Clinical Complexity of Youths With Major Depression and Cannabis Use Disorder: Evidence From a National Medicaid Cohort.

OBJECTIVE

Cannabis use disorder is rising among youths with major depressive disorder, yet little is known about how youths with both disorders differ from those with major depressive disorder alone.

METHODS

Using 2016-2021 national Medicaid data, the authors identified youths ages 9-24 years with newly diagnosed major depressive disorder and used multivariable logistic regression to compare individuals with or without cannabis use disorder diagnoses.

RESULTS

Among 1,898,383 youths with major depressive disorder, 76,289 (4.0%) had co-occurring cannabis use disorder. Youths with comorbid cannabis use disorder were significantly more likely to be male, Black, Hispanic, or multiracial and to have severe depression (adjusted OR [AOR]=1.97) and multiple comorbid conditions, particularly other substance use disorders (AOR=7.47) and histories of self-harm (AOR=1.84), and were less likely to receive psychotherapy (AOR=0.76) (all p<0.01), compared with youths without cannabis use disorder.

CONCLUSIONS

Youths with major depression and cannabis use disorder represent a clinically complex subgroup requiring evidence-based treatment addressing the co-occurrence of both disorders.