Cannabis Use is Related to Anhedonia in Adolescents With Diverse Mood and Anxiety Symptoms.

Abstract

Youth with depression use cannabis at high rates, and exposure to cannabinoids in adolescence has been shown to deleteriously alter the reward system. However, there has been sparse research on the link between adolescent cannabis use and anhedonia, a core symptom of depression and clinical manifestation of reward dysfunction. Here, in a sample of adolescents presenting predominantly with mood and anxiety symptoms, we investigated the relationships between cannabis use and anticipatory and consummatory aspects of anhedonia. Adolescents underwent psychiatric diagnostic interviews and completed dimensional symptom measures. Cannabis use was quantified using information from clinician interviews, self-reports, and urine toxicology screenings. Bivariate associations between cannabis use and anhedonia subconstructs were determined. To further assess associations adjusting for age and sex, linear regression models were performed. We additionally explored how cannabis use was related to other mood and anxiety symptoms, as well as age and sex effects. Among 153 participants (age: 15.9 ± 2.2 years, 64.1% biologically female), we identified 49 who used cannabis. Primary analyses showed that relative to those who never used or had only tried cannabis once, adolescents who used cannabis endorsed worse anticipatory anhedonia. More frequent cannabis use also correlated with greater anticipatory anhedonia. Exploratory analyses revealed that adolescents diagnosed with cannabis use disorder reported greater depression and anxiety than those with non-disordered cannabis use, and female and male youth differed in their experiences of mood and anxiety symptoms related to cannabis use. Our findings have important public health implications as policies on cannabis evolve. We advocate for the detection and interventions specific to anhedonia for the management of cannabis use in youth with internalizing conditions. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.We worked to ensure that the study questionnaires were prepared in an inclusive way.

In the evidence

This study is part of the evidence base for a synthesis in the library. Here is how each one recorded it.

• State of the evidence: Cannabis for anxiety ↓Opposes

  Adolescents who used cannabis reported worse anticipatory anhedonia than those who never used or tried cannabis once, with more frequent use correlating with greater anhedonia.

  Synthesized September 21, 2026

Comparable studies

Other cross-sectional and survey studies on cannabis for anxiety, most cited first.