Youths Who Use Marijuana Are at Increased Risk for Acute Psychotic Symptoms

girl smoking a joint
girl smoking a joint
Investigators examined whether adolescents who use marijuana heavily develop acute psychotic symptoms at a much higher rate than youths who use marijuana minimally or not at all.

There may be a strong association between adverse mental health outcomes and adolescent marijuana use, according to study data published in JAMA Pediatrics.

Investigators abstracted data from a survey of health and substance use administered to a convenience sample of youth age 14 to 18 who presented for routine care. The survey captured acute psychotic symptoms, anxiety, depression, sociodemographic characteristics, and frequency of cannabis use. The survey also included questions about cannabis use disorder. Logistic regression analyses were performed to examine any associations between psychiatric symptoms and cannabis use.

Survey participants were mean age 16.6±1.1, and 71.2% were girls. The majority (76.7%) of the study cohort was of non-Hispanic white race/ethnicity. A total of 40 respondents (27.4%) reported hallucinations, 49 (33.6%) reported paranoia or anxiety, and 63 (42.9%) reported having ≥1 psychiatric symptom. Neither hallucinations nor paranoia/anxiety were associated with age, sex, race/ethnicity, general health status, or socioeconomic status. However, patients who met the criteria for cannabis use disorder were more likely to report having experienced hallucinations or paranoia. A total of 70 respondents (47.9%) reported “monthly or more” marijuana use in the past year; this group was more likely to claim episodes of hallucinations and paranoia compared with respondents who reported use “once or twice” in the past year (60.0% vs 40.0%, respectively). Patients with positive results for depression were more likely to report paranoia than patients with negative results for depression (65.7% vs 34.3%).

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These results underscore the well-documented association between adolescent marijuana use and poor psychiatric outcomes. Specifically, these data suggest an increased risk for acute psychotic symptoms in youths with monthly or more frequent marijuana use. Further longitudinal research is necessary to elucidate the potential association between these acute psychotic symptoms and later development of a psychotic disorder.


Levy S, Weitzman ER. Acute mental health symptoms in adolescent marijuana users [published online December 17, 2018]. JAMA Pediatr. doi:10.1001/jamapediatrics.2018.3811