Academic literature on the topic 'Cannabis – Psychological aspects'

Cannabis is seen among general population as an “anti-depressive drug”. Many papers have been published in the field of investigation about the relationship between cannabis use and affective disorders. We pretend to find the aspect of the psychological consequences of cannabis use.MethodsUsing Pubmed and PsychInfo, we conducted a narrative review of the literature on cannabis and psychiatric comorbidity using the keywords cannabis, psychosis, mood, depression, mania, bipolar, and anxiety.ResultsThere is substantial evidence of an association between cannabis use and psychosis. A few reports suggest an association with bipolar disorder while the association with depression and anxiety disorders is mixed.ConclusionsThe present review confirms earlier findings of an association between cannabis use and a lower age at onset. Data shows that cannabis use, beginning in the adolescence and with a frequency higher than once a week, correlates with the development in adult age of affective symptoms and/or disorder, mainly in bipolar disorder, with a moderate relation with Depressive spectrum. Even more, some authors hypothesize that cannabis may play a role in the development of the disorder, that to say, affective disorder would not appear in the absence of cannabis use. The current findings suggest that recent cannabis use is associated with a more severe course of illness in the early phase of BD I.Recent cannabis use was also associated with more lifetime suicide attempts.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Background: Synthetic cannabinoids are, typically, full agonists at the cannabinoid CB1 receptor, and therefore considerably more potent than natural cannabis and may have correspondingly more serious psychological effects. Despite government sanctions against their production they continue to be available in ever-increasing varieties over the Internet. The psychological consequences of synthetic cannabinoid use are relatively unknown. Aim: The purpose of this study was to synthesise the available research on the psychological consequences of synthetic cannabinoid use. Method: A literature search of three databases was conducted in February 2018, including the following keywords: Spice, synthetic cannabis, cognition, affect, behaviour, psychosis, depression and anxiety. Results: Seventeen studies involving a variety of participants were eligible for inclusion: one controlled administration study, seven cross-sectional studies, five Internet surveys and four qualitative studies. The controlled administration study showed that, compared to placebo, synthetic cannabinoids acutely affected some aspects of cognitive functioning and subjective psychological ratings. Non-controlled, cross-sectional studies generally showed that synthetic cannabinoid users had lower performance on cognitive tasks and showed elevated symptomatology (e.g. paranoia) compared to both natural cannabis and non-cannabis users. Methodological limitations were noted across different study designs. There is limited research on how doses, frequency or type of synthetic cannabinoid influence outcomes. Conclusions: Acute synthetic cannabinoid use can result in a range of psychological outcomes and, when non-intoxicated, synthetic cannabinoid users appear to differ from natural cannabis and non-users on various affective and cognitive domains. As synthetic cannabinoid use is increasing in at-risk populations there is an urgent need for more and better research to inform users, professionals and policymakers.

Background: Cannabis intoxication is commonly reported to increase appetite and enhance appreciation of food (the ‘munchies’). These effects are attributed to activation of the endocannabinoid system. However, the psychological changes that underlie these phenomena are under-researched. We report here the results of an extensive online survey of cannabis users with an exploratory Cannabinoid Eating Experience Questionnaire (CEEQ). Method: Frequent cannabis users completed a 46-item questionnaire about their eating behaviour under the influence of cannabis. An English-speaking sample ( n=591) provided data for the initial exploratory validation of the scale. A second Dutch-language survey ( n=163) was used for confirmatory factor analysis. Test-retest reliability was based on a third English-speaking sample ( n=40) who completed the revised, 28-item CEEQ twice across 2 weeks. Results: Principal components analysis provided a two-factor solution. Factor 1 (hedonic) comprised 14 items that related primarily to the enjoyment and altered sensory aspects of eating. Factor 2 (appetitive) comprised a further 14 items related to motivational factors that instigate or promote eating. The two-factor structure was supported by confirmatory factor analysis. Both the hedonic and appetitive subscales had good internal reliability (α=0.92 for each subscale, in two independent samples). Good test-retest reliability was obtained for the revised 28-item questionnaire ( ps<.01 for Total CEEQ and each subscale). Conclusion: The Cannabinoid Eating Experience Questionnaire provided a valid, reliable assessment of the psychological features of cannabis-induced alterations to appetite. Our data confirm that cannabis principally influences the motivational factors that lead to the initiation of eating and the hedonic factors implicated in maintaining eating.

Abstract Objective Despite evidence of the analgesic benefits of cannabis, there remains a relative scarcity of research on the short- and long-term effects of cannabis use in individuals with chronic pain. Design The current study is a secondary analysis of clinical data from the Collaborative Health Outcomes Information Registry (CHOIR). Setting Data were drawn from a cohort of patients of a multidisciplinary tertiary care pain clinic. Subjects The study sample consisted of data from 7,026 new patient visits from CHOIR; of these, 1,668 patients with a follow-up time point within 180 days were included in a longitudinal analysis. Methods Clinical data were analyzed to characterize cross-sectional differences in pain and indicators of psychological and physical function according to self-reported, concurrent cannabis use. Additionally, a propensity score–weighted longitudinal analysis was conducted, examining cannabis use as a predictor of changes in clinical variables across time. Results Cross-sectional analyses suggested significantly poorer sleep and significantly higher intensities of pain, emotional distress, and physical and social dysfunction in patients reporting ongoing cannabis use; however, these differences were relatively small in magnitude. However, no differences between cannabis users and nonusers in terms of longitudinal changes in clinical variables were noted. Discussion Our results are among the first to examine concurrent cannabis use as a prognostic variable regarding trajectories of pain-related variables in tertiary care. Future studies may benefit from examining the effect of cannabis initiation, concurrent medication use, and specific aspects of cannabis use (dose, duration of use, or cannabis type) on clinical outcomes.

Nepal is a geographically, ecologically, bio-culturally and ethnically diverse country. Cannabis has been a flora, used in various forms and ways and its effect has been variably a matter of concern in Nepal. Perception to its use has also been changing with time with the dynamics of various factors and trends around and in the world. The views of its proponents at times appear with relatively more powerful influence among people though the views of the opponents seem less, and relatively less influential. Proponents advocate for its legalization with highlights of its different uses and benefits whereas opponents, mainly mental health professionals point out sporadically its adverse consequences, mainly in psychological health. The purpose of this review is to explore the existing literature regarding cannabis use and abuse in Nepal. Search for articles for this review was performed in PubMed, Google Scholar, and Nepal Journal Online. We summarize and discuss about cannabis in various aspects in the Nepalese context. The overarching objective is to reflect upon the ongoing debate regarding its harm and benefits, thereby upon the issue of its legalization in Nepal.

On the background of ever increasing HIV transmission in our community throughvarious routes, the psychosocial factors related with intravenous drug abuse has becomenecessary to be studied. Aim of the study was to assess the Socio-psychological factorsthat influence people to use drugs, especially to use Injectable drugs. We enrolled asample of 393 Intravenous drug users, all male, in the Kathmandu Valley. Participantswere administered a semi structured proforma to assess the psychosocial issues relatedwith the drug intravenous drug abuse. Mean age of the sample was 27.76+ 4.86 years.Majority were single, unemployed, Hindu and by caste Newars, with education morethan high school (SLC or more). The first psychoactive substance use by most of themwas cannabis. The most frequently used psychoactive substance was injectionBuprenorphine (Tidigesic), which was followed by mixture of various substances(opiates, benzodiazepines, antihistamines) and Diacetyl morphine (Brown sugar).Factors associated with the start of the drugs were for enjoyment, friend’s pressureand to alleviate mental tension. Many accepted Injectable drug use contributing toproblems in mental, marital, social, economic and legal aspects of their life. Despiteknowing the harms caused by the drugs majority persist on its use. A needle exchangeprogramme has been viewed positively by many.Key words: buprenorphin, needle sharing, needle replacement, HIV transmission.

IntroductionInternet Addiction (IA) is discussed as a serious health problem. Epidemiologic investigations show prevalence rates of 3% of internet users that fulfil criteria for IA. Reported symptoms like tolerance, withdrawal, and craving resemble those of substance-related disorders. Although there is no final agreement on the classification of IA, it has often been referred to as a non-substance-related addiction fostering current issues on the next revision of DSM (Holden, 2010).ObjectivesAlthough IA has been investigated in epidemiologic studies there is no research of its prevalence in patients in treatment because of a substance-related disorder. Regarding similarities between IA and substance-related disorders, theories suggest increased prevalence of comorbid IA in these patients.AimsThis study focused on the identification of prevalence of comorbid IA among patients with a primary substance-related disorder in different in-patient clinics across Germany.MethodsSponsored by the German Federal Ministry of Health 1826 patients were screened with a diagnostic inventory for IA. For further description additional questionnaires were given assessing aspects of personality (NEO-FFI) and psychopathology (SCL-90R, BDI-II).Results4.1% of the patients fulfilled criteria of IA. In these most common primary diagnoses were pathological gambling and dependency of cannabis. Concerning personality IA-subsample showed increased neuroticism and introversion. Highest symptom burden was found in depression and social insecurity.ConclusionsAmong patients with substance-related disorder prevalence of IA is more common than in healthy samples. Results recommend separate screening for IA in inpatient clinics for substance-related disorders to guarantee full psychological care for patients with IA.

194 Background: Pain is a common contributing factor to emergency department visits among patients with cancer. Acute exacerbation of pain in cancer patients who have a history of chronic pain poses a potentially greater challenge to pain management and understanding differences between patients with and without historical chronic pain may provide notable insights. The aim of this analysis was to compare aspects of ED healthcare utilization, as well as disease, pain, opioid, and psychosocial factors between cancer patients with or without a history of chronic pain. Methods: Patients presenting to the ED with a complaint of acute pain (> 4/10 NRS) completed validated self-report measures assessing socio-demographics, cancer diagnosis and treatments, pain severity (BPI-SF), medication use (opioids, non-opioid analgesics, cannabis), and psychosocial wellbeing (depression, anxiety, pain catastrophizing, sleep disturbance). Disease and hospital utilization data were abstracted from the medical record. Patients were stratified using the item: “Did you have other chronic pain (pain present for 3 months) at the time of your cancer diagnosis?” Mann-Whitney U, t-tests, and chi-square tests were used to compare differences in psychosocial and pain factors for those with and without previous chronic pain. Results: Approximately a third of the 113 participants reported having another type of chronic pain before cancer. Cancer diagnoses included breast (12%), colon (14%), lung (12%), and ovarian (11%); 74% had current metastatic disease. 43% used opioids, 27% used over-the-counter analgesics, and 6% used cannabis to manage pain. Patients with historical chronic pain reported greater widespread pain (m = 3.90 SD = 2.80 vs. m = 1.80 SD = 1.96, p= < 0.001), significantly higher current pain (m = 6.03 SD = 2.38 vs. m = 4.40 SD = 2.58, p= 0.002), as well as higher mean Brief Pain Inventory scores (m = 5.91 SD = 1.62 vs. m = 4.68 SD = 2.20, p= 0.003). Patients with historical chronic pain reported lower incomes ( p= 0.005), were more likely to have mental health comorbidities (61% vs. 40%, p= 0.039) including depression, substance use, and post-traumatic stress disorder. They were more likely to be prescribed non-opioid analgesics (79% vs. 52%, p= 0.006) and antidepressants (50% vs. 23%, p= 0.003), but not more likely to be taking opioids. There were no significant differences in symptoms of depression, pain catastrophizing, stress, or sleep disturbance, nor were there differences in disease type or length of ED/inpatient stay. Conclusions: Patients with cancer and historical chronic pain reported significantly higher pain than patients without a history of chronic pain. Providers should consider patients’ past experiences with pain when treating cancer pain. Patients with histories of chronic pain may have similar psychological needs as patients without histories of chronic pain.

Background: Cannabis exposure, particularly heavy cannabis use, has been associated with neuroanatomical alterations in regions rich with cannabinoid receptors such as the hippocampus in some but not in other (mainly cross-sectional) studies. However, it remains unclear whether continued heavy cannabis use alters hippocampal volume, and whether an earlier age of onset and/or a higher dosage exacerbate these changes. Methods: Twenty heavy cannabis users (mean age 21 years, range 18–24 years) and 23 matched non-cannabis using healthy controls were submitted to a comprehensive psychological assessment and magnetic resonance imaging scan at baseline and at follow-up (average of 39 months post-baseline; standard deviation=2.4). Cannabis users started smoking around 16 years and smoked on average five days per week. A novel aspect of the current study is that hippocampal volume estimates were obtained from manual tracing the hippocampus on T1-weighted anatomical magnetic resonance imaging scans, using a previously validated protocol. Results: Compared to controls, cannabis users did not show hippocampal volume alterations at either baseline or follow-up. Hippocampal volumes increased over time in both cannabis users and controls, following similar trajectories of increase. Cannabis dose and age of onset of cannabis use did not affect hippocampal volumes. Conclusions: Continued heavy cannabis use did not affect hippocampal neuroanatomical changes in early adulthood. This contrasts with prior evidence on alterations in this region in samples of older adult cannabis users. In young adults using cannabis at this level, cannabis use may not be heavy enough to affect hippocampal neuroanatomy.

Recent decades have seen much progress in the identification and characterization of cannabinoid receptors and the elucidation of the mechanisms by which derivatives of the Cannabis sativa plant bind to receptors and produce their physiological and psychological effects. The information generated in this process has enabled better understanding of the fundamental physiological and psychological processes controlled by the central and peripheral nervous systems and has fostered the development of natural and synthetic cannabinoids as therapeutic agents. A negative aspect of this decades-long effort is the proliferation of clandestinely synthesized analogs as recreational street drugs with dangerous effects. Currently, the interactions of cannabinoids with their biochemical substrates are extensively but inadequately understood, and the clinical application of derived and synthetic receptor ligands remains quite limited. The wide anatomical distribution and functional complexity of the cannabinoid system continue to indicate potential for both therapeutic and side effects, which offers challenges and opportunities for medicinal chemists involved in drug discovery and development.

Research into the comorbidity (or co-occurrence) of mental disorders is a relatively recent phenomenon. Much of this research has been conducted in clinical samples, which are prone to a range of biases that mean that the patterns observed are not representative of the general population. Although population-level research has previously been carried out, this thesis provides the first examination of comorbidity in the Australian population. This thesis examined the comorbidity of substance use and mental disorders among Australian adults. The major empirical work involved an examination of the patterns of homotypic comorbidity (other substance use disorders) and heterotypic comorbidity (mood disorders, anxiety disorders, and psychosis) of alcohol, tobacco and cannabis in the 1997 Australian National Survey of Mental Health and Well-Being (NSMHWB). These drugs were chosen as they are the most commonly used psychoactive substances in the Australian population. The NSMHWB involved a structured diagnostic interview of mental disorders with a representative sample of Australian adults. Three questions were addressed using this data: (1) What patterns of comorbidity exist between tobacco, alcohol and cannabis use, and other substance use and mental disorders?; (2) Are these patterns of comorbidity explained by common factors?; and (3) Does comorbidity affect the likelihood that mental health treatment has been sought? Similar patterns of homotypic comorbidity were observed for all three substances, and they were not explained by the other factors examined (gender, age, education, relationship status, employment and neuroticism). Cannabis dependence was the most strongly associated with other substance use disorders. Heterotypic comorbidity differed between alcohol, tobacco and cannabis use. Tobacco use predicted increased rates of all three groups of mental disorders (mood, anxiety and psychotic disorders). In the case of alcohol, only alcohol dependence was related to increased rates of all groups of mental disorders; alcohol use and abuse were not associated with heterotypic comorbidity. Any level of cannabis involvement was related to a similarly increased risk of mood and anxiety disorders. Cannabis use was linearly related to the risk of screening positively for psychosis. Common factors did not change the patterns of heterotypic comorbidity of tobacco and alcohol use. However, alcohol, tobacco and other drug use appeared to explain the higher rates of mood and anxiety disorders among cannabis users. Treatment seeking was much more likely among alcohol, tobacco and cannabis users when they had comorbid mental disorders. It was moderately increased when they had comorbid substance use disorders. The second piece of empirical work provided a more detailed examination of comorbid substance use problems among persons with psychosis. This topic was selected due to the limited epidemiological research on this issue, and the relatively large burden of disability that psychosis places upon the individual and the community. NSMHWB data were used to examine the prevalence of comorbid substance use disorders among persons who were likely to have met criteria for psychosis (as assessed by a screener used in the NSMHWB). Multiple regression analyses were used to test possible explanations for the higher rates of substance use disorders observed among persons reporting higher numbers of psychotic symptoms. The odds of alcohol dependence and regular tobacco use increased 1.5 times, and the odds of cannabis dependence increased twice, with each additional psychotic symptom reported, after adjusting for other substance use disorders, other mental disorders and demographic characteristics. Given the debate about the reasons for the association between cannabis use and psychosis, the final study used mathematical modelling to test four hypotheses about relationships between cannabis use and psychosis. Specifically, it examined trends in psychosis that would be predicted given the marked increases in the prevalence of cannabis use that have occurred in Australia over the past thirty years. The results suggested that a causal relationship - in which cannabis use caused psychosis among persons who would not otherwise have developed the disorder - is unlikely to explain the association. There was a better fit to the data provided by the other hypotheses examined, namely, that (a) cannabis use precipitates psychosis among vulnerable individuals; (b) cannabis use increases the risk of relapse among persons with psychosis; and (c) persons with psychosis are more likely to become regular cannabis users (without any effect upon the disorder). This thesis has demonstrated that in Australian adults there is significant comorbidity between alcohol, tobacco and cannabis use and other substance use and mental disorders. These patterns differ across the three substances. Some types of heterotypic comorbidity (e.g. between cannabis use and mood/anxiety disorders) are explained by common factors. The limited range of common factors tested here did not explain homotypic comorbidity. This thesis also suggested that mathematical modelling is a useful approach to consider when examining the plausibility of different relationships between risk factors and mental disorders. A number of hypotheses regarding comorbidity could not be tested using NSMHWB data, such as common genetic and other environmental factors. These can best be tested in research with samples of twins, and using longitudinal designs that assess a wide range of social and environmental factors. The findings of this thesis also have implications for treatment, because persons with comorbid disorders are more likely to seek treatment. There is an absence of validated treatments for persons with comorbid substance use and mental disorders, and more research is needed on this issue.

Background. Various studies show that cannabis use alters attention and cognitive functioning in healthy humans and may contribute to development of schizophrenia or worsening of pre-existing psychosis. However, the impact of cannabis use on brain function in humans is not well understood. Schizophrenia is associated with a deficit in prepulse inhibition (PPI), the normal inhibition of the startle reflex by a non-startling stimulus (prepulse), presented before the startle stimulus at short time intervals (lead-time intervals). Such PPI deficit is thought to reflect a sensorimotor gating dysfunction in schizophrenia. PPI is also modulated by attention and PPI reduction in schizophrenia is observed when patients are asked to attend to, not ignore, the stimuli producing PPI. The aim of the current study was to investigate the association between self-reported chronic cannabis use and attentional modulation of PPI in healthy controls and in patients with schizophrenia. Furthermore, the association between cannabis use and other startle reflex modulators, including prepulse facilitation (PPF) of the startle reflex magnitude at long lead-time intervals, prepulse facilitation of the startle reflex onset latency and habituation of the startle reflex magnitude, were examined. Method. Auditory-evoked electromyographic signals were recorded from orbicularis oculi muscles in chronic cannabis users (29 healthy controls and 5 schizophrenia patients) and non-users (22 controls and 14 patients). The data for 36 participants (12 non-user controls, 16 healthy cannabis users, and eight non-user patients) were used in the final analyses and the patient data were used as a pilot study, because relatively few participants met the rigorous exclusionary criteria. Participants were instructed to attend to or to ignore either the startle stimuli alone (70 100 dB) or prepulse (70 dB) and startle stimuli (100 dB) separated by short lead-time intervals (20 200 ms) and long lead-time intervals (1600 ms). In order to ignore the auditory stimuli the participants played a visually guided hand-held computer game. A pilot study showed that the response component of playing the game had no effects on attentional modulation of the startle reflex magnitude and onset latency. Results. Relative to controls, cannabis use in healthy humans was associated with a reduction in PPI similar to that observed in schizophrenia while attending to stimuli, and with an attention-dependent dysfunction in the startle reflex magnitude habituation. While ignoring the stimuli there were no statistical differences in PPI between cannabis users and controls, although PPI in cannabis users tended to differ from that of the patients. The reduction in PPI in cannabis users was correlated with the increased duration of cannabis use, in years, but not with the concentration of cannabinoid metabolites in urine or with the recency of cannabis use in the preceding 24 hours. Furthermore, cannabis use was not associated with any differences in PPF, onset latency facilitation, and startle reflex magnitude in the absence of prepulses. The accuracy of self-reports of substance use was also investigated in this study and was found to be excellent. In addition, the study examined the validity of the substance use module of the diagnostic interview, CIDI-Auto 2.1, which was found to be acceptable for cannabis misuse diagnoses (abuse and/or dependence). Finally, cannabis dependence was found to be associated with more diagnoses of mental illness other than schizophrenia (mainly depression). Conclusions. The results of the current study suggest that chronic cannabis use is associated with schizophrenia-like deficit in PPI in otherwise healthy humans. This PPI reduction is associated with attentional impairment rather than a global sensorimotor gating deficit in healthy cannabis users.

Introduction : la période de l’adolescence constitue la tranche d’âge pour laquelle les consommations de cannabis sont les plus élevées en France. L’usage problématique de cannabis à l’adolescence représente un facteur de stress important pour les parents. Cette recherche a pour premier objectif d’identifier une dynamique familiale spécifique ainsi que les stratégies de coping (individuelles et dyadiques) mobilisées par les parents dont l’adolescent est consommateur de cannabis. Le second objectif vise à investiguer les facteurs associés à la détresse psychologique en termes de dynamique familiale et de stratégies de coping (individuelles et dyadiques). Méthode : au cours de cette étude quantitative et qualitative, 50 parents consultant pour l’usage problématique de leur adolescent et 67 parents témoins ont répondu à un questionnaire sociodémographique, au Family Adaptability and Cohesion Scale (FACES IV) et au Family Relationship Index (FRI) pour évaluer la dynamique familiale, à la Brief Cope pour estimer les stratégies de coping situationnelles et au Dyadic Coping Inventory (DCI) pour relever les stratégies de coping dyadique mobilisées par les parents de l’échantillon en couple. Résultats : les parents d’adolescents consommateurs de cannabis présentaient une détresse psychologique élevée et ont obtenu des scores significativement différents aux dimensions de la dynamique familiale en comparaison des parents du groupe contrôle. Ainsi, le fonctionnement familial des parents d’adolescents consommateurs de cannabis était défini par une cohésion et des capacités de communication plus basses mais aussi une intensité de conflit élevée par rapport aux parents du groupe contrôle. Une dimension de la dynamique familiale (conflits) et quatre stratégies de coping situationnelles (expression des sentiments, blâme, utilisation de substances, désengagement comportemental) étaient positivement liées à la détresse psychologique. Les stratégies de coping dyadique (communication autour du stress, stratégies négatives, ect) étaient positivement liées à la détresse psychologique ressentie par les parents en couple. Conclusion : ces résultats montrent l’intérêt de mieux comprendre le vécu des parents confrontés à l’usage problématique de cannabis de l’adolescent et suggèrent des pistes de futures prises en charge
Introduction: the period of adolescence is the age group for which cannabis use is highest in France. Cannabis use in adolescence is an important stressor for parents. The first aim of the present study was to better identify specific family dynamics and coping strategies (individual and dyadic) mobilized by parents of adolescent cannabis users. Second, was to investigate the factors associated with psychological distress (family dynamics, coping strategies). Method: during this quantitative and qualitative study, 50 parents consult for a problematic adolescent cannabis use and 67 control parents answered at a sociodemographic questionnaire, the Family Adaptability and Cohesion Scale (FACES IV) and the Family Relationship Index (FRI) to assess family dynamics, the Brief Cope to estimate situational coping strategies and dyadic coping Inventory (DCI) to address the dyadic coping strategies mobilized by the sample's parents couple. Results: parents of adolescent cannabis users had a high psychological distress and have obtained significantly different scores on the dimensions of family dynamics, compare at parental control group. Thus, family functioning of parents of adolescent cannabis users was defined as cohesion and lower communication capabilities but also high intensity conflict from parents in the control group. A dimension of family dynamics (conflicts) and four situational coping strategies (expressing feelings, blame, substance use, behavioral disengagement) were positively related to psychological distress. Dyadic coping strategies (communication about the stress, negative strategies, ect) were positively related to psychological distress experienced by parents couple. Conclusion: these results show the interest of better understanding the experiences of parents facing the adolescent problem cannabis use and suggest directions for future supported