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Cannabis use and depression: a longitudinal study of a national cohort of Swedish conscripts

Edison Manrique-Garcia1*, Stanley Zammit2, Christina Dalman3, Tomas Hemmingsson4 and Peter Allebeck1

Author Affiliations

1 Department of Public Health Sciences, Division of Social Medicine, Karolinska Institutet, Norrbacka floor 6, Stockholm,, S-17176, Sweden

2 Department of Psychological Medicine & Neurology, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Henry Wellcome Building, Cardiff, CF14 4XN, UK

3 Department of Public Health Sciences, Division of Public Health Epidemiology, Karolinska Institutet, Norrbacka floor 7, Stockholm,, S-17176, Sweden

4 Department of Public Health Sciences, Division of Occupational and Environmental Medicine, Karolinska Institutet, Norrbacka floor 4, Stockholm,, S-17176, Sweden

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BMC Psychiatry 2012, 12:112  doi:10.1186/1471-244X-12-112

Published: 16 August 2012



While there is increasing evidence on the association between cannabis use and psychotic outcomes, it is still unclear whether this also applies to depression. We aim to assess whether risk of depression and other affective outcomes is increased among cannabis users.


A cohort study of 45 087 Swedish men with data on cannabis use at ages 18–20. Diagnoses of unipolar disorder, bipolar disorder, affective psychosis and schizoaffective disorder were identified from inpatient care records over a 35-year follow-up period. Cox proportional hazard modeling was used to assess the hazard ratio (HR) of developing these disorders in relation to cannabis exposure.


Only subjects with the highest level of cannabis use had an increased crude hazard ratio for depression (HR 1.5, 95% confidence interval (CI), 1.0-2.2), but the association disappeared after adjustment for confounders. There was a strong graded association between cannabis use and schizoaffective disorder, even after control for confounders, although the numbers were small (HR 7.4, 95% CI, 1.0-54.3).


We did not find evidence for an increased risk of depression among those who used cannabis. Our finding of an increased risk of schizoaffective disorder is consistent with previous findings on the relation between cannabis use and psychosis.

Cannabis; Depression; Schizoaffective disorder