Hostname: page-component-5d59c44645-7l5rh Total loading time: 0 Render date: 2024-02-20T13:59:39.986Z Has data issue: false hasContentIssue false

Cannabis use and mental health in secondary school children

Findings from a Dutch survey

Published online by Cambridge University Press:  02 January 2018

Karin Monshouwer*
Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht
Saskia Van Dorsselaer
Trimbos Institute and University of Amsterdam
Jacqueline Verdurmen
Trimbos Institute
Tom Ter Bogt
Trimbos Institute and Department of Clinical Child and Adolescent Studies, University of Leiden, The Netherlands
Ron De Graaf
Trimbos Institute and Department of Clinical Child and Adolescent Studies, University of Leiden, The Netherlands
Wilma Vollebergh
Trimbos Institute and Department of Clinical Child and Adolescent Studies, University of Leiden, The Netherlands
Karin Monshouwer, Trimbos Institute, PO Box 725, 3500 AS, Utrecht, The Netherlands. Tel: +31 30 297 1100; fax: +31 30 297 111; e-mail:
Rights & Permissions [Opens in a new window]


Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Cannabis use is associated with mental health problems, and young people in particular are at risk.


To investigate the association between cannabis use and mental health in adolescence.


Data from 5551 adolescents aged 12–16 years were drawn from the Dutch Health Behaviour in School-Aged Children school survey, carried out as part of the international 2001 World Health Organization project.


After adjusting for confounding factors, cannabis use was linked to externalising problems (delinquent and aggressive behaviour) but not to internalising problems (withdrawn behaviour, somatic complaints and depression). An increasing frequency of use resulted in stronger links. No significant gender or age by cannabis interaction effects were found.


In a country with a liberal drug policy like The Netherlands, cannabis use is associated with aggression and delinquency, just as in other countries. Cannabis use was not associated with internalising problems. Alcohol use and regular smoking were strong confounding factors.

Copyright © 2006 The Royal College of Psychiatrists 


Declaration of Interest



Achenbach, T. M. (1991) Manual for the Youth Self-Report and 1991 Profile. Burlington: University of Vermont Department of Psychiatry.Google Scholar
Arsenault, L., Cannon, M., Poulton, R., et al (2002) Cannabis use in adolescence andrisk for adult psychosis: longitudinal prospective study. BMJ, 325, 12121213.CrossRefGoogle Scholar
Boys, A., Farrell, M., Taylor, C., et al (2003) Psychiatric morbidity and substance use in young people aged 13–15 years: results from the Child and Adolescent Survey of Mental Health. British Journal of Psychiatry, 182, 509517.Google Scholar
Brook, J. S., Brook, W. D., Arencibia-Mireles, O., et al (2001) Risk factors for adolescent marijuana use across cultures and across times. Journal of Genetic Psychology, 162, 357374.CrossRefGoogle Scholar
Currie, C. E., Elton, R. A., Todd, J., et al (1997) Indicators of socio-economic status for adolescents: The WHO Health Behaviour in School-Aged Children Survey. Health Education Research, 12, 385397.CrossRefGoogle ScholarPubMed
Currie, C., Samdal, O., Boyce, W., et al (2001) Health Behaviour in School-Aged Children: A World Health Organization Cross-National Study Research Protocol for the 2001/2002 Survey. Edinburgh: Child and Adolescent Health Research Unit, University of Edinburgh.Google Scholar
Currie, C., Roberts, C., Morgan, A., et al (eds) (2004) Young Peoples Health in Context. Health Behaviour in School-aged Children (HBSC) Study: International Report from the 2001/2002 Survey. Copenhagen: WHO Regional Office for Europe.Google Scholar
Degenhardt, L., Hall, W. & Lynskey, M. (2001) Alcohol, cannabis and tobacco use among Australians: a comparison of their associations with other drug use and use disorders, affective and anxiety disorders, and psychosis. Addiction, 96, 16031614.CrossRefGoogle ScholarPubMed
Degenhardt, L., Hall, W. & Lynskey, M. (2003) Exploring the association between cannabis use and depression. Addiction, 98, 14931504.Google Scholar
Ehrenreich, H., Rinn, T., Kunert, H. J., et al (1999) Specific attentional dysfunction in adults following early start of cannabis use. Psychopharmacology, 142, 295301.Google Scholar
Fergusson, D. M. & Horwood, J. (1997) Early onset cannabis use and psychosocial adjustment in young adults. Addiction, 92, 279296.CrossRefGoogle ScholarPubMed
Fergusson, D. M., Horwood, J. & Swain-Campbell, N. (2002) Cannabis use and psychosocial adjustment in adolescence and young adulthood. Addiction, 98, 11231135.Google Scholar
Fergusson, D. M., Horwood, L. J. & Beautrais, A. L. (2003) Cannabis and educational achievement. Addiction, 98, 16811692.CrossRefGoogle ScholarPubMed
Henquet, C., Krabbendam, L., Spauwen, J., et al (2005) Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people. BMJ, 330, 11.Google Scholar
Jessor, R. (1987) Problem-behavior theory, psychosocial development, and adolescent problem drinking. British Journal of Addiction, 82, 33342.CrossRefGoogle ScholarPubMed
Lynskey, M. & Hall, W. (2000) The effects of adolescent cannabis use on educational attainment: a review. Addiction, 95, 62630.CrossRefGoogle ScholarPubMed
McGee, R., Williams, S., Poulton, R., et al (2000) A longitudinal study of cannabis use and mental health from adolescence to early adulthood. Addiction, 95, 49503.Google Scholar
Monshouwer, K., Van Dorsselaer, S., Gorter, A., et al (2004) Jeugd en Riskant Gedrag 2003 [Adolescents and Risk-taking Behaviour 2003]. Utrecht: Trimbos Institute.Google Scholar
Patton, G. C., Coffey, C., Carlin, J. B., et al (2002) Cannabis use and mental health in younger people: cohort study. BMJ, 325, 11951198.Google Scholar
Pedersen, W., Mastekaasa, A. & Wichstrom, L. (2001) Conduct problems and early cannabis initiation: a longitudinal study of gender differences. Addiction, 96, 415431.CrossRefGoogle ScholarPubMed
Rey, J. M., Sawyer, M. G., Raphael, B., et al (2002) Mental health of teenagers who use cannabis. Results of an Australian survey. British Journal of Psychiatry, 180, 216221.Google Scholar
Skinner, C. J., Holt, D. & Smith, T M. F. (1989) Analysis of Complex Surveys. Chichester: Wiley.Google Scholar
Smit, F., De Zwart, W. M., Spruit, I., et al (2002) Monitoring substance use in adolescents: school or household survey? Drugs: Education Prevention and Policy, 9, 267274.Google Scholar
Verhulst, F. C., Van der Ende, J. & Koot, H. M. (1997) Handleiding voor de Youth Self-Report (YSR) [Manual for the Youth Self-Report]. Rotterdam: Erasmus University.Google Scholar
Submit a response


No eLetters have been published for this article.