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Mental health differences between frequent cannabis users with and without dependence and the general population

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Titre :	Mental health differences between frequent cannabis users with and without dependence and the general population
in :	Addiction, vol.108, n°8, aout 2013
Auteurs :	P. VAN DER POL
Année de publication :	2013
Pagination :	1459-1469
Langues:	Anglais
Mots-clés :	SANTEPSY CANNABIS ; COMPARAISON ; DEPENDANCE ; ETUDE TRANSVERSALE ; POPULATION GENERALE ; PSYCHOPATHOLOGIE ; SANTE MENTALE ; TYPE D'USAGE ; USAGE HABITUEL
Résumé :	Aims: To compare the prevalence of mental disorders between frequent cannabis users with and without dependence and the general population. Design: Cross-sectional comparison of interview data. Setting: Enriched community sample of frequent cannabis users and a representative sample of non-users and non-frequent users from the general population. Participants: A total of 521 young adult (aged 18-30 years) frequent cannabis users, 252 of whom were with DSM-IV cannabis dependence (D+) and 269 without DSM-IV cannabis dependence (D-), and 1072 young adults from the general population. Measurements: Multinomial logistic regression was used to compare groups regarding the presence of DSM-IV mental disorders. Detailed measures of cannabis use, childhood adversity and other substance use were considered confounders. Findings: Compared with the general population, externalizing disorders were more prevalent in D- [odds ratio (OR) = 8.91, P < 0.001] and most prevalent in D+ (OR = 17.75, P < 0.001), but internalizing disorders were associated only with D+ (mood OR = 4.15, P < 0.001; anxiety OR = 2.20, P = 0.002). Associations were attenuated (and often became non-significant) after correction for childhood adversity and substance use other than cannabis. However, the prevalence of mental disorders remained higher in D+ compared with D- (OR = 2.40, P < 0.001), although cannabis use patterns were remarkably similar. Conclusions: Cannabis use patterns, childhood adversity and the use of other substances are similar in dependent and non-dependent frequent cannabis users. With the exception of more externalizing disorders, the mental health condition of non-dependent frequent cannabis users is similar to that of the general population, whereas it is worse in dependent frequent cannabis users. KEY FINDINGS: Dependent frequent cannabis users have worse mental health than both non-dependent frequent cannabis users and the general population.