Cannabis Use in Teens with Depression or Bipolar Disorder Linked to Higher Suicidality and Clinical Severity
Among adolescents with major depression or bipolar disorder, cannabis use and cannabis use disorder were associated with significantly higher odds of suicidal ideation and attempts, along with greater clinical severity.
Quick Facts
What This Study Found
Cannabis use was most prevalent in adolescents with MDD, followed by BD, then controls. Cannabis use disorder was most prevalent in adolescents with BD. In both MDD and BD groups, cannabis use and CUD were associated with significantly higher odds of lifetime suicidal ideation and attempts, as well as other indicators of clinical severity.
Key Numbers
MDD: 354 with cannabis use, 70 with CUD, 688 without. BD: 79 with cannabis use, 32 with CUD, 184 without. Controls: 1,413 with cannabis use, 333 with CUD, 6,970 without. Significantly higher suicidal ideation/attempts in cannabis-using mood disorder groups.
How They Did This
Cross-sectional data from the 2001-2004 National Comorbidity Survey-Adolescent Supplement. In-person epidemiologic survey of adolescents ages 13-18. MDD (n=1,112), BD (n=295), controls (n=8,716). Covariate-adjusted ordinal logistic regression.
Why This Research Matters
Adolescents with mood disorders are already at elevated risk for self-harm. Understanding that cannabis use further increases suicidality risk in this population is critical for clinicians treating young people with depression or bipolar disorder.
The Bigger Picture
Since this study used data from 2001-2004, before the increases in cannabis potency and availability over the past two decades, the authors note current adverse associations may be even stronger. This finding has direct implications for clinical screening and intervention.
What This Study Doesn't Tell Us
Cross-sectional design cannot determine causation. Data from 2001-2004 may not reflect current cannabis landscape. Self-reported cannabis use. Cannot determine temporal sequence between cannabis use and suicidality.
Questions This Raises
- ?Would the associations be stronger with current high-potency cannabis products?
- ?Does treating cannabis use disorder reduce suicidality risk in teens with mood disorders?
Trust & Context
- Key Stat:
- Evidence Grade:
- Large nationally representative sample with adjusted analyses, but cross-sectional design and older data (2001-2004) limit conclusions.
- Study Age:
- 2025 publication analyzing 2001-2004 survey data.
- Original Title:
- Correlates of cannabis use and cannabis use disorder among adolescents with major depressive disorder and bipolar disorder in the National Comorbidity Survey-Adolescent Supplement (NCS-A).
- Published In:
- Journal of affective disorders, 371, 268-278 (2025)
- Authors:
- Sultan, Alysha A, Goldstein, Benjamin I, Blanco, Carlos(5), Kennedy, Kody G, Conway, Kevin P, He, Jian-Ping, Merikangas, Kathleen
- Database ID:
- RTHC-07746
Evidence Hierarchy
A snapshot of a population at one point in time.
What do these levels mean? →Frequently Asked Questions
Is cannabis use risky for teens with depression?
This study found that teens with major depression who used cannabis had significantly higher odds of suicidal ideation and attempts compared to depressed teens who did not use cannabis. The association held after adjusting for other risk factors.
Does cannabis worsen bipolar disorder in teenagers?
Cannabis use disorder was most prevalent among teens with bipolar disorder, and both cannabis use and CUD were associated with greater clinical severity and higher suicidality in this group.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-07746APA
Sultan, Alysha A; Goldstein, Benjamin I; Blanco, Carlos; Kennedy, Kody G; Conway, Kevin P; He, Jian-Ping; Merikangas, Kathleen. (2025). Correlates of cannabis use and cannabis use disorder among adolescents with major depressive disorder and bipolar disorder in the National Comorbidity Survey-Adolescent Supplement (NCS-A).. Journal of affective disorders, 371, 268-278. https://doi.org/10.1016/j.jad.2024.09.114
MLA
Sultan, Alysha A, et al. "Correlates of cannabis use and cannabis use disorder among adolescents with major depressive disorder and bipolar disorder in the National Comorbidity Survey-Adolescent Supplement (NCS-A).." Journal of affective disorders, 2025. https://doi.org/10.1016/j.jad.2024.09.114
RethinkTHC
RethinkTHC Research Database. "Correlates of cannabis use and cannabis use disorder among a..." RTHC-07746. Retrieved from https://rethinkthc.com/research/sultan-2025-correlates-of-cannabis-use
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.