The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood

Authors

  • Louisa Degenhardt,

    Corresponding author
    1. Centre for Health Policy, Programs and Economics, School of Population Health, University of Melbourne, Melbourne, Victoria, Australia
    • National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
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  • Carolyn Coffey,

    1. Centre for Adolescent Health, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
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  • Helena Romaniuk,

    1. Centre for Adolescent Health, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
    2. Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute and University of Melbourne Department of Paediatrics, Melbourne, Victoria, Australia
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  • Wendy Swift,

    1. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
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  • John B. Carlin,

    1. Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute and University of Melbourne Department of Paediatrics, Melbourne, Victoria, Australia
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  • Wayne D. Hall,

    1. University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
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  • George C. Patton

    1. Centre for Adolescent Health, Royal Children's Hospital, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia
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Correspondence to: Louisa Degenhardt, National Drug and Alcohol Research Centre, University of NSW, NSW 2052, Australia. E-mail: l.degenhardt@unsw.edu.au

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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