A naturalistic examination of the perceived effects of cannabis on negative affect

J Affect Disord. 2018 Aug 1:235:198-205. doi: 10.1016/j.jad.2018.04.054. Epub 2018 Apr 6.


Background: Cannabis is commonly used to alleviate symptoms of negative affect. However, a paucity of research has examined the acute effects of cannabis on negative affect in everyday life. The current study provides a naturalistic account of perceived changes in symptoms of depression, anxiety, and stress as a function of dose and concentration of Δ9tetrahydrocannabinol (THC) and cannabidiol (CBD).

Method: Data from the app StrainprintTM (which provides medical cannabis users a means of tracking changes in symptoms as a function of different doses and chemotypes of cannabis) were analyzed using multilevel modeling. In total, 11,953 tracked sessions were analyzed (3,151 for depression, 5,085 for anxiety, and 3,717 for stress).

Results: Medical cannabis users perceived a 50% reduction in depression and a 58% reduction in anxiety and stress following cannabis use. Two puffs were sufficient to reduce ratings of depression and anxiety, while 10+ puffs produced the greatest perceived reductions in stress. High CBD (>9.5%)/low THC (<5.5%) cannabis was associated with the largest changes in depression ratings, while high CBD (>11%)/high THC (>26.5%) cannabis produced the largest perceived changes in stress. No changes in the perceived efficacy of cannabis were detected across time. However, baseline symptoms of depression (but not anxiety or stress) appeared to be exacerbated across time/tracked sessions.

Limitations: The primary limitations are the self-selected nature of the sample and the inability to control for expectancy effects.

Conclusions: Cannabis reduces perceived symptoms of negative affect in the short-term, but continued use may exacerbate baseline symptoms of depression over time.

Keywords: Anxiety; Cannabis; Depression; Dose effects; Multilevel modeling; Stress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affect / drug effects
  • Anxiety / drug therapy*
  • Anxiety / psychology
  • Cannabidiol / administration & dosage*
  • Depression / drug therapy*
  • Depression / psychology
  • Dose-Response Relationship, Drug
  • Dronabinol / administration & dosage*
  • Female
  • Humans
  • Male
  • Perception / drug effects
  • Stress, Psychological / drug therapy*
  • Stress, Psychological / psychology


  • Cannabidiol
  • Dronabinol