Cannabis Abuse as a Risk Factor for Depressive Symptoms

University of Pennsylvania Treatment Research Center, Philadelphia, PA 19104, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 01/2002; 158(12):2033-7. DOI: 10.1176/appi.ajp.158.12.2033
Source: PubMed


This study sought to estimate the degree to which cannabis abuse is a risk factor for depressive symptoms rather than an effort to self-medicate depression.
Participants (N=1,920) in the 1980 Baltimore Epidemiologic Catchment Area (ECA) study who were reassessed between 1994 and 1996 as part of a follow-up study provided the data. The analysis focused on two cohorts: those who reported no depressive symptoms at baseline (N=849) and those with no diagnosis of cannabis abuse at baseline (N=1,837). Symptoms of depression, cannabis abuse, and other psychiatric disorders were assessed with the Diagnostic Interview Schedule.
In participants with no baseline depressive symptoms, those with a diagnosis of cannabis abuse at baseline were four times more likely than those with no cannabis abuse diagnosis to have depressive symptoms at the follow-up assessment, after adjusting for age, gender, antisocial symptoms, and other baseline covariates. In particular, these participants were more likely to have experienced suicidal ideation and anhedonia during the follow-up period. Among the participants who had no diagnosis of cannabis abuse at baseline, depressive symptoms at baseline failed to significantly predict cannabis abuse at the follow-up assessment.
Further research is needed to identify characteristics of individuals who abuse cannabis that account for their higher risk of depression to estimate the degree of impairment resulting from their depression.

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Available from: Gregory Bovasso, Apr 22, 2014
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    • "These adaptations manifest as dysphoria and anhedonia when the drug is withdrawn, motivating further substance use to " self-medicate " this reward deficit. Consistent with this model, there is evidence from human studies that anhedonia increases following the onset of substance abuse (Bovasso, 2001), predicts increased likelihood of relapse in dependent users attempting to quit (Cook, Spring, McChargue, & Doran, 2010; Leventhal, Waters, Kahler, Ray, & Sussman, 2009), and declines over time with successful abstinence in those recovering from substance dependence (Dawes, Sitharthan, Conigrave, Phung, & Weltman, 2011; Dawkins, Powell, Pickering, Powell, & West, 2009; Martinotti et al., 2011; McGregor et al., 2005; Newton, Kalechstein, Duran, Vansluis, & Ling, 2004). Taken together, these findings suggest that impaired reward responsiveness is likely to emerge alongside the development of a substance use disorder, and may diminish with abstinence. "
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