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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.
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BMC Psychiatry

ISSN: 1471-244X

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