title: The association between cannabis use and anxiety disorders: Results from a population-based representative sample.
abstract: The cross-sectional association between cannabis use and anxiety disorders is well documented, yet less is known about the longitudinal association between the two. This study explored the association between cannabis use, cannabis use disorders (CUDs) and anxiety disorders in a 3-year prospective study. Data was drawn from waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Anxiety disorders, including generalized anxiety disorder, social anxiety, panic disorder and specific phobias, were controlled for at baseline. Initiation of cannabis use was defined as any cannabis use by former lifetime abstainers in the time period between baseline and follow-up, CUDs were defined as a diagnosis of cannabis abuse or dependence. Results indicate that cannabis use was not associated with increased incidence of any anxiety disorder (Adjusted Odds Ratio (AOR)=1.12(0.63-0.98)). Though heavy cannabis use was associated with increased incidence of social anxiety in most models, this was not fully retained in the final adjusted model (AOR=1.98(0.99-1.98)). Investigation of the association between baseline CUDs and anxiety disorders at follow-up revealed similar results. Any baseline anxiety disorder was not associated with future initiation of cannabis use (AOR=1.03(0.62-1.69)) or onset of a CUD (AOR=0.68(0.41-1.14)), yet individuals with baseline panic disorder were more prone to initiate cannabis use at follow-up (AOR=2.2(1.15-4.18)), possibly as a means of self-medication. Our findings suggest that cannabis use and CUDs are not associated with increased incidence of most anxiety disorders and inversely, most anxiety disorders are not associated with increased incidence of cannabis use or CUDs.
authors.affiliation: Ariel University, Israel; Addiction Medicine and Dual Diagnosis Services, Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel. Electronic address: d.y.feingold@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Feingold
authors.affiliation: Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Mark
authors.initials: M
authors.lastname: Weiser
authors.affiliation: Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Technische Universität Dresden, Klinische Psychologie & Psychotherapie, Dresden, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
authors.affiliation: Addiction Medicine and Dual Diagnosis Services, Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
authors.forename: Shaul
authors.initials: S
authors.lastname: Lev-Ran
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology*; D018672:Community Health Planning; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology*; D008385:Marijuana Smoking / Q000453:epidemiology*; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D055815:Young Adult
keywords: Anxiety disorders; Cannabis use; Cannabis use disorders; NESARC; Panic disorder; Social anxiety