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Cannabis use as an indicator of risk for mental health problems in adolescents: a population-based study at secondary schools

Published online by Cambridge University Press:  03 December 2012

W. A. van Gastel ,
W. Tempelaar ,
C. Bun ,
C. D. Schubart ,
R. S. Kahn ,
C. Plevier  and
M. P. M. Boks
W. A. van Gastel*
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
W. Tempelaar
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
C. Bun
Affiliation:
Public Health Service greater Utrecht area (GGD Midden Nederland), Zeist, The Netherlands
C. D. Schubart
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
R. S. Kahn
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
C. Plevier
Affiliation:
Public Health Service greater Utrecht area (GGD Midden Nederland), Zeist, The Netherlands
M. P. M. Boks
Affiliation:
Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, Utrecht, The Netherlands
*
*Address for correspondence: W. A. van Gastel, M.Sc., Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Department of Psychiatry, HP B01.206, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. (Email: W.vanGastel@umcutrecht.nl)
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Abstract

Background

Although the association between cannabis use and a wide range of psychiatric symptoms is fairly well established, it is not clear whether cannabis use is also a risk factor for general mental health problems at secondary school.

Method

A total of 10 324 secondary school children aged 11–16 years, participating in an ongoing Public Health Service School Survey, gave information on demographics, substance use, school factors and stressful life events and completed the Strengths and Difficulties Questionnaire (SDQ).

Results

Cannabis use in the past month was associated with a clinically relevant score on the SDQ [unadjusted odds ratio (OR) 4.46, 95% confidence interval (CI) 3.46–5.76]. Other risk factors associated with poor psychosocial functioning were: a low level of education, alcohol use, cigarette smoking, hard drug use, frequent truancy, an unfavourable school evaluation, feeling unsafe at school, being victimized, frequent absence due to illness, a mentally ill parent, molestation by a parent, financial problems and feeling distressed by an adverse event. In a full model adjusting for these risk factors, cannabis was not significantly associated with mental health problems, although an association at trend level was apparent. Of these risk factors, regular alcohol use, cigarette smoking, hard drug use, frequent truancy, an unfavourable school evaluation and frequent absence due to illness were also associated with cannabis use.

Conclusions

The association between cannabis use and poor psychosocial functioning in adolescence is due, at least in part, to confounding by other risk factors. Thus, cannabis use can best be viewed as an indicator of risk for mental health problems in adolescence.

Keywords

Adolescencecannabis usemental health problemsriskrisk profile
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 9 , September 2013 , pp. 1849 - 1856
Copyright
Copyright © Cambridge University Press 2012 

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