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Changes in Cross-Sectional Associations Between Cannabis Use and Anxiety, Depression, and Suicidality in a Nationally Representative Sample of Canadians From 2012 to 2022: Évolution des relations transversales entre la consommation de cannabis et la dépression, l'anxiété et les idées suicidaires au sein d'un échantillon représentatif de Canadiens à l'échelle nationale, de 2012 à 2022

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Title: Changes in Cross-Sectional Associations Between Cannabis Use and Anxiety, Depression, and Suicidality in a Nationally Representative Sample of Canadians From 2012 to 2022: Évolution des relations transversales entre la consommation de cannabis et la dépression, l'anxiété et les idées suicidaires au sein d'un échantillon représentatif de Canadiens à l'échelle nationale, de 2012 à 2022
Authors: Halladay, Jillian (NURSE), Ji, Chris (AUTHOR), Georgiades, Katholiki (AUTHOR), McDonald, André (AUTHOR), Sunderland, Matthew (AUTHOR), Slade, Tim (AUTHOR), Chapman, Cath (AUTHOR), MacKillop, James (AUTHOR)
Source: Canadian Journal of Psychiatry. May2026, Vol. 71 Issue 5, p383-395. 13p.
Subjects: Anxiety, Mental depression, Epidemiology, Canadians, Suicidal ideation, Teenagers, Marijuana abuse, Mental health
Geographic Terms: Canada
Abstract (English): Objective: As epidemiological patterns of cannabis use and internalizing problems evolve globally, it is critical to reassess their associations—particularly in the post-legalization and post-pandemic context. Methods: Participants were assessed in the 2012 Canadian Community Health Survey's Mental Health Component (CCHS-MH; n = 25,113) and 2022 Mental Health and Access to Care Survey (MHACS; n = 9,861), two nationally representative cross-sectional epidemiologic surveys of Canadians aged 15+. Robust Poisson Regression analyses examined associations between frequency of cannabis use and past 12-month generalized anxiety disorder (GAD), major depressive episode (MDE), and suicidality assessed using the World Health Organization Composite International Diagnostic Interview. Results: Between 2012 and 2022, the prevalence of GAD, MDE, and cannabis use (any and 2+/week) approximately doubled, while suicidality remained unchanged in the full sample but increased by 44% among youth. Across all models, cannabis frequency was consistently associated with a higher prevalence of GAD, MDE, and suicidality in a frequency-dependent fashion. Additive interactions between year and cannabis on each of the outcomes demonstrated stronger associations in 2022 versus 2012. For example, from 2012 to 2022, those using cannabis 2+/week (relative to no use) had a: (1) prevalence ratio (PR) for GAD of 2.3 (95% CI, 1.6–3.4) increase to 4.5 (3.8–5.2); (2) PR for MDE of 3.0 (2.3–3.9) increase to 5.2 (4.6–5.7); and (3) PR for suicidality of 3.0 (2.1–4.0) increase to 5.4 (4.7–6.1). Select moderation effects indicated associations between cannabis and MDE or suicidality strengthened more among youth (15–24 vs. 25+), and associations with GAD strengthened more among females. Conclusions: Cannabis use was consistently related to a higher prevalence of internalizing problems, and these associations strengthened between 2012 and 2022. Given continued escalations in co-occurring cannabis use and internalizing problems, greater investment in early identification, intervention, and access to integrated substance use and mental health treatment is needed. Plain Language Summary: This study found that cannabis use among Canadians is linked with anxiety, depression, and suicidality. From 2012 to 2022, both cannabis use and depression and anxiety disorders rose, with stronger links between them over time. These findings reveal a growing association between cannabis use and depression, anxiety, and suicidality in Canada. Policymakers and practitioners should consider strengthening prevention and intervention efforts to ensure both cannabis use and mental health are addressed together. [ABSTRACT FROM AUTHOR]
Abstract (French): Alors que les tendances épidémiologiques liées à la consommation de cannabis et aux troubles intériorisés évoluent à l'échelle mondiale, il est essentiel de réévaluer leurs associations, particulièrement dans le contexte après la légalisation et la pandémie. Les participants ont été évalués dans la composante Santé mentale de l'Enquête sur la santé dans les collectivités canadiennes de 2012 (ESCC – SM, n = 25 113) et dans l'Enquête sur la santé mentale et l'accès aux soins de 2022 (ESMAS, n = 9 861), deux enquêtes épidémiologiques transversales représentatives, à l'échelle nationale, de la population canadienne âgée de 15 ans et plus. Des analyses de la régression de Poisson robustes visaient à examiner les associations entre la fréquence de consommation de cannabis et la présence, au cours des 12 derniers mois, d'un trouble d'anxiété généralisée (TAG), d'un épisode dépressif majeur (EDM) ou d'idées suicidaires, évalués à l'aide du Composite International Diagnostic Interview (entretien diagnostique international composite) de l'Organisation mondiale de la Santé. Entre 2012 et 2022, la prévalence du TAG, de l'EDM et de la consommation de cannabis (toute consommation et consommation de deux fois ou plus par semaine) a environ doublé, tandis que les idées suicidaires sont demeurées stables dans l'échantillon complet, mais ont augmenté de 44% chez les jeunes. Dans l'ensemble des modèles, une fréquence de consommation plus élevée était systématiquement associée à une plus forte prévalence du TAG, de l'EDM et des idées suicidaires, selon un effet dépendant de la fréquence. Les interactions additives entre l'année et la consommation de cannabis pour chacun des indicateurs ont révélé des associations plus fortes en 2022 qu'en 2012. Par exemple, de 2012 à 2022, les personnes consommant du cannabis au moins deux fois par semaine (comparativement à celles qui n'en consommaient pas) présentaient : 1) un ratio de prévalence (RP) pour le TAG passant de 2,3 (IC à 95% : 1,6; 3,4) à 4,5 (3,8; 5,2); 2) un RP pour l'EDM passant de 3,0 (2,3; 3,9) à 5,2 (4,6; 5,7); et 3) un RP pour les idées suicidaires passant de 3,0 (2,1; 4,0) à 5,4 (4,7; 6,1). Des effets de modération observés indiquaient que les associations entre consommation de cannabis et l'EDM ou les idées suicidaires s'étaient davantage renforcés chez les jeunes (15 à 24 ans) que chez les personnes de 25 ans et plus, tandis que les associations avec le TAG s'étaient davantage accentuées chez les femmes. La consommation de cannabis était systématiquement associée à une prévalence plus élevée des troubles intériorisés, et ces associations se sont intensifiées entre 2012 et 2022. Compte tenu de la hausse continue de la concomitance entre la consommation de cannabis et les troubles intériorisés, il est nécessaire d'investir davantage dans le repérage précoce, l'intervention et l'accès à des traitements intégrés en toxicomanie et en santé mentale. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Objective: As epidemiological patterns of cannabis use and internalizing problems evolve globally, it is critical to reassess their associations—particularly in the post-legalization and post-pandemic context. Methods: Participants were assessed in the 2012 Canadian Community Health Survey's Mental Health Component (CCHS-MH; n = 25,113) and 2022 Mental Health and Access to Care Survey (MHACS; n = 9,861), two nationally representative cross-sectional epidemiologic surveys of Canadians aged 15+. Robust Poisson Regression analyses examined associations between frequency of cannabis use and past 12-month generalized anxiety disorder (GAD), major depressive episode (MDE), and suicidality assessed using the World Health Organization Composite International Diagnostic Interview. Results: Between 2012 and 2022, the prevalence of GAD, MDE, and cannabis use (any and 2+/week) approximately doubled, while suicidality remained unchanged in the full sample but increased by 44% among youth. Across all models, cannabis frequency was consistently associated with a higher prevalence of GAD, MDE, and suicidality in a frequency-dependent fashion. Additive interactions between year and cannabis on each of the outcomes demonstrated stronger associations in 2022 versus 2012. For example, from 2012 to 2022, those using cannabis 2+/week (relative to no use) had a: (1) prevalence ratio (PR) for GAD of 2.3 (95% CI, 1.6–3.4) increase to 4.5 (3.8–5.2); (2) PR for MDE of 3.0 (2.3–3.9) increase to 5.2 (4.6–5.7); and (3) PR for suicidality of 3.0 (2.1–4.0) increase to 5.4 (4.7–6.1). Select moderation effects indicated associations between cannabis and MDE or suicidality strengthened more among youth (15–24 vs. 25+), and associations with GAD strengthened more among females. Conclusions: Cannabis use was consistently related to a higher prevalence of internalizing problems, and these associations strengthened between 2012 and 2022. Given continued escalations in co-occurring cannabis use and internalizing problems, greater investment in early identification, intervention, and access to integrated substance use and mental health treatment is needed. Plain Language Summary: This study found that cannabis use among Canadians is linked with anxiety, depression, and suicidality. From 2012 to 2022, both cannabis use and depression and anxiety disorders rose, with stronger links between them over time. These findings reveal a growing association between cannabis use and depression, anxiety, and suicidality in Canada. Policymakers and practitioners should consider strengthening prevention and intervention efforts to ensure both cannabis use and mental health are addressed together. [ABSTRACT FROM AUTHOR]
ISSN:07067437
DOI:10.1177/07067437261420701