A typology of cannabis-related problems among individuals with repeated illegal drug use in the first three decades of life: Evidence for heterogeneity and different treatment needs.
BACKGROUND
Cannabis use (CU) and disorders (CUD) are highly prevalent among adolescents and young adults. We aim to identify clinically meaningful latent classes of users of cannabis and other illegal substances with distinct problem profiles.


METHODS
N=3021 community subjects aged 14-24 at baseline were followed-up over a period ranging up to 10 years. Substance use (SU) and disorders (SUD) were assessed with the DSM-IV/M-CIDI. Latent class analysis (LCA) was conducted with a subset of N=1089 subjects with repeated illegal SU. The variables entered in the LCA were CU-related problems, CUD, other SUD, and other mental disorders.


RESULTS
Four latent classes were identified: "Unproblematic CU" (class 1: 59.2%), "Primary alcohol use disorders" (class 2: 14.4%), "Delinquent cannabis/alcohol DSM-IV-abuse" (class 3: 17.9%), "CUD with multiple problems" (class 4: 8.5%). Range and level of CU-related problems were highest in classes 3 and 4. Comorbidity with other mental disorders was highest in classes 2 and 4. The probability of alcohol disorders and unmet treatment needs was considerable in classes 2-4.


CONCLUSIONS
While the majority of subjects with repeated illegal SU did not experience notable problems over the 10-year period, a large minority (40.8%) experienced problematic outcomes, distinguished by clinically meaningful profiles. The data underline the need for specifically tailored interventions for adolescents with problematic CU and highlight the potentially important role of alcohol and other mental disorders.
Wittchen
Hans-Ulrich
HU
Institute of Clinical Psychology and Psychotherapy, Technische Universitaet Dresden, Chemnitzer Str. 46, D-01187 Dresden, Germany.
Behrendt
Silke
S
Höfler
Michael
M
Perkonigg
Axel
A
Rehm
Jürgen
J
Lieb
Roselind
R
Beesdo
Katja
K
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation; D000987:Antisocial Personality Disorder / Q000523:psychology; D002648:Child; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation*; D014029:Tobacco Use Disorder / Q000150:complications / Q000523:psychology; D055815:Young Adult
D013287:Illicit Drugs