TOPLINE:

Major depressive disorder (MDD) was prevalent among 32% of all individuals with cannabis use disorder (CUD) in a new meta-analysis, and CUD was prevalent among 10% of those with MDD, highlighting a bidirectional and clinically meaningful association between the two conditions, researchers noted.

METHODOLOGY:

• A systematic review and meta-analysis of 55 studies published through April 2024 of more than 3.2 million individuals, including more than 454,000 with CUD and more than 112,000 with MDD, from community and psychiatric populations primarily in North America and Europe.
• The prevalence of current and lifetime diagnoses of MDD was estimated among individuals with CUD, and those of CUD were estimated among individuals with MDD.
• Subgroup analyses differentiated psychiatric sample groups from community sample groups.
• Moderators included age, sex, population type, diagnostic criteria, and region.

TAKEAWAY:

• Current MDD prevalence among individuals with CUD was 19% (95% CI, 3.4%-42.95%) in psychiatric sample groups and 22% (95% CI, 16.3%-27.50%) in community sample groups. Lifetime MDD prevalence in those with CUD was 35% and 32% in the psychiatric and community sample groups, respectively.
• Current CUD prevalence among individuals with MDD was substantially higher in psychiatric vs community populations at 28% vs 5%, respectively, whereas lifetime CUD prevalence was 8% vs 12%.
• Older age vs younger age and diagnostic classification based on the International Classification of Diseases, 10th Revision vs the Diagnostic and Statistical Manual of Mental Disorders were associated with higher MDD prevalence among individuals with CUD. No significant moderators were identified for CUD prevalence in patients with MDD.

IN PRACTICE:

“Cannabis use may exacerbate depressive symptoms, while individuals with MDD are at an increased risk of developing CUD,” the investigators of the study wrote.

“Given the growing legalization of cannabis and its rising use among younger populations, this relationship represents a pressing public health concern. Integrated treatment approaches addressing both disorders concurrently are critical to mitigate their long-term consequences,” they added.

SOURCE:

The study was led by João Pini Alemar, Medical School, FMABC University Center, São Paulo, Brazil. It was published online on February 26 in the Journal of Psychiatric Research.

LIMITATIONS:

The study only included articles published in English and Portuguese, social characteristics of the included countries and populations were not analyzed, and data on sex or age were missing in some studies. Because only one study in nonpsychiatric clinical populations was found, generalizability across clinical settings was limited. The overlap between cannabis withdrawal symptoms and MDD diagnostic criteria may have led to diagnostic ambiguity and potential overestimation of MDD prevalence among individuals with heavy or dependent cannabis use.

DISCLOSURES:

The study was funded in part by Fundação de Amparo à Pesquisa do Estado de São Paulo and Conselho Nacional de Desenvolvimento Científico e Tecnológico. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.