Cannabis has been associated with poorer mental health, but little is known of the effect of synthetic cannabinoids or cannabidiol (often referred to as CBD).

To investigate associations of cannabis, synthetic cannabinoids and cannabidiol with mental health in adolescence.

We conducted a cross-sectional analysis with 13- to 14-year-old adolescents across England and Wales in 2019–2020. Multilevel logistic regression was used to examine the association of lifetime use of cannabis, synthetic cannabinoids and cannabidiol with self-reported symptoms of probable depression, anxiety, conduct disorder and auditory hallucinations.

Of the 6672 adolescents who participated, 5.2% reported using of cannabis, 1.9% reported using cannabidiol and 0.6% reported using synthetic cannabinoids. After correction for multiple testing, adolescents who had used these substances were significantly more likely to report a probable depressive, anxiety or conduct disorder, as well as auditory hallucinations, than those who had not. Adjustment for socioeconomic disadvantage had little effect on associations, but weekly tobacco use resulted in marked attenuation of associations. The association of cannabis use with probable anxiety and depressive disorders was weaker in those who reported using cannabidiol than those who did not. There was little evidence of an interaction between synthetic cannabinoids and cannabidiol.

To our knowledge, this study provides the first general population evidence that synthetic cannabinoids and cannabidiol are associated with probable mental health disorders in adolescence. These associations require replication, ideally with prospective cohorts and stronger study designs.

大麻与较差的心理健康有关，但人们对合成大麻素或大麻二酚（通常称为 CBD）的影响知之甚少。

研究大麻、合成大麻素和大麻二酚与青春期心理健康的关系。

我们对 2019 年至 2020 年英格兰和威尔士 13 至 14 岁的青少年进行了横断面分析。使用多级逻辑回归来检查终生使用大麻、合成大麻素和大麻二酚与自我报告的可能抑郁、焦虑、品行障碍和幻听症状的关系。

在参与的 6672 名青少年中，5.2% 报告使用大麻，1.9% 报告使用大麻二酚，0.6% 报告使用合成大麻素。经过多次测试校正后，使用这些物质的青少年比没有使用过的青少年更有可能报告可能的抑郁、焦虑或品行障碍以及幻听。社会经济劣势的调整对关联影响不大，但每周吸烟会导致关联显着减弱。报告使用大麻二酚的人与未使用大麻的人相比，大麻使用与可能的焦虑和抑郁症的关联较弱。几乎没有证据表明合成大麻素和大麻二酚之间存在相互作用。

据我们所知，这项研究首次提供了一般人群证据，证明合成大麻素和大麻二酚与青春期可能的精神健康障碍有关。这些关联需要复制，最好是前瞻性队列和更强大的研究设计。