Cannabis use, depression and suicidal ideation/attempt in adolescence:comorbidity and direction of associations in a contemporary Quebec cohort
Bibliographic record
Abstract
Background: Given Canada’s recent cannabis legalization, its effects on depression and suicidal ideation/attempt in adolescence is of public health importance. Adolescence is a crucial developmental period marked with high consumption of cannabis, depression, and suicidal risk. Yet, most of the research available to date has focused on these associations in adulthood and few longitudinal studies have explored the direction of association between cannabis use, depression, and suicidal ideation/attempt in adolescence. Objective: The purpose of the present study was to explore both the concurrent and developmental sequence of association between cannabis use, depression, and suicidal ideation/attempt by examining the secondary substance use (depression/suicidal ideation/attempt precede cannabis use) and the secondary psychiatric disorder (cannabis use precedes depression/suicidal ideation/attempt) hypotheses. Clarifying the directionality of cannabis use and mental health outcomes will carry important implications for the treatment of adolescents presenting these conditions simultaneously.Methodology: Participants were drawn from the Quebec Longitudinal Study of Child Development, a contemporary birth cohort of Canadian adolescents followed over 20 years (n = 1606). We investigated concurrent associations between validated self-report measures of frequency of cannabis use, depression, and suicidal ideation/attempt at ages 15, 17 and 20 years, using logistic regressions. Longitudinal associations were assessed using cross-lagged panel analyses. Results: The prevalence of weekly cannabis use was 7.0% at age 15 years, 12.7% at age 17 years, and 15.6% at age 20 years. Adolescents who reported using cannabis weekly at one age were 15.81 to 11.31 (Odds Ratios [ORs]) times more likely to continue using cannabis over time. In our cross-lagged analysis, weekly cannabis use was associated with suicidal ideation/attempt, but not depression. Adolescents who used cannabis weekly at age 15 years were at a higher risk of suicidal ideation/attempt at age 17 years (OR = 2.19, 95% CI = 1.04–4.58). However, this association was fully explained by comorbid alcohol and other substance use (OR = 1.38, 95%CI = 0.52–3.20). Further, adolescents who reported having depression at 15 years were at higher risk of weekly cannabis use at 17 years, even after adjusting for comorbid alcohol and other substance use (OR = 2.30, 95% CI = 1.19–4.43). Those who used cannabis weekly at 17 years remained weekly users at 20 years (OR = 11.31, 95%CI = 5.20–24.61). Conclusion: The results of this study demonstrated that depression in adolescence predates weekly cannabis use, supporting the secondary substance use hypothesis. Evidence for the secondary substance use hypothesis has implications for the intervention plans of adolescents presenting with depression. Targeting symptoms of depression during mid-adolescence may prevent increases in cannabis use in late-adolescence. It has been demonstrated that weekly cannabis use is associated with aversive outcomes in young adulthood such as poorer mental health and impaired cognitive function
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".