Clinical Takeaway
Adolescents with higher levels of depression and anxiety symptoms show increased likelihood of initiating and using cannabis more frequently over time, supporting the self-medication hypothesis in this age group. This longitudinal evidence suggests that untreated internalising disorders in early adolescence represent a meaningful risk factor for cannabis uptake, independent of other social influences. Clinicians should screen adolescent patients for anxiety and depression as part of routine substance use risk assessment.
#14 Anxiety, depression and risk of cannabis use: Examining the internalising pathway to use among Chilean adolescents.
Citation: Stapinski Lexine A et al.. Anxiety, depression and risk of cannabis use: Examining the internalising pathway to use among Chilean adolescents.. Drug and alcohol dependence. 2016. PMID: 27427415.
Design: 5 Journal: 0 N: 4 Recency: 0 Pop: 3 Human: 1 Risk: -2
Quality Gate Alerts:
- Preclinical only
Abstract: BACKGROUND: Adolescents who experience internalising symptoms may be susceptible to the use of alcohol and other substances in an attempt to alleviate or cope with these symptoms. We examined the hypothesised internalising pathway from symptoms of depression, generalised anxiety, social anxiety and panic, to incidence and frequency of cannabis use 18 months later. METHOD: Longitudinal cohort study of participants (n=2508; 45% female; mean age 14.5 years) recruited from the 9th grade at 22 low-income secondary schools in Santiago, Chile. Baseline internalising symptoms were assessed using the Beck Depression Inventory and the Revised Child Anxiety and Depression Scale. Frequency of cannabis was assessed at baseline, 6 month and 18 month follow-up. RESULTS: High rates of use were observed in this sample, with 40.3% reporting cannabis use at least once over the study period. Adjusted for baseline cannabis use, symptoms of depression, panic and generalised anxiety were associated with greater cannabis use frequency 18 months later. When all predictors were considered simultaneously, only generalised anxiety symptoms showed an independent association with subsequent cannabis use frequency (OR: 1.23, 95% CI: 1.08-1.41). Generalised anxiety symptoms were also associated with a 25% increased risk of transitioning from non-user to use of cannabis during the study (OR: 1.25, 95% CI: 1.09-1.44). CONCLUSIONS: Internalising symptoms, and in particular symptoms of generalised anxiety, increase risk of cannabis use during adolescence. Targeted interventions that promote adaptive anxiety management among high-risk adolescents may represent a promising strategy to prevent uptake of cannabis use during adolescence.
|