Examining the Association and Directionality between Mental Health Disorders and Substance Use among Adolescents and Young Adults in the U.S. and Canada—A Systematic Review and Meta-Analysis

Abstract

Background: The purpose of this systematic review was to examine the association and directionality between mental health disorders and substance use among adolescents and young adults in the U.S. and Canada. Methods: The following databases were used: Medline, PubMed, Embase, PsycINFO, and Cochrane Library. Meta-analysis used odds ratios as the pooled measure of effect. Results: A total of 3656 studies were screened and 36 were selected. Pooled results showed a positive association between depression and use of alcohol (odds ratio (OR) = 1.50, 95% confidence interval (CI): 1.24–1.83), cannabis (OR = 1.29, 95% CI: 1.10–1.51), and tobacco (OR = 1.65, 95% CI: 1.43–1.92). Significant associations were also found between anxiety and use of alcohol (OR = 1.54, 95% CI: 1.19–2.00), cannabis (OR = 1.36, 95% CI: 1.02–1.81), and tobacco (OR = 2.21, 95% CI: 1.54–3.17). A bidirectional relationship was observed with tobacco use at baseline leading to depression at follow-up (OR = 1.87, CI = 1.23–2.85) and depression at baseline leading to tobacco use at follow-up (OR = 1.22, CI = 1.09–1.37). A unidirectional relationship was also observed with cannabis use leading to depression (OR = 1.33, CI = 1.19–1.49). Conclusion: This study offers insights into the association and directionality between mental health disorders and substance use among adolescents and young adults. Our findings can help guide key stakeholders in making recommendations for interventions, policy and programming.

Psychological Morbidity among Psychoactive Substance Users in a Rehabilitation Centre in Nigeria

“…This study found that the subjects with substance use were mainly males aged 20-39 years. This finding is similar to that of other researchers in this environment and internationally, who reported that youth especially males predominate in the substance use scene [2,5]. Most of the subjects in this study were found to have started taking substances before twenty years of age, with the youngest age of onset found to be 11years.…”

“…A number of studies conducted in the past decade in this environment have established that substance abuse and dependence (SAD) are relatively common [2,3]. Psychiatric comorbidity among substance users has been a topic of considerable interest and it has been widely recognized that anxiety and depression commonly co-exist with psychoactive substance abuse among adolescents and adults of both sexes [4,5].…”

“…The consequences of the Co-morbidity of substance abuse and anxiety and depression are serious and diverse as they have been associated with increased psychiatric admissions, poorer long and short term outcomes of treatment, increased risk of inpatient admissions and psychotic relapse, substantial functional impairment, younger age of onset of psychosis, a higher number of homicides and poor compliance with medications [5,14,15]. The aim of this study was to determine the prevalence and correlates of anxiety and depression among psychoactive substance users in a rehabilitation centre in Lagos state, Nigeria.…”

Cannabis users: Screen systematically, treat individually. A descriptive study of participants in a randomized trial in primary care

“…However, motivations for use differed among clusters: Risky Adolescents users (C1) and Risky young unemployed users (C2) mostly smoked for self-treatment (relaxation and sleep), and also more often received psychotropic treatment. Given the interplay between substance use and vulnerability to mental health disorders [33], identification of symptoms of anxiety or depression in those clusters may be an issue for the care of these individuals. Finally, risk-taking was also different: the first 3 groups drove more often after using cannabis.…”

Cannabidiol as a Treatment for Mood Disorders: A Systematic Review: Le cannabidiol comme traitement des troubles de l’humeur: une revue systématique

“…93,94 Notwithstanding these theoretical digressions and experimental evidence, the clinical impact of cannabis use on mood disorders is well-known and indirectly shows the relationship of these illnesses and the endocannabinoid system. For example, longitudinal studies have associated cannabis use during adolescence with later development of MDD, depressive symptoms, 95,96 and suicidal ideation. [97][98][99][100] In addition, a prospective study also suggested that adolescent cannabis use may be an independent risk factor for the development of hypomania in young adulthood.…”