What question did this study set out to answer?

This research aims to quantify the relationship between Major Depressive Disorder and Cannabis Use Disorder, focusing on current diagnoses.

February 28, 2026Open Access

The association between Major Depressive Disorder and Cannabis Use Disorder: a meta-analysis and meta-regression analysis

Key Points

This research aims to quantify the relationship between Major Depressive Disorder and Cannabis Use Disorder, focusing on current diagnoses.
Systematic search of literature following PRISMA and MOOSE guidelines across major databases.
Random-effects models were used to estimate current-diagnosis prevalence of MDD in individuals with CUD and vice versa.
Conducted subgroup analyses on psychiatric and community samples, along with sensitivity analyses and Egger’s tests.
Current MDD prevalence was 19.24% among psychiatric samples with CUD and 21.65% in community samples.
Current CUD prevalence was significantly higher in psychiatric populations at 28.45% compared to 4.61% in community samples.
Meta-regressions indicated older populations and ICD-10 users showed higher MDD prevalence in CUD groups.

Abstract

Major Depressive Disorder (MDD) and Cannabis Use Disorder (CUD) frequently co-occur, yet prevalence estimates vary widely across settings. This meta-analysis updates the evidence on the bidirectional association between MDD and CUD, emphasizing current-diagnosis subgroups, which are the most clinically relevant. Following PRISMA and MOOSE guidelines, we systematically searched PubMed, Google Scholar, and SciELO. Random-effects models estimated current-diagnosis prevalence of MDD among individuals with CUD and of CUD among individuals with MDD. Subgroup analyses differentiated psychiatric and community samples. Sensitivity analyses (leave-one-out) and Egger’s tests assessed robustness and publication bias. Meta-regressions evaluated demographic, methodological, and geographic moderators. In total, 55 studies comprising 3,279,774 individuals were included (454,547 and 112,328 living with CUD and MDD, respectively). Current MDD prevalence among individuals with CUD was elevated in both psychiatric samples (19.24%) and community samples (21.65%), indicating consistent comorbidity across settings. Current CUD prevalence among individuals with MDD showed stronger contextual variation, being substantially higher in psychiatric populations (28.45%) compared with community samples (4.61%). Sensitivity analyses demonstrated stable estimates across model specifications, although psychiatric samples exhibited greater variance. Studies with older populations and using ICD-10 (compared to DSM) presented higher MDD prevalence among individuals living with CUD in meta-regression models. Egger’s tests revealed no consistent evidence of publication bias. Current-diagnosis estimates highlight a strong and clinically meaningful bidirectional association between MDD and CUD. Differences between psychiatric and community samples—especially the markedly higher current CUD prevalence in patients with MDD—underscore the need for systematic screening across treatment settings. Future work should improve diagnostic differentiation, particularly regarding the overlap between depressive symptoms and cannabis withdrawal.

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