Does cannabis use in adolescence predict self-harm or suicide? Results from a Finnish Birth Cohort Study

Acta Psychiatr Scand. 2022 Mar;145(3):234-243. doi: 10.1111/acps.13384. Epub 2021 Nov 22.


Objective: Longitudinal studies examining the association between adolescent cannabis use and self-harm are rare, heterogeneous and mixed in their conclusions. We study this association utilizing a large general population-based sample with prospective data.

Methods: The Northern Finland Birth Cohort 1986 (n = 6582) with linkage to nationwide register data was used to study the association of self-reported cannabis use at age 15-16 years and self-harm and suicide death until age 33 (until year 2018), based on register information. Cox regression analysis with Hazard Ratios (HR) and 95% confidence intervals (CI) was used. Psychiatric disorders, parental psychiatric disorders and other substance use were considered as confounders.

Results: In all, 6582 (49.2% male) were included in the analysis, and 377 adolescents (5.7%) reported any cannabis use until the age of 15-16 years. Based on register information, 79 (55.7% male) had visited in health care services due to self-harm, and 22 (90.1% male) had died by suicide. In crude analyses, adolescent cannabis use was associated with self-harm (HR = 3.93; 95% CI 2.24-6.90). The association between cannabis use and self-harm remained statistically significant after adjusting for sex, psychiatric disorders at baseline, frequent alcohol intoxications, other illicit drug use, and parental psychiatric disorders (HR 2.06; 95% CI 1.07-3.95). In contrast, the association of cannabis use with suicide did not reach statistical significance even in crude analysis (HR 2.60; 95% CI 0.77-8.78).

Conclusion: Cannabis use in adolescence may increase risk of self-harm independent of adolescent psychopathology and other substance use.

Keywords: adolescent; birth cohort; cannabis; self-harm.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Birth Cohort
  • Cannabis*
  • Cohort Studies
  • Female
  • Finland / epidemiology
  • Humans
  • Male
  • Prospective Studies
  • Risk Factors
  • Self-Injurious Behavior* / epidemiology
  • Self-Injurious Behavior* / psychology
  • Substance-Related Disorders* / epidemiology
  • Suicide* / psychology