Skip to main content

Table 3 Odds ratios ( OR ) for anxiety (or anxiety + depression) vs. no disorder in cannabis users vs. non-users (or in cannabis users with CUD vs. no CUD) in N= 31 studies

From: A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population- a meta-analysis of 31 studies

Study/Name (Part 1: anxiety diagnoses) Cannabis use vs. no use CUD vs. no CUD (or no use) OR(95% CI) Anxiety/no anxiety in user/non-user OR(95% CI) Anxiety/no anxiety in CUD/no CUD Data location in study ORadjusted for
Agosti et al., 2002; NCS, USA [26]   Current AD in lifetime CD who used within past month vs. no CD   2.6 (1.5-4.5) Text p. 646 No information
Beard et al., 2006; NoRMHS, Australia [27]1   T0 CUD (vs. no CUD) to T1 AD   .78 (.18-3.30) Table three Unadjusted (comorbidity with other diagnoses possible)
Brook et al., 1998; Upstate NY, USA [28] T4 AD to T3 use vs. no use   1.16 (1.00-1.35)   Table two Demographics, prior AD
Brook et al., 2001; Columbia [29]2 T1 AD to T2 regular vs. non-regular use   .94 (.86-1.03)   Table one Demographics, cannabis use at T1
  T1 regular vs. non-regular use to T2 AD   1.48 (1.09-2.01)   Table two Demographics, AD at T1
  Combined: AD or regular use: T1 vs. T2   1.18 (.94-1.48)    
Buckner et al., 2008; Oregon, USA [30]   T1 SAD to T4 CD vs. no CD   4.88 (1.43-16.64) Text p. 235 Gender, T1 anxiety, conduct, mood, alcohol use disorders, T1 CUD excluded
Cascone et al., 2011; Switzerland [33]   Past 12 months CD (vs. no CD) predicted with STAI-Y B   1.02 (.97-1.08) Table five Withdrawal coping, social problems, recruitment context
Cougle et al., 2011; NCS-R, USA [37]3 Lifetime: PTSD to use vs. no use   2.45 (1.70-3.52)   Table one Demographics, lifetime alcohol/nicotine dependence/abuse
Crum et al., 1993; ECA, USA [38]4 Past 12 months: OCD to use vs. no use   1.54 (.78-3.04)   Table one Excluded past or baseline OCD cases
Degenhardt et al., 2001; NSMHWB, Australia [39] Past 12 months: AD to use vs. no use Past 12 months: AD to CD vs. no use .88 (.60-1.29) 1.40 (.84-2.37) Table four Demographics, other substance use, neuroticism
Degenhardt et al., 2013; VAHCS, Australia [41] AD at 29 to ≥ weekly vs. no use at 15-29 AD at 29 to CD at 29 vs. no CD 3.2 (1.1-9.2) 2.2 (1.1-4.4) Table one, three Demographics, alcohol/substance use at 29, adolescent anxiety/depression
Fergusson et al., 1996; CHDS, New Zealand [42] AD at 16 to use vs. no use at 15   1.2 (.5-2.8)   Table three Demographics, substance use and dependence, anxiety/depression, other mental health problems at 15
Low et al., 2008; USA [45]   Past 6 months: CA (vs. no CA) to AD   1.4 (.4-4.7) Table four Demographics, sampling site, depression
Martins & Gorelick, 2011; NESARC, USA [46]   Lifetime: CUD (vs. no CUD) to AD   3.2 (2.0-5.2) Table four Demographics
Roberts et al., 2007; TH2K, USA [49]   Past 12 months: AD to CUD vs. no CUD   .9 (.4-2.1) Table six Concurrent (past 12 months) mood, conduct, ADHD disorders; alcohol, other substance abuse/dependence
van der Pol et al., 2013; CanDep + NEMESIS-2, Netherlands [51]   Past 12 months: AD to CD (vs. no/non-frequent use) (D + vs. N2 groups)   1.12 (.48-2.63) Table two; Authors Demographics, childhood adversity, tobacco (past month), frequent alcohol, cocaine, ecstasy use (past 12 months)
van Laar et al., 2007; NEMESIS, Netherlands [52] AD (T0-T2) to T0 use vs. no use   1.18 (.71-1.97)   Table four Demographics, neuroticism, childhood trauma, lifetime: alcohol, other SUDs, psychotic symptoms, AD
Wittchen et al., 2007; EDSP, Germany [53] Lifetime use vs. no use to T0 AD Lifetime CUD vs. no CUD to T0 AD 1.5 (1.1-2.1) 1.7 (1.1-2.5) Table four Gender
Zvolensky et al., 2006; CSHS, USA [54] Lifetime: use vs. no use to PA Lifetime: CD vs. no CD to PA .89 (.63-1.30) 2.1 (1.1-4.3) Text p. 482 Demographics, other substance use
Zvolensky et al., 2010; NCS-R, USA [55]3 Lifetime: PD to use vs. no use   1.70 (1.33-2.17)   Table one Demographics, lifetime alcohol, nicotine, illicit substance abuse/dependence
NCS-R combined3 Lifetime: PTSD + PD to use vs. no use   2.04 (1.50-2.78)    
Study/Name (Part 2: anxiety severity scores)* Non-user M (SD); N (timeframe) Cannabis User M (SD); N
(timeframe)
CUD M (SD); N (timeframe) OR ( 95% CI ) Anxiety/no anxiety in user/non-user OR ( 95% CI ) Anxiety/no anxiety in CUD/no CUD Location in study Scale (study exclusionary criteria)
Buckner & Schmidt, 2008; USA [31] 23.6 (11.6); 105 (lifetime) 22.2 (13.1); 109 (≥weekly frequent use; lifetime)   .81 (.50-1.33)   Table one SIAS (none)
Buckner et al., 2012; USA [32] 21.3 (15.5); 66 (lifetime) 21.7 (13.7); 134 (past month)   1.05 (.62-1.80)   Table one; Authors SIAS (high-risk suicidal behaviour, psychotic)
Chabrol et al., 2005; France [34]5 35.3 (11.1); 98 (past 6 months) 37.1 (10.3); 114 (past 6 months) 38.1 (9.8); 44 (past 6 months) 1.36 (.83-2.22) 1.61 (.84-3.07) Table two Table three STAI A (none)
Chabrol et al., 2008; France [35] 38.3 (12.4); 189 (past 6 months) 42.9 (13.3); 59 (past 6 months)   1.94 (1.14-3.30)   Table one STAI A (none)
Lamers et al., 2006; USA [44] 4.0 (4.3); 15 (past 12 months) 2.9 (1.9); 15 (lifetime)   .55 (.15-2.03)   Table three BAI (alcohol, drug dependence, schizophrenia, depression, antisocial behaviour, psychoactive drug use)
Study/Name (Part 3: anxiety + depression, AMD) Cannabis use vs. no use CUD vs. no CUD (or no use) OR ( 95% CI ) AMD/no AMD in user/non-user OR ( 95% CI ) AMD/no AMD in CUD/no CUD Location in study OR adjusted for
Cheung et al., 2010; CAMH, Canada [36] Past 12 months: AMD to daily use vs. no use   2.05 (1.18-2.93)   Table two Demographics, alcohol misuse
Degenhardt et al., 2010; VAHCS, Australia [40]6 AMD at 24 (wave 8) to weekly + use vs. no use past 6 months at 15–17 (wave 1–6)   .88 (.55-1.40)   Table two Demographics, adolescent: AMD, alcohol, nicotine use
Hayatbakhsh et al., 2007; MUSP, Australia [43] AMD at 21 to frequent (past month) vs. never used drugs (lifetime)   2.1 (1.1-4.0)   Table four Demographics, no other illicit drugs, maternal and adolescent: AMD, alcohol, nicotine use
McGee et al., 2000; DMHDS, New Zealand [47]7 Internalising disorders at 15 to use vs. no use past 12 months at 15   2.45 (1.41-4.25)   Table five Unadjusted (adjusted OR could not be used because 95% CI were not reported)
NPMS, UK; appendix, Moore et al., 2007 [10] AMD (CIS-R ≥ 12) to ever use vs. no use AMD (CIS-R ≥ 12) to CD vs. no CD .8 (.4-1.6) .9 (.2-3.6) p. IV Excluded if baseline CIS-R ≥ 12, demographics, other drugs, alcohol, nicotine use
Patton et al., 2002; VAHCS, Australia [48]6 AMD (CIS-R ≥ 12) at 21 (wave 7) to < weekly use vs. no use past 6 months at 15–17 (wave 1–6)   1.4 (.94-2.0)   Table three AMD at 15–17, alcohol use, parental demographics
Swift et al., 2008; VAHCS, Australia [50]6 Weekly + use vs. no use (past 12 months at 24, wave 8, who used cannabis at 15–17, waves 1–6) to AMD (CIS-R > 11) at 15–17 (at 3/6 waves of wave 1–6) CD vs. no CD (past 12 months at 24, wave 8, who used cannabis at 15–17, waves 1–6) to AMD (CIS-R> 11) at 15–17 (at 3/6 waves of wave 1–6) 2.0 (1.0-3.8) 1.4 (.71-2.9) Table four Demographics, adolescent: maximum level of cannabis use, nicotine and alcohol use, antisocial behaviour
VAHCS combined6 AMD at 15–24 to at least < weekly use at 15–17 (vs. no use)   1.35 (.80-2.27)    
  1. Notes: For abbreviations refer to Table 2.
  2. 1The OR was computed based on the following N of cases in the ‘Anxiety’ column and ‘Baseline No Diagnosis’ and ‘Cannabis Diagnosis’ rows reported in Table three of the article: N = 2 (CUD/anxiety), N = 46 (CUD/no anxiety), N = 51 (no CUD/anxiety), N = 914 (no CUD/no anxiety).
  3. 2The two ORs were combined according to the formulae for combining dependent effect sizes shown in the Additional file 1.
  4. 3Both studies reported ORs based on the same number of cases from the same study (NCS-R). It was assumed that both studies were dependent (same cases might have been used to compute the ORs in both studies). Thus, both ORs were combined into one common OR that was used in all subsequent analyses using the formulae shown in the Additional file 1.
  5. 4The OR was computed based on the following N of cases in the ‘Cases’ (OCD) vs. ‘Non-cases’ columns and ‘Use of marijuana only’ and ‘No drug use’ rows reported in Table one of the article: N = 12 (use/anxiety), N = 42 (use/no anxiety), N = 82 (no use/anxiety), N = 441 (no use/no anxiety). The risk ratio (RR), adjusted for confounders, was also reported in the study (Table two). However, RR and OR are not equivalent [56] and thus unadjusted OR is computed here which is more conservative than the RR in Table two of the study (RR = 2.1, 95% CI: 1.0-4.5).
  6. 5The STAI A scores reported separately for girls and boys were combined into one score in each of the three groups- non-users, users, and users with CUD using the formulae shown in the Additional file 1. The ORs in this study were computed based on these combined scores since all other studies in the current analysis reported anxiety scores in both genders combined rather than separately.
  7. 6The ORs in studies utilising VAHCS data from waves 1–8 were combined according to the formulae for combining dependent effect sizes shown in the Additional file 1.
  8. 7The OR was computed based on the following N of cases in the ‘Cannabis use at age 15’ and ‘Mental disorder- Internal (anxiety and depression)’ columns reported in Table five of the article: N = 20 (use/internal), N = 62 (use/no disorder), N = 84 (no use/internal), N = 637 (no use/no disorder).
  9. *The standardised mean difference (Cohen’s d) was computed for user – non-user or CUD – non-user groups in all studies in Part 2 of this table. This effect size was then converted into OR using the formulae shown in the Additional file 1.