Adolescent with cannabis use disorder and other mental health disorders: does dual disorder worsen school impairment?

Introduction Despite evidence of the impact on academic performance of cannabis use disorder (CUD) there is little information about what happens in those cases of dual diagnosis, when CUD occurs along with other mental health disorders (DD). Methods Participants in this study ( N = 300) were recruited from patients seeking treatment for CUD at an adolescent addictive behaviors unit. A multivariate logistic regression analysis was conducted to evaluate the effects of DD on school impairment (listwise deletion strategy). The interaction between CUD and other mental health disorders was included, along with covariates such as age of onset, years elapsed from first use to problematic use, and sex. Results The presence of co-occurring internalizing and/or externalizing disorders among adolescents with CUD was associated with higher odds of school impairment (OR = 3.73; 95% CI: 1.06–13.12; p = .04). In the adjusted model, psychiatric comorbidity was also associated with approximately twice the likelihood of repeating a grade or dropping out of school (OR = 2.05; 95% CI: 1.10–3.84; p = .03), whereas the CUD-only group, sex, age of initiation, and latency to regular cannabis use were not statistically significant predictors. These findings suggest that school impairment is particularly associated with the co-occurrence of CUD and other mental health disorders. Conclusions DD in adolescents emerges as a risk factor for academic performance. It is crucial to develop early intervention policies and approaches that comprehensively address DD.