Pathways to ecstasy use in young adults: anxiety, depression or behavioural deviance?
OBJECTIVE
To investigate pathways to ecstasy use disorders from pre-birth to early adulthood with particular attention to the relationship between early depressive and anxiety symptoms and later ecstasy use disorders.


METHODS
Prospective, longitudinal, population-based study started in Brisbane, South East Queensland (Australia) in 1981. Participants were 2143 young adults, followed up from pre-birth to young adulthood.


METHODS
Ecstasy use disorders were assessed with the composite international diagnostic interview (CIDI-Auto). Maternal socio-economic position and mental health status were assessed at baseline (antenatal visit); maternal substance use was measured at the 5-year follow-up, adolescents' behaviour at the 5- and 14-year follow-up and tobacco and alcohol use were assessed at the 14-year follow-up.


RESULTS
Eight syndrome scales of childhood behaviour were examined. After adjustment for important confounders, delinquent and aggressive behaviour in early adolescence remained significantly associated with ecstasy use disorders in early adulthood. The associations became statistically non-significant when adolescent tobacco and alcohol use were included in the model [OR=1.50 (95%CI=0.75, 3.01) for delinquency and OR=1.69 (95%CI=0.92, 3.12) for aggression]. Formal mediation tests were statistically significant (p=0.001 for delinquent behaviour and p=0.05 for aggressive behaviour).


CONCLUSIONS
Our findings suggest a pathway from early deviant behaviour to ecstasy use disorders, possibly mediated through licit drug experimentation in early adolescence.
Alati
Rosa
R
School of Population Health, The University of Queensland, Qld, Australia. r.alati@sph.uq.edu.au
Kinner
Stuart A
SA
Hayatbakhsh
Mohammad R
MR
Mamun
Abdullah Al
AA
Najman
Jake M
JM
Williams
Gail M
GM
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology*; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000523:psychology; D002675:Child, Preschool; D015331:Cohort Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology*; D005190:Family; D005260:Female; D006213:Hallucinogens; D006801:Humans; D007604:Juvenile Delinquency / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology*; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011793:Queensland / Q000453:epidemiology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology*
D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine