Skip to main content

Advertisement

Log in

Cannabis Use is a Better Indicator of Poor Mental Health in Women Than in Men: A Cross-Sectional Study in Young Adults from the General Population

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

Cannabis use is a known risk factor for a range of mental health problems, but less is known on the association with general mental health. We aim to explore the relationship between cannabis use and general mental health. We did a cross-sectional online survey of 1,929 young adults aged 18–30 years. Participants reported socio-demographic data, substance use and the Symptom Checklist-90 (SCL-90). Monthly cannabis use was associated with a higher total score on the SCL-90, both in a crude (OR 1.94, 95 % CI 1.57–2.38) and fully adjusted model (OR 1.48, 95 % CI 1.07–2.03). The association between cannabis and mental health was stronger in women and weekly users, and was independent of age at first use of cannabis. We conclude that moderate cannabis use is associated with general mental health problems in young adulthood. This relationship is independent of age at first use and of other risk factors, and is strongest in women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Arrindell, W. A., & Ettema, J. H. M. (2005). Symptom-checklist 90 Handleiding bij een multidimensionale psychopathologie-indicator. Amsterdam: Harcourt Assessment.

    Google Scholar 

  • Arseneault, L., Cannon, M., Poulton, R., Murray, R., Caspi, A., & Moffitt, T. E. (2002). Cannabis use in adolescence and risk for adult psychosis: Longitudinal prospective study. BMJ, 325, 1212–1213.

    Article  PubMed  PubMed Central  Google Scholar 

  • Balter, K. A., Balter, O., Fondell, E., & Lagerros, Y. T. (2005). Web-based and mailed questionnaires: A comparison of response rates and compliance. Epidemiology, 16, 577–579.

    Article  PubMed  Google Scholar 

  • Bossong, M. G., & Niesink, R. J. (2010). Adolescent brain maturation, the endogenous cannabinoid system and the neurobiology of cannabis-induced schizophrenia. Progress in Neurobiology, 92, 370–385.

    Article  PubMed  CAS  Google Scholar 

  • Bovasso, G. B. (2001). Cannabis abuse as a risk factor for depressive symptoms. American Journal of Psychiatry, 158, 2033–2037.

    Article  PubMed  CAS  Google Scholar 

  • Brook, J. S., Cohen, P., & Brook, D. W. (1998). Longitudinal study of co-occurring psychiatric disorders and substance use. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 322–330.

    Article  PubMed  CAS  Google Scholar 

  • Buckner, J. D., Bonn-Miller, M. O., Zvolensky, M. J., & Schmidt, N. B. (2007). Marijuana use motives and social anxiety among marijuana-using young adults. Addictive Behaviors, 32, 2238–2252.

    Article  PubMed  PubMed Central  Google Scholar 

  • Buckner, J. D., Ecker, A. H., & Vinci, C. (2012). Cannabis use vulnerability among socially anxious users: Cannabis craving during a social interaction. Psychology of Addictive Behaviors, 27, 236.

    Article  PubMed  Google Scholar 

  • Chaves, S. S., Gargiullo, P., Zhang, J. X., Civen, R., Guris, D., Mascola, L., et al. (2007). Loss of vaccine-induced immunity to varicella over time. New England Journal of Medicine, 356, 1121–1129.

    Article  PubMed  CAS  Google Scholar 

  • Cheetham, A., Allen, N. B., Whittle, S., Simmons, J. G., Yucel, M., & Lubman, D. I. (2012). Orbitofrontal volumes in early adolescence predict initiation of cannabis use: A 4-year longitudinal and prospective study. Biological Psychiatry, 71, 684–692.

    Article  PubMed  Google Scholar 

  • Compton, M. T., Kelley, M. E., Ramsay, C. E., Pringle, M., Goulding, S. M., Esterberg, M. L., et al. (2009). Association of pre-onset cannabis, alcohol, and tobacco use with age at onset of prodrome and age at onset of psychosis in first-episode patients. American Journal of Psychiatry, 166, 1251–1257.

    Article  PubMed  PubMed Central  Google Scholar 

  • de Beer, H., & van de Glind, G. (2009). Richtlijn Multidisciplinaire stoornissen in het gebruik van alcohol. Houten: Ladenius Communicatie, CBO/Trimbos Institute.

    Google Scholar 

  • Degenhardt, L., Coffey, C., Romaniuk, H., Swift, W., Carlin, J. B., Hall, W. D., et al. (2013). The persistence of the association between adolescent cannabis use and common mental disorders into young adulthood. Addiction, 108, 124–133.

    Article  PubMed  Google Scholar 

  • Degenhardt, L., & Hall, W. (2001). The relationship between tobacco use, substance-use disorders and mental health: Results from the National Survey of Mental Health and Well-being. Nicotine & Tobacco Research, 3, 225–234.

    Article  CAS  Google Scholar 

  • Degenhardt, L., Hall, W., & Lynskey, M. (2001). Alcohol, cannabis and tobacco use among Australians: A comparison of their associations with other drug use and use disorders, affective and anxiety disorders, and psychosis. Addiction, 96, 1603–1614.

    Article  PubMed  CAS  Google Scholar 

  • Degenhardt, L., Hall, W., & Lynskey, M. (2003). Exploring the association between cannabis use and depression. Addiction, 98, 1493–1504.

    Article  PubMed  Google Scholar 

  • Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974). The Hopkins Symptom Checklist (HSCL): A self-report symptom inventory. Behavioral Science, 19, 1–15.

    Article  PubMed  CAS  Google Scholar 

  • Ehrenreich, H., Rinn, T., Kunert, H. J., Moeller, M. R., Poser, W., Schilling, L., et al. (1999). Specific attentional dysfunction in adults following early start of cannabis use. Psychopharmacology (Berl), 142, 295–301.

    Article  CAS  Google Scholar 

  • Ekman, A., Dickman, P. W., Klint, A., Weiderpass, E., & Litton, J. E. (2006). Feasibility of using web-based questionnaires in large population-based epidemiological studies. European Journal of Epidemiology, 21, 103–111.

    Article  PubMed  Google Scholar 

  • Fattore, L., & Fratta, W. (2010). How important are sex differences in cannabinoid action? British Journal of Pharmacology, 160, 544–548.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Ferdinand, R. F., & Verhulst, F. C. (1994). The prediction of poor outcome in young adults: comparison of the Young Adult Self-Report, the General Health Questionnaire and the Symptom Checklist. Acta Psychiatry Scandinavica, 89, 405–410.

    Article  CAS  Google Scholar 

  • Fergusson, D. M., Horwood, L. J., & Swain-Campbell, N. (2002). Cannabis use and psychosocial adjustment in adolescence and young adulthood. Addiction, 97, 1123–1135.

    Article  PubMed  Google Scholar 

  • Fergusson, D. M., Lynskey, M. T., & Horwood, L. J. (1993). Conduct problems and attention deficit behaviour in middle childhood and cannabis use by age 15. Australian and New Zealand Journal of Psychiatry, 27, 673–682.

    Article  PubMed  CAS  Google Scholar 

  • Fontes, M. A., Bolla, K. I., Cunha, P. J., Almeida, P. P., Jungerman, F., Laranjeira, R. R., et al. (2011). Cannabis use before age 15 and subsequent executive functioning. British Journal of Psychiatry, 198, 442–447.

    Article  PubMed  Google Scholar 

  • Fox, C. L., Towe, S. L., Stephens, R. S., Walker, D. D., & Roffman, R. A. (2011). Motives for cannabis use in high-risk adolescent users. Psychology of Addictive Behaviors, 25, 492–500.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goodman, A. (2010). Substance use and common child mental health problems: Examining longitudinal associations in a British sample. Addiction, 105, 1484–1496.

    Article  PubMed  Google Scholar 

  • Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. American Psychologist, 59, 93–104.

    Article  PubMed  Google Scholar 

  • Greenland, S. (1989). Modeling and variable selection in epidemiologic analysis. American Journal of Public Health, 79, 340–349.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  • Gregg, L., Barrowclough, C., & Haddock, G. (2007). Reasons for increased substance use in psychosis. Clinical Psychology Review, 27, 494–510.

    Article  PubMed  Google Scholar 

  • Hayatbakhsh, M. R., Najman, J. M., Jamrozik, K., Mamun, A. A., 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.

    Article  PubMed  Google Scholar 

  • Henquet, C., Krabbendam, L., Spauwen, J., Kaplan, C., Lieb, R., Wittchen, H. U., et al. (2005). Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. BMJ, 330, 11.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hollis, C., Groom, M. J., Das, D., Calton, T., Bates, A. T., Andrews, H. K., et al. (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.

    Article  PubMed  Google Scholar 

  • Holstein, B. E., Currie, C., Boyce, W., Damsgaard, M. T., Gobina, I., Kokonyei, G., et al. (2009). Socio-economic inequality in multiple health complaints among adolescents: International comparative study in 37 countries. International Journal of Public Health, 54(Suppl 2), 260–270.

    Article  PubMed  Google Scholar 

  • Horwood, L. J., Fergusson, D. M., Hayatbakhsh, M. R., Najman, J. M., Coffey, C., Patton, G. C., et al. (2010). Cannabis use and educational achievement: Findings from three Australasian cohort studies. Drug and Alcohol Dependence, 110, 247–253.

    Article  PubMed  Google Scholar 

  • Kendler, K. S., Neale, M. C., MacLean, C. J., Heath, A. C., Eaves, L. J., & Kessler, R. C. (1993). Smoking and major depression. A causal analysis. Archives of General Psychiatry, 50, 36–43.

    Article  PubMed  CAS  Google Scholar 

  • Koeter, M. W. (1992). Validity of the GHQ and SCL anxiety and depression scales: A comparative study. Journal of Affective Disorders, 24, 271–279.

    Article  PubMed  CAS  Google Scholar 

  • Konings, M., Stefanis, N., Kuepper, R., de Graff, R., Have, M. T., van Os, J., et al. (2012). Replication in two independent population-based samples that childhood maltreatment and cannabis use synergistically impact on psychosis risk. Psychological Medicine, 42, 149–159.

    Article  PubMed  CAS  Google Scholar 

  • Larsson, S., Andreassen, O. A., Aas, M., Rossberg, J. I., Mork, E., Steen, N. E., et al. (2012) High prevalence of childhood trauma in patients with schizophrenia spectrum and affective disorder. Comprehensive Psychiatry, 54, 123–127.

    Article  PubMed  Google Scholar 

  • Ledgerwood, D. M., Goldberger, B. A., Risk, N. K., Lewis, C. E., & Price, R. K. (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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lev-Ran, S., Imtiaz, S., Taylor, B. J., Shield, K. D., Rehm, J., & Le, F. B. (2012). Gender differences in health-related quality of life among cannabis users: Results from the National Epidemiologic Survey on alcohol and related conditions. Drug and Alcohol Dependence, 123, 190–200.

    Article  PubMed  Google Scholar 

  • Macleod, J., Davey, S. G., Heslop, P., Metcalfe, C., Carroll, D., & Hart, C. (2002). Psychological stress and cardiovascular disease: Empirical demonstration of bias in a prospective observational study of Scottish men. BMJ, 324, 1247–1251.

    Article  PubMed  PubMed Central  Google Scholar 

  • Macleod, J., Oakes, R., Copello, A., Crome, I., Egger, M., Hickman, M., et al. (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.

    Article  PubMed  Google Scholar 

  • McLaughlin, K. A., Breslau, J., Green, J. G., Lakoma, M. D., Sampson, N. A., Zaslavsky, A. M., et al. (2011). Childhood socio-economic status and the onset, persistence, and severity of DSM-IV mental disorders in a US national sample. Social Science and Medicine, 73, 1088–1096.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meyerson, P., & Tryon, W. W. (2003). Validating internet research: A test of the psychometric equivalence of internet and in-person samples. Behavior Research Methods, Instruments, & Computers, 35, 614–620.

    Article  Google Scholar 

  • Monshouwer, K., Van, D. S., Verdurmen, J., Bogt, T. T., De Graff, 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.

    Article  PubMed  Google Scholar 

  • Moore, T. H., Zammit, S., Lingford-Hughes, A., Barnes, T. R., Jones, P. B., Burke, M., et al. (2007). Cannabis use and risk of psychotic or affective mental health outcomes: A systematic review. Lancet, 370, 319–328.

    Article  PubMed  Google Scholar 

  • Morgan, C. D., Wiederman, M. W., & Magnus, R. D. (1998). Discriminant validity of the SCL-90 dimensions of anxiety and depression. Assessment, 5, 197–201.

    Article  PubMed  CAS  Google Scholar 

  • Mortensen, P. B., Pedersen, C. B., Westergaard, T., Wohlfahrt, J., Ewald, H., Mors, O., et al. (1999). Effects of family history and place and season of birth on the risk of schizophrenia. New England Journal of Medicine, 340, 603–608.

    Article  PubMed  CAS  Google Scholar 

  • O’Hare, T., Shen, C., Sherrer, M. (2012) Differences in trauma and posttraumatic stress symptoms in clients with schizophrenia spectrum and major mood disorders. Psychiatry Research, 205, 85–89.

    Google Scholar 

  • Patton, G. C., Coffey, C., Carlin, J. B., Degenhardt, L., Lynskey, M., & Hall, W. (2002). Cannabis use and mental health in young people: Cohort study. BMJ, 325, 1195–1198.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pedersen, W., Mastekaasa, A., & Wichstrom, L. (2001). Conduct problems and early cannabis initiation: A longitudinal study of gender differences. Addiction, 96, 415–431.

    Article  PubMed  CAS  Google Scholar 

  • Rossler, W., Hengartner, M. P., Angst, J., & Ajdacic-Gross, V. (2012). Linking substance use with symptoms of subclinical psychosis in a community cohort over 30 years. Addiction, 107, 1174–1184.

    Article  PubMed  Google Scholar 

  • Rubino, T., Zamberletti, E., & Parolaro, D. (2012). Adolescent exposure to cannabis as a risk factor for psychiatric disorders. Journal of Psychopharmacology, 26, 177–188.

    Article  PubMed  CAS  Google Scholar 

  • Saha, S., Scott, J. G., Varghese, D., Degenhardt, L., Slade, T., & McGrath, J. J. (2011). The association between delusional-like experiences, and tobacco, alcohol or cannabis use: A nationwide population-based survey. BMC Psychiatry, 11, 202.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schubart, C. D., Boks, M. P., Breetvelt, E. J., van Gastel, W. A., Groenwold, R. H., Ophoff, R. A., et al. (2011). Association between cannabis and psychiatric hospitalization. Acta Psychiatrica Scandinavica, 123, 368–375.

    Article  PubMed  CAS  Google Scholar 

  • Schubart, C.D., van Gastel, W.A., Breetvelt, E.J., Beetz, S.L., Ophoff, R.A., Sommer, I.E., et al. (2010) Cannabis use at a young age is associated with psychotic experiences. Psychological Medicine, 123, 1–10.

    Google Scholar 

  • Selten, J. P., Laan, W., Kupka, R., Smeets, H. M., & van Os, J. (2012). Risk of psychiatric treatment for mood disorders and psychotic disorders among migrants and Dutch nationals in Utrecht, The Netherlands. Social Psychiatry and Psychiatric Epidemiology, 47, 271–278.

    Article  PubMed  CAS  Google Scholar 

  • Smith, G. D., Phillips, A. N., & Neaton, J. D. (1992). Smoking as “independent” risk factor for suicide: Illustration of an artifact from observational epidemiology? Lancet, 340, 709–712.

    Article  PubMed  CAS  Google Scholar 

  • Swendsen, J., Ben-Zeev, D., & Granholm, E. (2011). Real-time electronic ambulatory monitoring of substance use and symptom expression in schizophrenia. American Journal of Psychiatry, 168, 202–209.

    Article  PubMed  Google Scholar 

  • Termorshuizen, F., Wierdsma, A. I., Visser, E., Drukker, M., Sytema, S., Laan, W., et al. (2012). Psychosis and suicide risk by ethnic origin and history of migration in the Netherlands. Schizophrenia Research, 138, 268–273.

    Article  PubMed  Google Scholar 

  • van Gastel, W. A., MacCabe, J. H., Vreeker, A., Tempelaar, W., Kahn, R. S., Boks, M. P. M. (2013a). Cigarette smoking and cannabis use are equally strongly associated with psychotic-like experiences: a cross-sectional study in 1929 young adults. Psychological Medicine, 43(11), 2393–2401.

    Google Scholar 

  • van Gastel, W. A., Tempelaar, W., Bun, C., Schubart, C. S., Kahn, R. S., Plevier, C., et al. (2013b). Cannabis use as an indicator of risk for mental health problems in adolescents: a population-based study at secondary schools. Psychological Medicine, 43(9), 1849–1856.

  • van Leeuwen, A. P., Verhulst, F. C., Reijneveld, S. A., Vollebergh, W. A., Ormel, J., & Huizink, A. C. (2011). Can the gateway hypothesis, the common liability model and/or, the route of administration model predict initiation of cannabis use during adolescence? A survival analysis—The TRAILS study. Journal of Adolescent Health, 48, 73–78.

    Article  PubMed  Google Scholar 

  • Veling, W., & Susser, E. (2011). Migration and psychotic disorders. Expert Review of Neurotherapeutics, 11, 65–76.

    Article  PubMed  Google Scholar 

  • Vendrig, L., Derksen, J., & de Mey, H. (2000). Veranderingen in het psychisch welbevinden van de nederlandse bevolking. Gedrag en Gezondheid, 28, 47–53.

    Google Scholar 

  • Wittchen, H. U., Frohlich, C., Behrendt, S., Gunther, A., Rehm, J., Zimmermann, P., et al. (2007). Cannabis use and cannabis use disorders and their relationship to mental disorders: A 10-year prospective-longitudinal community study in adolescents. Drug and Alcohol Dependence, 88(Suppl 1), S60–S70.

    Article  PubMed  Google Scholar 

  • Zaldivar, B. F., Garcia Montes, J. M., Flores, C. P., Sanchez, S. F., Lopez, R. F., & Molina, M. A. (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 

Download references

Conflict of interest

None of the authors has any conflict of interest which may arise from being named as an author on the manuscript or has received any (financial) support from pharmaceutical companies.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to W. A. van Gastel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

van Gastel, W.A., MacCabe, J.H., Schubart, C.D. et al. Cannabis Use is a Better Indicator of Poor Mental Health in Women Than in Men: A Cross-Sectional Study in Young Adults from the General Population. Community Ment Health J 50, 823–830 (2014). https://doi.org/10.1007/s10597-014-9699-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-014-9699-6

Keywords

Navigation