Date of Award


Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Mayur Desai

Second Advisor

Ilan Harpaz-Rotem


The existing body of literature focuses on the onset of panic disorders or other side effects as an association with cannabis use, but does little to address how possible concomitant cannabis use affects symptom presentation in already-diagnosed patients. The present project aims to take a closer look at adults with a lifetime history of DSM-5 diagnosed anxiety disorders, their prescribed (non-cannabis) medication use, cannabis use frequency, and associated symptom severity.

In general, we find that cannabis use is associated with higher panic-anxiety symptom severity across panic disorder without agoraphobia, generalized anxiety disorder, and people with combined anxious-distress diagnoses, after controlling for prescription medication status and professional help seeking. However, the difference between users and non-users is often small and not necessarily clinically relevant: only 1 or 2 symptoms. Worth noting is that we found no dose-response relationship for frequency of cannabis use. Being an infrequent user is not significantly different than being a daily user in terms of unique symptom presentation. This means that increasingly higher cannabis use does not necessarily induce increasingly more severe anxiety or distress. Rather, it seems that once an individual’s cannabis use crosses over a certain threshold, symptom presentation increases. For some disorders, this is an all-or-none phenomenon; any cannabis use is associated with more severe symptoms than staying abstinent. For others, only daily users present with higher symptoms than non-users. The sole divergence to this conclusion is that panic without agoraphobia patients who use infrequently seem to have more severe symptoms than non-users and daily users.


This thesis is restricted to Yale network users only. It will be made publicly available on 08/28/2021