Clinical Takeaway
Adolescents who use cannabis face significantly elevated risks of developing psychotic disorders, bipolar disorder, depression, and anxiety disorders in both adolescence and young adulthood, based on longitudinal population-level evidence. These associations persist even after accounting for confounding factors, suggesting cannabis exposure during critical developmental periods may alter psychiatric vulnerability. Clinical screening for cannabis use should be integrated into adolescent mental health assessment, particularly for individuals with family histories of psychiatric illness.
#14 Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders.
Citation: Young-Wolff Kelly C et al.. Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders.. JAMA health forum. 2026. PMID: 41719031.
Design: 0 Journal: 4 N: 0 Recency: 3 Pop: 3 Human: 1 Risk: 0
Methodological Considerations:
- Self-reported outcomes — recall and social-desirability bias risk
Abstract: IMPORTANCE: As cannabis becomes more accessible and socially accepted, concerns have grown about its potential implications for adolescent mental health. While prior research has linked adolescent cannabis use to psychiatric symptoms, few large, population-based, longitudinal studies have examined associations with clinically diagnosed psychiatric disorders. OBJECTIVE: To evaluate whether adolescent cannabis use is associated with an increased risk of incident psychotic, bipolar, depressive, and anxiety disorders during adolescence and young adulthood. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included adolescents aged 13 to 17 years who were screened for past-year cannabis use at Kaiser Permanente Northern California from 2016 to 2023. Adolescents were followed up through age 25 years or until December 31, 2023. Data were analyzed from February 21, 2024, to August 27, 2025. EXPOSURE: Time-varying self-reported past-year cannabis use based on universal, confidential screening during standard pediatric care. MAIN OUTCOMES AND MEASURES: Incident clinician-diagnosed psychotic, bipolar, depressive, and anxiety disorders, which were identified through electronic health records using International Classification of Disease codes. Cox proportional hazards regression models were used to measure the strength of associations between adolescent cannabis use and incident psychiatric diagnoses, with adjustments for sex, race and ethnicity, neighborhood deprivation index, insurance type, and time-varying alcohol and other substance use. RESULTS: Of 463 396 adolescents (234 114 males [50.5%]; mean [SD] age, 14.5 [1.3] years) included in the sample, 136 708 were Hispanic individuals (29.5%), 93 737 were non-Hispanic Asian individuals (20.2%), 35 346 were non-Hispanic Black individuals (7.6%), 153 102 were non-Hispanic White individuals (33.0%), and 18 795 individuals were multiracial or of other races or ethnicities (4.1%). At baseline, 26 345 adolescents (5.7%) self-rep
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