title: Cannabis Use and Risk of Psychiatric Disorders: Prospective Evidence From a US National Longitudinal Study.
abstract: OBJECTIVE
  With rising rates of marijuana use in the general population and an increasing number of states legalizing recreational marijuana use and authorizing medical marijuana programs, there are renewed clinical and policy concerns regarding the mental health effects of cannabis use.
  
  
  OBJECTIVE
  To examine prospective associations between cannabis use and risk of mental health and substance use disorders in the general adult population.
  
  
  METHODS
  A nationally representative sample of US adults aged 18 years or older was interviewed 3 years apart in the National Epidemiologic Survey on Alcohol and Related Conditions (wave 1, 2001-2002; wave 2, 2004-2005). The primary analyses were limited to 34 653 respondents who were interviewed in both waves. Data analysis was conducted from March 15 to November 30, 2015.
  
  
  METHODS
  We used multiple regression and propensity score matching to estimate the strength of independent associations between cannabis use at wave 1 and incident and prevalent psychiatric disorders at wave 2. Psychiatric disorders were measured with a structured interview (Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-IV). In both analyses, the same set of wave 1 confounders was used, including sociodemographic characteristics, family history of substance use disorder, disturbed family environment, childhood parental loss, low self-esteem, social deviance, education, recent trauma, past and present psychiatric disorders, and respondent's history of divorce.
  
  
  RESULTS
  In the multiple regression analysis of 34 653 respondents (14 564 male [47.9% weighted]; mean [SD] age, 45.1 [17.3] years), cannabis use in wave 1 (2001-2002), which was reported by 1279 respondents, was significantly associated with substance use disorders in wave 2 (2004-2005) (any substance use disorder: odds ratio [OR], 6.2; 95% CI, 4.1-9.4; any alcohol use disorder: OR, 2.7; 95% CI, 1.9-3.8; any cannabis use disorder: OR, 9.5; 95% CI, 6.4-14.1; any other drug use disorder: OR, 2.6; 95% CI, 1.6-4.4; and nicotine dependence: OR, 1.7; 95% CI, 1.2-2.4), but not any mood disorder (OR, 1.1; 95% CI, 0.8-1.4) or anxiety disorder (OR, 0.9; 95% CI, 0.7-1.1). The same general pattern of results was observed in the multiple regression analyses of wave 2 prevalent psychiatric disorders and in the propensity score-matched analysis of incident and prevalent psychiatric disorders.
  
  
  CONCLUSIONS
  Within the general population, cannabis use is associated with an increased risk for several substance use disorders. Physicians and policy makers should take these associations of cannabis use under careful consideration.
authors.affiliation: Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Bethesda, Maryland.
authors.forename: Carlos
authors.initials: C
authors.lastname: Blanco
authors.affiliation: Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Hasin
authors.affiliation: Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Corentin Celton Hospital, Paris, France4Department of Psychiatry, Paris Descartes University, Pôle de Recherche et d'Enseignement Supérieur Sorbonne Paris Cité, Paris, France.
authors.forename: Ludwing
authors.initials: L
authors.lastname: Flórez-Salamanca
authors.affiliation: Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York3Assistance Publique-Hôpitaux de Paris, Corentin Celton Hospital, Paris, France4Department of Psychiatry, Paris Descartes University, Pôle de Recher.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Hoertel
authors.affiliation: Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York.
authors.forename: Shuai
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York.
authors.forename: Bradley T
authors.initials: BT
authors.lastname: Kerridge
authors.affiliation: Department of Psychiatry, Columbia University Medical Center/New York State Psychiatric Institute, New York.
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000453:epidemiology; D002188:Cannabis / Q000009:adverse effects*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology*; D001523:Mental Disorders / Q000139:chemically induced / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D057216:Propensity Score; D011446:Prospective Studies; D012306:Risk; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology