Self-reported psychopathological symptoms in recreational ecstasy (MDMA) users are mainly associated with regular cannabis use: further evidence from a combined cross-sectional/longitudinal investigation

Psychopharmacology (2004) 173:398404DOI 10.1007/s00213-003-1719-0ORIGINAL INVESTIGATIONJrg Daumann Gernot Hensen Bastian Thimm

Markus Rezk Bianca Till Euphrosyne Gouzoulis-MayfrankSelf-reported psychopathological symptoms

in recreational ecstasy (MDMA) users are mainly associated

with regular cannabis use: further evidence from a combined

cross-sectional/longitudinal investigationReceived: 30 July 2003 / Accepted: 10 November 2003 / Published online: 14 January 2004

Springer-Verlag 2004Abstract Rationale: 3,4-Methylenedioxymethamphet-

amine (MDMA, ecstasy) has become a widely used

recreational drug among young people. This is of great

concern, since MDMA is neurotoxic in animal studies and

its use has been associated with psychological distress and

a variety of self-reported psychiatric symptoms. However,

exploring the origins of psychopathology in ecstasy users

is hampered by the frequent polydrug use and by the

cross-sectional design of all investigations, so far. Objectives: The present study combines a cross-sectional with a

longitudinal approach to further clarify the impact of the

use of other illicit drugs on psychopathological symptoms

reported by ecstasy users. Methods: At baseline, we

administered self-rating scales for impulsivity, sensation

seeking and general psychological complaints to 60

recreational ecstasy users and 30 matched controls. From

the initial sample of ecstasy users, 38 subjects were reexamined 18 months later. Results: At baseline, ecstasy

users reported significantly more psychological complaints than controls. However, self-reported psychopathology was mainly associated with regular cannabis use.

At follow-up, subjects who had abstained from ecstasy

use during the follow-up period did not differ from those

reporting continued consumption. In contrast, subjects

with regular concomitant cannabis use during the followup period reported more anxiety, interpersonal sensitivity

and obsessive-compulsive behaviour than cannabis-absti-nent users. Finally, higher levels of obsessive-compulsive

behaviour, interpersonal sensitivity, depression, anxiety,

phobic anxiety and paranoid ideation were significantly

correlated with the duration of regular interim cannabis

use. Conclusions: The present findings suggest that selfreported psychopathology in ecstasy users is predominantly attributable to concomitant use of cannabis.

Abstinence from cannabis and not ecstasy seems to be a

reliable predictor for remission of psychological complaints in ecstasy users.Keywords MDMA THC Cannabis Ecstasy

SCL-90-R PsychopathologyIntroduction3,4-Methylenedioxymethamphetamine (MDMA, ecstasy)

has become a widely used recreational drug among young

people. According to a German epidemiological study,5.1% of 14- to 15-year-olds and 7.1% of young adults

have tried ecstasy at least once (Speck and Reimers

1999). Several studies in other western European countries and the USA indicate...