Youth with cannabis use disorder (CUD) have a higher risk of developing schizophrenia, major depression, and anxiety disorders compared with youth with other substance use disorders (SUDs), according to a
study published this week in
The American Journal of Psychiatry.
Among adults, however, CUD was largely associated with lower risks of most mental illnesses compared with other SUDs.
Why It’s Relevant
Evidence that CUD and other SUDs may be linked to the development of psychotic disorders has been growing. Yet cannabis legalization and commercialization have advanced at a faster pace than the science, raising concerns about the impact on mental health,
particularly among youth.
By the Numbers
- The researchers compared the medical and pharmacy records of 345,903 adults and 24,793 youth with CUD with a matched set of patients with other SUDs (including alcohol use disorder). Participants had no prior history of mental illness.
- Compared with youth with other SUDs, youth with CUD had a 52% higher risk of developing schizophrenia, a 30% higher risk of developing major depression, and a 21% higher risk of developing an anxiety disorder. Youth with CUD had a 14% lower risk of attention-deficit/hyperactivity disorder, however.
- Compared with adults with other SUDs, adults with CUD had a 19% lower risk of developing schizophrenia, a 22% lower risk of developing major depression, a 12% lower risk of developing bipolar disorder, and a 41% lower risk of suicide attempts.
What’s More
In a second matched cohort analysis, the researchers found that adults who had CUD and another SUD had a lower risk for multiple psychiatric disorders compared with patients with multiple non-cannabis SUDs.
The Other Side
The data set did not indicate the severity of the SUD or the age of first drug use. Additionally, it didn’t include information on the type of cannabis product used, which can vary considerably in potency.
What’s Next
“Differences in substance-specific addiction-reward pathways may contribute to differential risk for mental disorders among adults, whereas cannabis use in pediatric populations may result in greater susceptibility for schizophrenia and [depression] because of vulnerabilities in the developing adolescent brain,” the researchers wrote. “The association of cannabis use with mental disorders requires further investigation with behavioral, neuroimaging, and pathology studies.”
Related Information
Source
Ryan C. Nicholson, et al. Association of cannabis use disorder versus other substance use disorders with psychiatric conditions: a propensity-matched retrospective cohort analysis. The American Journal of Psychiatry. Published March 3, 2026. doi.org/10.1176/appi.ajp.20250336
(Image: Getty Images/iStock/Alina Rosanova)