Trends in the diagnostic prevalence of cannabis-related disorders and co-occurring psychiatric disorders in adolescents: analysis of German health insurance data from 2013 to 2022

Cannabis use can have detrimental effects on adolescents' mental health, often co-occurring with child and adolescent psychiatric disorders (CAPD). This study assessed diagnostic prevalence trends in cannabis-related disorders and co-occurring diagnosed CAPD in adolescents receiving outpatient treatment in Germany. Outpatient claims data from the national public health insurance system, covering almost 4 million children and adolescents, were assessed for diagnostic prevalence of cannabis-related disorders (ICD-10 diagnoses F12.X) in insurees aged 12 to 17 years for the years 2013-22, stratified by age group and sex. In addition, the diagnostic prevalence of co-occurring CAPD during the year 2022 was evaluated. From 2013 to 2022, the diagnostic prevalence of cannabis-related disorders among German adolescents utilizing outpatient services increased from 0.08% to 0.10% (+22.4%), with a decline during the COVID-19 pandemic and a higher diagnostic prevalence in older adolescents. Up to 14 years of age, the diagnostic prevalence of cannabis-related disorders was distributed evenly among males and females, while from age 15 onwards, the diagnostic prevalence was higher in males. Overall, 78.3% of adolescents diagnosed with cannabis-related disorders had at least one co-occurring CAPD diagnosis in 2022. Most common co-occurring conditions were depressive disorders, conduct disorders, adjustment disorders, attention-deficit/hyperactivity disorders, and anxiety disorders. Co-occurring depression was particularly often diagnosed, underscoring the urgent need for integrated treatment approaches addressing both disorders simultaneously in this age group.