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Attenuated Psychotic Symptoms in Adolescents With Chronic Cannabis and MDMA Use

Melina Wiedmann, Sören Kuitunen-Paul, Lukas A Basedow, Veit Roessner, Yulia Golub

Frontiers in Psychiatry January 21, 2022 DOI: 10.3389/fpsyt.2021.696133 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional study Longitudinal Peer reviewed
Sample size 46
Population Adolescent psychiatry outpatients with substance use disorder
Topics Addiction Cannabis MDMA
Keywords Marihuana Psychosis Substance abuse
Citations 5
Key findings MDMA use, but not cannabis use, was associated with attenuated psychotic symptoms in adolescents with substance use disorder.

Abstract

ObjectivesBoth substance use, on the one hand, and the first signs of psychosis, on the other, commonly begin in adolescence. Adolescents with substance use disorder (SUD) frequently show recreational use of cannabis and 3,4-methylenedioxymethamphetamine (MDMA). When attenuated psychotic symptoms (APS) occur during the course of SUD, they are commonly attributed to the cannabis use, neglecting the role of other substances abused, such as MDMA in the risk of psychosis.MethodsWe analyzed retrospective self-reports on APS (Prodromal Questionnaire, PQ-16) and amount of cannabis and MDMA use in n = 46 adolescent psychiatry outpatients with SUD. N = 17 (35%) individuals reported MDMA consume additional to cannabis. Furthermore, we examined the associations of APS with cannabis and MDMA use in stepwise hierarchical regressions while controlling for trauma history, birth complications and gender.ResultsAPS were not related to cannabis (B = 0.04, p = 0.842), but to MDMA use (B = 4.88, p = 0.001) and trauma history (B = 0.72, p = 0.001). Gender (B = −0.22, p = 0.767) and birth complications (B = −0.68, p = 0.178) were not associated with APS.DiscussionOur results indicate that MDMA use additional to cannabis use is associated with APS among adolescent SUD patients. Contrary to our expectations, we did not see an association of cannabis use and APS. We speculate that cannabis increases the risk for psychosis after a longer period of use and in combination with other risk factors, such as trauma history. Clinicians should screen for APS among SUD patients using MDMA and cannabis in order to adapt treatment plans of SUDs. Future research should validate these findings in longitudinal studies including polysubstance use and trauma history.

Comparable studies

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

Study Year Design Participants
Persisting Reductions in Cannabis, Opioid, and Stimulant Misuse After Naturalistic Psychedelic Use: An Online Survey Online survey respondents 2020 Cross-sectional survey
User perceptions of the benefits and harms of hallucinogenic drug use: A web-based questionnaire study Users of hallucinogenic drugs who completed a web-based questionnaire 2010 Cross-sectional survey n = 600
Neural Correlates of the Severity of Cocaine, Heroin, Alcohol, MDMA and Cannabis Use in Polysubstance Abusers: A Resting-PET Brain Metabolism Study Polysubstance users enrolled in residential treatment 2012 Cross-sectional n = 49
MDMA Use by Paris Medical Students: Prevalence and Characteristics Paris VII medical students 2020 Cross-sectional study n = 592
Personality Characteristics of Adolescents with Hallucinogen, Methamphetamine, and Cannabis Dependence: A Comparative Study Adolescents referred to a residential substance abuse treatment program with... 2005 Cross-sectional comparison n = 60

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