Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T11:49:32.798Z Has data issue: false hasContentIssue false
  • English
  • Français

Cannabis use as an indicator of risk for mental health problems in adolescents: a population-based study at secondary schools

Published online by Cambridge University Press:  03 December 2012

W. A. van Gastel ,
W. Tempelaar ,
C. Bun ,
C. D. Schubart ,
R. S. Kahn ,
C. Plevier  and
M. P. M. Boks
W. A. van Gastel*
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
W. Tempelaar
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
C. Bun
Affiliation:
Public Health Service greater Utrecht area (GGD Midden Nederland), Zeist, The Netherlands
C. D. Schubart
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
R. S. Kahn
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
C. Plevier
Affiliation:
Public Health Service greater Utrecht area (GGD Midden Nederland), Zeist, The Netherlands
M. P. M. Boks
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
*
*Address for correspondence: W. A. van Gastel, M.Sc., Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, HP B01.206, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. (Email: W.vanGastel@umcutrecht.nl)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Although the association between cannabis use and a wide range of psychiatric symptoms is fairly well established, it is not clear whether cannabis use is also a risk factor for general mental health problems at secondary school.

Method

A total of 10 324 secondary school children aged 11–16 years, participating in an ongoing Public Health Service School Survey, gave information on demographics, substance use, school factors and stressful life events and completed the Strengths and Difficulties Questionnaire (SDQ).

Results

Cannabis use in the past month was associated with a clinically relevant score on the SDQ [unadjusted odds ratio (OR) 4.46, 95% confidence interval (CI) 3.46–5.76]. Other risk factors associated with poor psychosocial functioning were: a low level of education, alcohol use, cigarette smoking, hard drug use, frequent truancy, an unfavourable school evaluation, feeling unsafe at school, being victimized, frequent absence due to illness, a mentally ill parent, molestation by a parent, financial problems and feeling distressed by an adverse event. In a full model adjusting for these risk factors, cannabis was not significantly associated with mental health problems, although an association at trend level was apparent. Of these risk factors, regular alcohol use, cigarette smoking, hard drug use, frequent truancy, an unfavourable school evaluation and frequent absence due to illness were also associated with cannabis use.

Conclusions

The association between cannabis use and poor psychosocial functioning in adolescence is due, at least in part, to confounding by other risk factors. Thus, cannabis use can best be viewed as an indicator of risk for mental health problems in adolescence.

Keywords

Adolescencecannabis usemental health problemsriskrisk profile
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 9 , September 2013 , pp. 1849 - 1856
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arseneault, L, Cannon, M, Poulton, R, Murray, R, Caspi, A, Moffitt, TE (2002). Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study. British Medical Journal 325, 1212–1213.CrossRefGoogle ScholarPubMed
Chaves, SS, Gargiullo, P, Zhang, JX, Civen, R, Guris, D, Mascola, L, Seward, JF (2007). Loss of vaccine-induced immunity to varicella over time. New England Journal of Medicine 356, 1121–1129.CrossRefGoogle ScholarPubMed
Degenhardt, L, Hall, W, Lynskey, M (2003). Exploring the association between cannabis use and depression. Addiction 98, 1493–1504.CrossRefGoogle ScholarPubMed
Ehrenreich, H, Rinn, T, Kunert, HJ, Moeller, MR, Poser, W, Schilling, L, Gigerenzer, G, Hoehe, MR (1999). Specific attentional dysfunction in adults following early start of cannabis use. Psychopharmacology (Berlin) 142, 295–301.CrossRefGoogle Scholar
Emerson, E, McCulloch, A, Graham, H, Blacher, J, Llwellyn, GM, Hatton, C (2010). Socioeconomic circumstances and risk of psychiatric disorders among parents of children with early cognitive delay. American Journal of Intellectual and Developmental Disabilities 115, 30–42.CrossRefGoogle ScholarPubMed
Fergusson, DM, Horwood, LJ, Swain-Campbell, N (2002). Cannabis use and psychosocial adjustment in adolescence and young adulthood. Addiction 97, 1123–1135.CrossRefGoogle ScholarPubMed
Fontes, MA, Bolla, KI, Cunha, PJ, Almeida, PP, Jungerman, F, Laranjeira, RR, Bressan, RA, Lacerda, AL (2011). Cannabis use before age 15 and subsequent executive functioning. British Journal of Psychiatry 198, 442–447.CrossRefGoogle ScholarPubMed
Galera, C, Bouvard, MP, Melchior, M, Chastang, JF, Lagarde, E, Michel, G, Encrenaz, G, Messiah, A, Fombonne, E (2010). Disruptive symptoms in childhood and adolescence and early initiation of tobacco and cannabis use: the Gazel Youth study. European Psychiatry 25, 402–408.CrossRefGoogle ScholarPubMed
Goodman, R, Meltzer, H, Bailey, V (1998). The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. European Child and Adolescent Psychiatry 7, 125–130.CrossRefGoogle ScholarPubMed
Goodman, R, Renfrew, D, Mullick, M (2000). Predicting type of psychiatric disorder from Strengths and Difficulties Questionnaire (SDQ) scores in child mental health clinics in London and Dhaka. European Child and Adolescent Psychiatry 9, 129–134.CrossRefGoogle ScholarPubMed
Greenland, S (1989). Modeling and variable selection in epidemiologic analysis. American Journal of Public Health 79, 340–349.CrossRefGoogle ScholarPubMed
Hayatbakhsh, MR, McGee, TR, Bor, W, Najman, JM, Jamrozik, K, Mamun, AA (2008). Child and adolescent externalizing behavior and cannabis use disorders in early adulthood: an Australian prospective birth cohort study. Addictive Behaviors 33, 422–438.CrossRefGoogle ScholarPubMed
Hayatbakhsh, MR, Najman, JM, Jamrozik, K, Mamun, AA, Alati, R, Bor, W (2007). Cannabis and anxiety and depression in young adults: a large prospective study. Journal of the American Academy of Child and Adolescent Psychiatry 46, 408–417.CrossRefGoogle ScholarPubMed
Henquet, C, Murray, R, Linszen, D, van Os, J (2005). The environment and schizophrenia: the role of cannabis use. Schizophrenia Bulletin 31, 608–612.CrossRefGoogle ScholarPubMed
Hollis, C, Groom, MJ, Das, D, Calton, T, Bates, AT, Andrews, HK, Jackson, GM, Liddle, PF (2008). Different psychological effects of cannabis use in adolescents at genetic high risk for schizophrenia and with attention deficit/hyperactivity disorder (ADHD). Schizophrenia Research 105, 216–223.CrossRefGoogle ScholarPubMed
Horwood, LJ, Fergusson, DM, Hayatbakhsh, MR, Najman, JM, Coffey, C, Patton, GC, Silins, E, Hutchinson, DM (2010). Cannabis use and educational achievement: findings from three Australasian cohort studies. Drug and Alcohol Dependence 110, 247–253.CrossRefGoogle ScholarPubMed
Husler, G, Plancherel, B, Werlen, E (2005). Psychosocial predictors of cannabis use in adolescents at risk. Prevention Science 6, 237–244.CrossRefGoogle ScholarPubMed
Korhonen, T, Levalahti, E, Dick, DM, Pulkkinen, L, Rose, RJ, Kaprio, J, Huizink, AC (2010). Externalizing behaviors and cigarette smoking as predictors for use of illicit drugs: a longitudinal study among Finnish adolescent twins. Twin Research and Human Genetics 13, 550–558.CrossRefGoogle ScholarPubMed
Kuepper, R, van Os, J, Lieb, R, Wittchen, HU, Hofler, M, Henquet, C (2011). Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study. British Medical Journal 342, d738.CrossRefGoogle ScholarPubMed
Ledgerwood, DM, Goldberger, BA, Risk, NK, Lewis, CE, Price, RK (2008). Comparison between self-report and hair analysis of illicit drug use in a community sample of middle-aged men. Addictive Behaviors 33, 1131–1139.CrossRefGoogle Scholar
MacLeod, J, Oakes, R, Copello, A, Crome, I, Egger, M, Hickman, M, Oppenkowski, T, Stokes-Lampard, H, Davey, SG (2004). Psychological and social sequelae of cannabis and other illicit drug use by young people: a systematic review of longitudinal, general population studies. Lancet 363, 1579–1588.CrossRefGoogle ScholarPubMed
Mattejat, F, Remschmidt, H (2008). The children of mentally ill parents. Deutsches Ärzteblatt International 105, 413–418.Google ScholarPubMed
McGrath, J, Welham, J, Scott, J, Varghese, D, Degenhardt, L, Hayatbakhsh, MR, Alati, R, Williams, GM, Bor, W, Najman, JM (2010). Association between cannabis use and psychosis-related outcomes using sibling pair analysis in a cohort of young adults. Archives of General Psychiatry 67, 440–447.CrossRefGoogle Scholar
Monshouwer, K, van Dorsselaer, S, Verdurmen, J, ter Bogt, T, de Graaf, R, Vollebergh, W (2006). Cannabis use and mental health in secondary school children. Findings from a Dutch survey. British Journal of Psychiatry 188, 148–153.CrossRefGoogle ScholarPubMed
Moore, TH, Zammit, S, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370, 319–328.CrossRefGoogle ScholarPubMed
Muris, P, Meesters, C, van den Berg, F (2003). The Strengths and Difficulties Questionnaire (SDQ) – further evidence for its reliability and validity in a community sample of Dutch children and adolescents. European Child and Adolescent Psychiatry 12, 1–8.CrossRefGoogle Scholar
Patton, GC, Coffey, C, Carlin, JB, Degenhardt, L, Lynskey, M, Hall, W (2002). Cannabis use and mental health in young people: cohort study. British Medical Journal 325, 1195–1198.CrossRefGoogle ScholarPubMed
Rubino, T, Zamberletti, E, Parolaro, D (2011). Adolescent exposure to cannabis as a risk factor for psychiatric disorders. Journal of Psychopharmacology 26, 177–188.CrossRefGoogle ScholarPubMed
Schubart, CD, van Gastel, WA, Breetvelt, EJ, Beetz, SL, Ophoff, RA, Sommer, IE, Kahn, RS, Boks, MP (2010). Cannabis use at a young age is associated with psychotic experiences. Psychological Medicine 7, 1–10.Google Scholar
Smit, F, de Zwart, WM, Spruit, I, Monshouwer, K, Ameijden, E (2002). Monitoring substance use in adolescents: school or household survey? Drugs: Education, Prevention and Policy 9, 267–274.Google Scholar
Stevens, JP (2002). Applied Multivariate Statistics for the Social Sciences. Lawrence Erlbaum Associates: Mahwah, New Jersey; London.Google Scholar
van Gastel, WA, Wigman, JT, Monshouwer, K, Kahn, RS, van Os, J, Boks, MP, Vollebergh, WA (2012). Cannabis use and subclinical positive psychotic experiences in early adolescence: findings from a Dutch survey. Addiction 107, 381–387.CrossRefGoogle ScholarPubMed
von Sydow, K, Lieb, R, Pfister, H, Hofler, M, Wittchen, HU (2002). What predicts incident use of cannabis and progression to abuse and dependence? A 4-year prospective examination of risk factors in a community sample of adolescents and young adults. Drug and Alcohol Dependence 68, 49–64.CrossRefGoogle Scholar
Widenfelt, B, Goedhart, A, Treffers, P, Goodman, R (2003). Dutch version of the Strengths and Difficulties Questionnaire (SDQ). European Child and Adolescent Psychiatry 12, 281–289.CrossRefGoogle ScholarPubMed
Zaldivar, BF, Garcia Montes, JM, Flores, CP, Sanchez, SF, Lopez, RF, Molina, MA (2009). Validity of the self-report on drug use by university students: correspondence between self-reported use and use detected in urine. Psicothema 21, 213–219.Google Scholar
Zammit, S, Allebeck, P, Andreasson, S, Lundberg, I, Lewis, G (2002). Self reported cannabis use as a risk factor for schizophrenia in Swedish conscripts of 1969: historical cohort study. British Medical Journal 325, 1199.CrossRefGoogle ScholarPubMed
Supplementary material: File

Gastel Supplementary Material

Appendix

Download Gastel Supplementary Material(File)
File 107 KB