title: Testing the self-medication hypothesis of depression and aggression in cannabis-dependent subjects.
abstract: BACKGROUND
  A self-medication hypothesis has been proposed to explain the association between cannabis use and psychiatric and behavioral problems. However, little is known about the reasons for use and reactions while intoxicated in cannabis users who suffer from depression or problems controlling violent behavior.
  
  
  METHODS
  We assessed 119 cannabis-dependent subjects using the Schedules of Clinical Assessment in Neuropsychiatry (SCAN), parts of the Addiction Severity Index (ASI), and questionnaires on reasons for cannabis use and reactions to cannabis use while intoxicated. Participants with lifetime depression and problems controlling violent behavior were compared to subjects without such problems. Validity of the groupings was corroborated by use of a psychiatric treatment register, previous use of psychotropic medication and convictions for violence.
  
  
  RESULTS
  Subjects with lifetime depression used cannabis for the same reasons as others. While under the influence of cannabis, they more often experienced depression, sadness, anxiety and paranoia, and they were less likely to report happiness or euphoria. Participants reporting problems controlling violent behavior more often used cannabis to decrease aggression, decrease suspiciousness, and for relaxation; while intoxicated they more often reacted with aggression.
  
  
  CONCLUSIONS
  Subjects with prior depression do not use cannabis as a mean of self-medication. They are more likely to experience specific increases of adverse symptoms while under the influence of cannabis, and are less likely to experience specific symptom relief. There is some evidence that cannabis is used as a means of self-medication for problems controlling aggression.
authors.affiliation: Center for Basic Psychiatric Research, Aarhus University Hospital, Risskov, Denmark. mca@psykiatri.aaa.dk
authors.forename: Mikkel
authors.initials: M
authors.lastname: Arendt
authors.forename: Raben
authors.initials: R
authors.lastname: Rosenberg
authors.forename: Lone
authors.initials: L
authors.lastname: Fjordback
authors.forename: Jack
authors.initials: J
authors.lastname: Brandholdt
authors.forename: Leslie
authors.initials: L
authors.lastname: Foldager
authors.forename: Leo
authors.initials: L
authors.lastname: Sher
authors.forename: Povl
authors.initials: P
authors.lastname: Munk-Jørgensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000187:drug effects / Q000523:psychology*; D003718:Denmark / Q000453:epidemiology; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis* / Q000453:epidemiology; D015203:Reproducibility of Results; D012651:Self Medication; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires