How common is it to have both cannabis use disorder and depression or anxiety?
A meta-analysis of eight nationally representative surveys found that people with cannabis use disorder were about three times more likely to also have major depression or generalized anxiety disorder.
Quick Facts
What This Study Found
Cannabis use disorder was strongly associated with major depressive episodes (OR 3.22; 95% CI 2.31-4.49) and with generalized anxiety disorder (OR 2.99; 95% CI 2.14-4.16). Both 12-month and lifetime comorbidity estimates showed consistent patterns of co-occurrence.
Key Numbers
8 nationally representative surveys; CUD + major depression OR 3.22 (95% CI 2.31-4.49); CUD + GAD OR 2.99 (95% CI 2.14-4.16)
How They Did This
Systematic review and meta-analysis of Medline, CINAHL, PsycINFO, EMBASE, and grey literature. Included 8 nationally representative epidemiological surveys of non-clinical, randomly selected adult populations. Random-effects model used to address heterogeneity.
Why This Research Matters
The threefold co-occurrence of cannabis use disorder with depression and anxiety underscores the complexity of treating either condition in isolation. Integrated treatment approaches may be needed for this substantial overlap.
The Bigger Picture
Whether cannabis use disorder causes depression and anxiety, or whether people with these conditions are more likely to develop problematic cannabis use, remains an open question. Regardless of direction, the consistent threefold association across large population samples signals that screening for one condition should prompt assessment for the others.
What This Study Doesn't Tell Us
Cross-sectional surveys cannot determine causal direction. Heterogeneity from combining studies across geographic regions with different diagnostic criteria. Self-report measures used in population surveys.
Questions This Raises
- ?Does treating cannabis use disorder improve depression and anxiety outcomes, or vice versa?
- ?Are certain cannabis use patterns (frequency, potency, age of onset) more strongly linked to psychiatric comorbidity?
- ?Would integrated treatment approaches improve outcomes compared to treating each condition separately?
Trust & Context
- Key Stat:
- 3x odds of depression and anxiety
- Evidence Grade:
- Meta-analysis of nationally representative surveys with consistent effect sizes, though cross-sectional design limits causal inference.
- Study Age:
- Published in 2021; large-scale longitudinal studies may further clarify causal directions.
- Original Title:
- Comorbid Cannabis Use Disorder with Major Depression and Generalized Anxiety Disorder: A Systematic Review with Meta-analysis of Nationally Representative Epidemiological Surveys.
- Published In:
- Journal of affective disorders, 281, 467-475 (2021)
- Authors:
- Onaemo, Vivian N, Fawehinmi, Timothy O, D'Arcy, Carl
- Database ID:
- RTHC-03397
Evidence Hierarchy
Combines results from multiple studies to find an overall pattern.
What do these levels mean? →Frequently Asked Questions
Does cannabis cause depression?
This meta-analysis found a strong association (3x odds) but cannot determine whether cannabis use disorder causes depression, depression drives cannabis misuse, or both share common underlying factors.
How strong is the link with anxiety?
People with cannabis use disorder had about 3 times the odds of also having generalized anxiety disorder (OR 2.99), a strength of association similar to the depression finding.
What does "nationally representative" mean for this research?
The included surveys used random sampling methods designed to reflect the general adult population of entire countries, making the findings more generalizable than studies from clinical settings or convenience samples.
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Cite This Study
https://rethinkthc.com/research/RTHC-03397APA
Onaemo, Vivian N; Fawehinmi, Timothy O; D'Arcy, Carl. (2021). Comorbid Cannabis Use Disorder with Major Depression and Generalized Anxiety Disorder: A Systematic Review with Meta-analysis of Nationally Representative Epidemiological Surveys.. Journal of affective disorders, 281, 467-475. https://doi.org/10.1016/j.jad.2020.12.043
MLA
Onaemo, Vivian N, et al. "Comorbid Cannabis Use Disorder with Major Depression and Generalized Anxiety Disorder: A Systematic Review with Meta-analysis of Nationally Representative Epidemiological Surveys.." Journal of affective disorders, 2021. https://doi.org/10.1016/j.jad.2020.12.043
RethinkTHC
RethinkTHC Research Database. "Comorbid Cannabis Use Disorder with Major Depression and Gen..." RTHC-03397. Retrieved from https://rethinkthc.com/research/onaemo-2021-comorbid-cannabis-use-disorder
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.