Acute Mental Health Symptoms in Adolescent Marijuana Users

Marijuana use is associated with acute psychotic symptoms,¹ but the prevalence of these symptoms in youth is not known, to our knowledge. We surveyed adolescents presenting for routine medical care to assess whether they had experienced acute psychotic symptoms during or right after marijuana use.

We analyzed data from a survey of health and substance use that was administered to a convenience sample of youths aged 14 to 18 years presenting for routine care; 1235 patients were approached and 527 consented for a response rate of 42.7%. Youths were enrolled with a waiver of parental consent under the approval of the Boston Children’s Hospital Institutional Review Board. Measures included 2 questions about acute psychotic symptoms (“In the past 12 months, how often have you felt anxious or paranoid during or after using marijuana?” and, “In the past 12 months, how often have you seen, felt, or heard things that were not really there [ie, hallucinations] during or after using marijuana?”) and standardized questions about symptoms of cannabis use disorder (based on the modified World Mental Health Composite International Diagnostic Interview),² anxiety (based on the 2-item Generalized Anxiety Disorder scale),³ and depression (based on the Patient Health Questionnaire 2)⁴ and sociodemographic characteristics. One hundred forty-six respondents who affirmed past-year marijuana use and had complete data for measures of interest were included in the analysis.