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Problematic and non-problematic ecstasy (MDMA) usage : cognitive and psychopathological aspects

Kirstie Soar

UEL Research Repository 2005 DOI: 10.15123/pub.3408 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case study and group comparison studies Case report Peer reviewed
Population Ecstasy users (problematic and nonproblematic), polydrug controls, and drug-naive participants
Measures modified Brief Symptom Inventory, Rivermead Behavioural Memory Test, Tower of London, Auditory Verbal Learning Task, Locus of Control scale
Topics MDMA
Key findings Only self-reported problematic ecstasy users consistently display cognitive and psychopathological problems. Pre-existing psychiatric histories, intensity of ecstasy dosing, and polydrug use appear to contribute to these problems, but patterns of ecstasy use alone do not distinguish problematic from nonproblematic users.

Abstract

This research thesis aimed to explore the apparent dichotomy of ecstasy (MDMA) users who report cognitive and psychopathological problems which they attribute to their use of this drug ("problematic" users), and those who report no adverse ecstasy-related effects ("nonproblematic" users). In the first study, possible psychological sequalae linked to past ecstasy use were assessed in problematic and non-problematic ecstasy users using the modified Brief Symptom Inventory, aspects of the Rivermead Behavioural Memory Test, Tower of London and Auditory Verbal Learning Task. Problematic ecstasy users displayed higher psychopathological symptoms and a small number of selective cognitive deficits compared to non-problematic ecstasy users and polydrug controls. However, problematic ecstasy use did not appear to be related to patterns of ecstasy use or polydrug use. Using the same assessment measures, a case study based on a heavy problematic ecstasy user (RW), who had been abstinent for seven years, was presented. RW displayed cognitive deficits and extensive psychological problems suggesting that heavy ecstasy consumption may be associated with irreversible problems. The persistence of possible psychological and cognitive problems was further investigated in the second group study, using the same battery of tests. However no significant differences in cognitive and psychopathological performances were found between polydrug controls, current and ex-ecstasy users. It is argued that impairments in performance were possibly masked by poor cognitive performance in polydrug controls. The validity of the polydrug control group was addressed (in the third study) by assessing 20 drug-naive participants on the same measures. The introduction of a drug-naive control group only suggested that problematic and non-problematic ecstasy users were exhibiting more errors on the Tower of London task compared to polydrug and drug-naive controls. The final study assessed psychopathological symptoms in problematic and non-problematic ecstasy users relative to drug-naive and polydrug controls, and explored factors which may be integral in the development of problematic ecstasy use, including certain pre-existing factors. Users were assessed on the BSI and Locus of Control scale. Pre-existing psychiatric histories, the intensity of ecstasy dosing and the role of polydrug use in relation to ecstasy use, appeared to contribute in higher psychopathological symptoms in problematic ecstasy users. Together these studies suggest that only self-reported problematic ecstasy users consistently display cognitive and psychopathological problems. For these vulnerable individuals the intensity of ecstasy use, patterns of other drug use and pre-existing psychiatric histories are thought to contribute to the development of these problems.

Comparable studies

Other case reports and case series on MDMA, most cited first.

Study Year Design Participants
'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA Individuals whose deaths were associated with MDMA or MDEA use 1987 Case series n = 5
Pathology of deaths associated with "ecstasy" and "eve" misuse. Young white men aged 20 to 25 who died after using ring-substituted amphetamines (MDMA... 1996 Case series n = 7
'Eve' and 'Ecstasy' Individuals who died after using MDMA or MDEA 1987 Case series n = 5
A Method of Conducting Therapeutic Sessions with MDMA Clients with clear therapeutic purpose, excluding those with serious functional... 1998 Case study n = 2
Diversity of Psychopathology Associated with use of 3,4-Methylenedioxymethamphetamine (‘Ecstasy’) Psychiatric patients presenting between 1990 and 1992 whose symptoms developed in the... 1994 Case series n = 13

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