg, socioeconomic status and family functioning and structure). Higher perceived social support was associated with fewer symptoms of depression (β = -0.23; 95% CI, -0.26 to -0.18; P = <.001 and odds ratio [OR], 0.53; 95% CI, 0.42-0.66 for severe depression) and anxiety (β = -0.10; 95% CI, -0.15 to -0.04; P < .001 and OR, 0.78; 95% CI, 0.62-0.98 for severe anxiety). Higher perceived social support was associated with a lower risk for suicide-related outcomes (OR, 0.59 [95% CI, 0.50-0.70] for suicidal ideation and OR, 0.60 [95% CI, 0.46-0.79] for suicide attempts).Conclusions and relevanceIn this cohort study, emerging adults who perceived higher levels of social support reported experiencing fewer mental health problems 1 year later. These findings suggest that perceived social support may protect against mental health problems during the transition into adulthood, even in those who experience mental health problems in adolescence. Leveraging social support in prevention and treatment options may protect against mental health symptoms during this transition period.

Project description:ImportanceAnimal studies have shown that the adolescent brain is sensitive to disruptions in endocannabinoid signaling, resulting in altered neurodevelopment and lasting behavioral effects. However, few studies have investigated ties between cannabis use and adolescent brain development in humans.ObjectiveTo examine the degree to which magnetic resonance (MR) imaging-assessed cerebral cortical thickness development is associated with cannabis use in a longitudinal sample of adolescents.Design, setting, and participantsData were obtained from the community-based IMAGEN cohort study, conducted across 8 European sites. Baseline data used in the present study were acquired from March 1, 2008, to December 31, 2011, and follow-up data were acquired from January 1, 2013, to December 31, 2016. A total of 799 IMAGEN participants were identified who reported being cannabis naive at study baseline and had behavioral and neuroimaging data available at baseline and 5-year follow-up. Statistical analysis was performed from October 1, 2019, to August 31, 2020.Main outcomes and measuresCannabis use was assessed at baseline and 5-year follow-up with the European School Survey Project on Alcohol and Other Drugs. Anatomical MR images were acquired with a 3-dimensional T1-weighted magnetization prepared gradient echo sequence. Quality-controlled native MR images were processed through the CIVET pipeline, version 2.1.0.ResultsThe study evaluated 1598 MR images from 799 participants (450 female participants [56.3%]; mean [SD] age, 14.4 [0.4] years at baseline and 19.0 [0.7] years at follow-up). At 5-year follow-up, cannabis use (from 0 to >40 uses) was negatively associated with thickness in left prefrontal (peak: t785 = -4.87, cluster size = 1558 vertices; P = 1.10 × 10-6, random field theory cluster corrected) and right prefrontal (peak: t785 = -4.27, cluster size = 1551 vertices; P = 2.81 × 10-5, random field theory cluster corrected) cortices. There were no significant associations between lifetime cannabis use at 5-year follow-up and baseline cortical thickness, suggesting that the observed neuroanatomical differences did not precede initiation of cannabis use. Longitudinal analysis revealed that age-related cortical thinning was qualified by cannabis use in a dose-dependent fashion such that greater use, from baseline to follow-up, was associated with increased thinning in left prefrontal (peak: t815.27 = -4.24, cluster size = 3643 vertices; P = 2.28 × 10-8, random field theory cluster corrected) and right prefrontal (peak: t813.30 = -4.71, cluster size = 2675 vertices; P = 3.72 × 10-8, random field theory cluster corrected) cortices. The spatial pattern of cannabis-related thinning was associated with age-related thinning in this sample (r = 0.540; P < .001), and a positron emission tomography-assessed cannabinoid 1 receptor-binding map derived from a separate sample of participants (r = -0.189; P < .001). Analysis revealed that thinning in right prefrontal cortices, from baseline to follow-up, was associated with attentional impulsiveness at follow-up.Conclusions and relevanceResults suggest that cannabis use during adolescence is associated with altered neurodevelopment, particularly in cortices rich in cannabinoid 1 receptors and undergoing the greatest age-related thickness change in middle to late adolescence.

Project description:BackgroundPsychosomatic complaints are reported by high shares of adolescents in Sweden and elsewhere. Yet, little is known about to the extent to which the frequency, number, and persistence of such complaints in adolescence are associated with subsequent mental health problems. The aim of this study was to examine how the frequency, number, and persistence of psychosomatic complaints in middle and late adolescence are associated with depression and anxiety symptoms in young adulthood.MethodsA Swedish national cohort study of adolescents who were surveyed in 2017 (t1; age 15-16), in 2019 (t2; age 17-18) and in 2022 (t3; age 20-21 years) was used. Psychosomatic complaints were measured by questions on stomach ache, headache and difficulties falling asleep at t1 and t2. Depression and anxiety symptoms were measured by the Patient Health Questionnaire-4 (PHQ-4) at t3. Multivariable binary logistic regression analyses stratified by gender were based on data from t1, t2 and t3 (n = 2779).ResultsThe frequency, number, and persistence of psychosomatic complaints during adolescence were associated with symptoms of depression and anxiety in young adulthood. Both earlier (at t1 only) and more recent (at t2 only) complaints were linked to subsequent depression and anxiety symptoms, while persistent (at both t1 and t2) psychosomatic complaints showed stronger associations in girls.ConclusionsPsychosomatic complaints in adolescence were associated with depression and anxiety symptoms in young adulthood. This was true for the frequency, number, and persistence of psychosomatic complaints. Among girls, those who reported persistent psychosomatic complaints from middle to late adolescence had the highest likelihood of reporting subsequent depression and anxiety symptoms. Taken together, the results indicate that psychosomatic complaints during adolescence can translate into later depression and anxiety symptoms. Furthermore, repeated measurements of psychosomatic complaints can be used to identify the most vulnerable group.