Cannabis Use Is Associated With Depression Severity and Suicidality in the National Comorbidity Survey−Adolescent Supplement

Hinckley, Jesse D.; Mikulich‐Gilbertson, Susan K.; He, Jie; Bhatia, Devika; Ellingson, Jarrod M.; Vu, Brian Nguyenkhoa; Merikangas, Kathleen R.; Sakai, Joseph T.

doi:10.1016/j.jaacop.2023.02.002

Cited by 14 publications

(3 citation statements)

References 47 publications

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“…Our study revealed that hospitalized adolescents with CUD had over double the rates of depression, anxiety, ADHD, Conduct Disorder, and all the substance use disorders included (Alcohol, Nicotine, Cocaine and Stimulant) when compared to adolescents without CUD. We also found that comorbid CUD and depression were associated with higher odds of suicidal behavior compared to CUD alone, similar to findings from a recent publication [ 27 ]. Both depression and anxiety, being internalizing disorders, are often chronic and less readily detected.…”

Section: Discussionsupporting

confidence: 91%

“…Most studies that examined the association between substance use and suicidal behavior in adolescents have not focused on cannabis, and available studies have been predominantly conducted in the adult population [15,[22][23][24][25]. Existing studies examining the association between cannabis use and suicidal behaviors among adolescents have focused on the general population [26,27] or included a small inpatient population limited to adolescents admitted for psychiatric hospitalization [28,29]. Adolescents, including those with ongoing cannabis use, most often present for care in medical settings for medical problems and may not be seen by a psychiatrist in these settings unless a consult is requested and a provider is available, an increasing challenge in context of mental health provider shortage.…”

Section: Introductionmentioning

confidence: 99%

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Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States

Oladunjoye,

Li,

Aneni

et al. 2023

PLoS ONE

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Background Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents. Objectives To determine the association between cannabis use disorder (CUD) and suicide attempt/self-harm in a hospitalized sample of adolescents. Methods We conducted a cross-sectional observation study using data from the Nationwide Inpatient Sample collected over four years from January 1, 2016, through December 31, 2019. We included adolescents aged 10–19 hospitalized during the above period (N = 807,105). The primary outcome was suicide attempt/self-harm and the main predictor was CUD. The International Classification of Diseases Tenth Revision (ICD 10) diagnostic codes was used to identify a diagnosis of CUD, suicide attempt/self-harm, and other diagnoses included in the analyses. Adolescents diagnosed with CUD (n = 53,751) were compared to adolescents without CUD (n = 753,354). Univariate and multivariate logistic regressions were conducted to determine the association between CUD and suicide attempts/self-harm. Results 807,105 adolescent hospitalizations were analyzed, of which 6.9% had CUD. Adolescents with CUD were more likely to be older (17 years vs. 15 years), female (52% vs. 48%), have depression (44% vs. 17%), anxiety (32% vs. 13%), an eating disorder (1.9% vs. 1.2%), ADHD (16.3% vs. 9.1%), Conduct Disorder (4.1% vs. 1.3%), Alcohol Use Disorder (11.9% vs. 0.8%), Nicotine Use Disorder (31.1% vs. 4.1%), Cocaine Use Disorder (5.4% vs. 0.2%), Stimulant Use Disorder (0.8% vs. 0.4%) and report suicide attempts/self-harm (2.8% vs. 0.9%) [all ps<0.001]. After adjusting for potential confounders, CUD was associated with a higher risk of suicide attempts/self-harm (OR = 1.4, 95% CI 1.3–1.6, p <0.001). Post-hoc analyses showed the presence of depression moderated the association between CUD and suicide attempts/self-harm in that adolescents with CUD and depression had 2.4 times the odds of suicide attempt/self-harm compared to those with CUD but no depression after controlling for potential confounders (p<0.001). Conclusions Our study provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk. Identifying high-risk adolescents in inpatient settings provides an opportunity for intervention.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States

Oladunjoye,

Li,

Aneni

et al. 2023

PLoS ONE

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“…Legend. *, alternatively, participants used cannabis more than twice a week; age classes, children (< 11 years); adolescents(12)(13)(14)(15)(16)(17)(18); young adults(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30); middle-aged(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50); elderly(51 +); No.+, age classes covered above the age shown by the number; COVID19, study performed during the Covid-19 pandemic; IBD, Inflammatory bowel disease; PTSD, posttraumatic stress disorder; sample size classes, n+, larger than n; <100, smaller than n;…”

mentioning

confidence: 99%

Herbal Cannabis and Depression: A Review of Findings Published over the Last Three Years

Haller

2024

Preprint

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Public perception contrasts scientific findings on the depression-related effects of cannabis. However, earlier studies were performed when cannabis was predominantly illegal, its production was mostly uncontrolled, and the idea of medical cannabis was incipient only. We hypothesized that recent changes in attitudes and legislations may have favorably affected research. In addition, publication bias against cannabis may have also decreased. To investigate this hypothesis, we conducted a systematic review of research studies published over the last three years. We found 156 relevant studies. In most cross-sectional studies, depression was higher in those who consumed cannabis than in those who did not. An increase in cannabis consumption was typically followed by an increase in depression, whereas withdrawal from cannabis ameliorated depression in most cases. Albeit medical cannabis reduced depression in most studies, none of these were placebo controlled. In clinical studies published in the same period, placebo also ameliorated depression and in addition, the average effect size of placebo was larger than the average effect size of medical cannabis. We also investigated the plausibility of the antidepressant effects of cannabis by reviewing molecular and pharmacological studies. Taken together, the reviewed findings do not support the antidepressant effects of herbal cannabis.

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Understanding cannabis use and mental health difficulties in context with women's experiences of stressful events and social health issues in pregnancy: The Aboriginal Families Study

Mensah,

Glover,

Leane

et al. 2024

Comprehensive Psychiatry

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Cannabis Use Is Associated With Depression Severity and Suicidality in the National Comorbidity Survey−Adolescent Supplement

Cited by 14 publications

References 47 publications

Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States

Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States

Herbal Cannabis and Depression: A Review of Findings Published over the Last Three Years

Understanding cannabis use and mental health difficulties in context with women's experiences of stressful events and social health issues in pregnancy: The Aboriginal Families Study

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