title: 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.
abstract: BACKGROUND
  3,4-Methylenedioxymethamphetamine (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.
  
  
  OBJECTIVE
  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 re-examined 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 follow-up period reported more anxiety, interpersonal sensitivity and obsessive-compulsive behaviour than cannabis-abstinent 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 self-reported 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.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty of the University of Technology (RWTH), Pauwelsstrasse 30, 52074 Aachen, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Daumann
authors.forename: Gernot
authors.initials: G
authors.lastname: Hensen
authors.forename: Bastian
authors.initials: B
authors.lastname: Thimm
authors.forename: Markus
authors.initials: M
authors.lastname: Rezk
authors.forename: Bianca
authors.initials: B
authors.lastname: Till
authors.forename: Euphrosyne
authors.initials: E
authors.lastname: Gouzoulis-Mayfrank
mesh_terms: D000328:Adult; D002188:Cannabis / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D005260:Female; D006213:Hallucinogens / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced*; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000008:administration & dosage / Q000009:adverse effects*; D011569:Psychiatric Status Rating Scales
chemical_list: D006213:Hallucinogens; D013287:Illicit Drugs; D018817:N-Methyl-3,4-methylenedioxyamphetamine