Depression in adolescence predicted later weekly cannabis use, but cannabis-suicidal ideation link was explained by other substance use

In a longitudinal study of 1,606 adolescents, depression at age 15 predicted weekly cannabis use at 17, while the apparent link between cannabis and suicidal ideation was fully explained by concurrent alcohol, tobacco, and other drug use.

Bolanis, Despina et al.·Journal of affective disorders·2020·Moderate EvidenceLongitudinal Cohort
RTHC-02433Longitudinal CohortModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
N=1,606

What This Study Found

Depression at age 15 predicted weekly cannabis use at age 17 (OR = 2.30, 95% CI: 1.19-4.43), even after adjusting for other substance use. Weekly cannabis use at 15 was initially associated with suicidal ideation at 17 (OR = 2.19, 95% CI: 1.04-4.58), but this association disappeared after controlling for other substance use.

Key Numbers

Weekly cannabis use: 7.0% at age 15, rising to 15.6% by age 20. Weekly users were 11-15 times more likely to continue using over time. Depression predicting cannabis: OR = 2.30. Cannabis-suicidal ideation link (before adjustment): OR = 2.19.

How They Did This

Population-based cohort of 1,606 adolescents from Quebec followed from 1997, with cross-lagged analyses examining the direction of associations between cannabis use frequency, depressive symptoms, and suicidal ideation at ages 15, 17, and 20.

Why This Research Matters

This study helps untangle the direction of the cannabis-depression relationship, suggesting depression may drive cannabis use rather than the reverse, and that polysubstance use complicates simple causal narratives.

The Bigger Picture

The finding that depression precedes cannabis use rather than the reverse challenges assumptions that cannabis causes depression. Meanwhile, the polysubstance context of suicidal ideation risk underscores that cannabis rarely operates in isolation.

What This Study Doesn't Tell Us

Quantity of cannabis consumed was not measured; self-reported data; Quebec-specific population may limit generalizability; observational design cannot fully establish causation.

Questions This Raises

  • ?Are depressed adolescents using cannabis as self-medication?
  • ?Would earlier treatment of depression reduce subsequent cannabis use?

Trust & Context

Key Stat:
Depressed 15-year-olds were 2.3x more likely to use cannabis weekly by age 17
Evidence Grade:
Large population-based longitudinal cohort with cross-lagged analysis, though observational design limits causal inference.
Study Age:
Published in 2020.
Original Title:
Cannabis use, depression and suicidal ideation in adolescence: direction of associations in a population based cohort.
Published In:
Journal of affective disorders, 274, 1076-1083 (2020)
Database ID:
RTHC-02433

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Does this study show cannabis causes depression?

The opposite direction was supported: depression at earlier time points predicted later cannabis use, not the other way around. The findings suggest depressed adolescents may be more likely to start using cannabis regularly.

Does weekly cannabis use increase suicide risk?

An initial association was found, but it disappeared after accounting for concurrent alcohol, tobacco, and other drug use. The suicidal ideation risk appears tied to polysubstance use patterns rather than cannabis specifically.

Read More on RethinkTHC

Cite This Study

RTHC-02433·https://rethinkthc.com/research/RTHC-02433

APA

Bolanis, Despina; Orri, Massimiliano; Castellanos-Ryan, Natalie; Renaud, Johanne; Montreuil, Tina; Boivin, Michel; Vitaro, Frank; Tremblay, Richard E; Turecki, Gustavo; Côté, Sylvana M; Séguin, Jean R; Geoffroy, Marie-Claude. (2020). Cannabis use, depression and suicidal ideation in adolescence: direction of associations in a population based cohort.. Journal of affective disorders, 274, 1076-1083. https://doi.org/10.1016/j.jad.2020.05.136

MLA

Bolanis, Despina, et al. "Cannabis use, depression and suicidal ideation in adolescence: direction of associations in a population based cohort.." Journal of affective disorders, 2020. https://doi.org/10.1016/j.jad.2020.05.136

RethinkTHC

RethinkTHC Research Database. "Cannabis use, depression and suicidal ideation in adolescenc..." RTHC-02433. Retrieved from https://rethinkthc.com/research/bolanis-2020-cannabis-use-depression-and

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.