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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    • "Exposure to an urban environment (Vassos et al. 2012), early childhood trauma (Varese et al. 2012) and cannabis use (Minozzi et al. 2010) are consistently associated with psychotic outcome in rigorously designed epidemiological studies, including prospective studies, in both clinical and general populations. Confirming the shared vulnerability theory of psychopathology , environmental factors, particularly cannabis use and trauma, are also associated with affective disorders, albeit less pronounced (Bovasso, 2001; Moore et al. 2007; Breetvelt et al. 2010; Nanni et al. 2012; Kedzior & Laeber, 2014). Similarly, a nationwide "
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    ABSTRACT: Evidence suggests that in affective, non-psychotic disorders: (i) environmental exposures increase risk of subthreshold psychotic experiences (PEs) and strengthen connectivity between domains of affective and subthreshold psychotic psychopathology; and (ii) PEs are a marker of illness severity. In 3021 adolescents from the Early Developmental Stages of Psychopathology cohort, we tested whether the association between PEs and presence of DSM-IV mood disorder (MD)/obsessive-compulsive disorder (OCD) would be moderated by risk factors for psychosis (cannabis use, childhood trauma and urbanicity), using the interaction contrast ratio (ICR) method. Furthermore, we analysed whether the interaction between environment and PEs was mediated by non-psychotic psychopathology. The association between PEs and MD/OCD was moderated by urbanicity (ICR = 2.46, p = 0.005), cannabis use (ICR = 3.76, p = 0.010) and, suggestively, trauma (ICR = 1.91, p = 0.063). Exposure to more than one environmental risk factor increased the likelihood of co-expression of PEs in a dose-response fashion. Moderating effects of environmental exposures were largely mediated by the severity of general non-psychotic psychopathology (percentage explained 56-68%, all p < 0.001). Within individuals with MD/OCD, the association between PEs and help-seeking behaviour, as an index of severity, was moderated by trauma (ICR = 1.87, p = 0.009) and urbanicity (ICR = 1.48, p = 0.005), but not by cannabis use. In non-psychotic disorder, environmental factors increase the likelihood of psychosis admixture and help-seeking behaviour through an increase in general psychopathology. The findings are compatible with a relational model of psychopathology in which more severe clinical states are the result of environment-induced disturbances spreading through a psychopathology network.
    Psychological Medicine 03/2015; 45(11):1-13. DOI:10.1017/S0033291715000380 · 5.94 Impact Factor
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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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    ABSTRACT: Attenuated responses to natural rewards have been found to predict subsequent substance use among dependent populations, suggesting that this may be a premorbid risk factor for later problematic substance use. However, research on adolescent risk-taking suggests that exaggerated, rather than blunted, reward responsiveness predicts later substance abuse. Acoustic startle-induced event-related potentials (ERP) were recorded in a sample of 11-13 year-olds while they viewed affective pictures, and participants were reassessed four years later regarding alcohol use and experience of alcohol-related problems. Increased attenuation of the amplitude of the P300 component of the ERP during viewing of pleasant pictures, relative to amplitude during neutral pictures (an indicator of increased attention to pleasant pictures), predicted increased likelihood of alcohol-related problems at follow-up. These findings further support research indicating that increased reward responsiveness predicts risky behaviours in adolescence, with anhedonia primarily a consequence of substance dependence. Copyright © 2015. Published by Elsevier B.V.
    Biological psychology 03/2015; 108. DOI:10.1016/j.biopsycho.2015.03.014 · 3.40 Impact Factor
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    • "People with a history of alcohol dependence are four times more likely to have depression compare to the general population.22,23 In addition, marijuana users are four times more likely to develop depression.24 Cigarette smoking and depression are also significantly associated.25,26 "
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