title: Contextualising psychological distress among regular ecstasy users: the importance of sociodemographic factors and patterns of drug use.
abstract: OBJECTIVE
  Considerable concern has been raised about associations between ecstasy use and mental health. Studies of ecstasy users typically investigate varying levels of lifetime use of ecstasy, and often fail to account for other drug use and sociodemographic characteristics of participants, which may explain mixed findings. The current study aimed to examine the relationship between patterns of recent (last six months) ecstasy use and psychological distress among current, regular ecstasy users, controlling for sociodemographic risk factors and patterns of other drug use.
  
  
  METHODS
  Data were collected from regular ecstasy users (n = 752) recruited from each capital city in Australia as part of the Ecstasy and related Drugs Reporting System (EDRS). Psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Data were analysed using multinomial logistic regression.
  
  
  RESULTS
  Seven per cent of the sample scored in the 'high' distress category and 55% in the 'medium' distress category. Patterns of ecstasy use were not independently associated with psychological distress. The strongest predictors of distress were female sex, lower education, unemployment, 'binge' drug use including ecstasy (use for >48 h without sleep), frequent cannabis use and daily tobacco use.
  
  
  CONCLUSIONS
  Regular ecstasy users have elevated levels of psychological distress compared with the general population; however, ecstasy use per se was not independently related to such distress. Other factors, including sociodemographic characteristics and other drug use patterns, appear to be more important. These findings highlight the importance of targeting patterns of polydrug use in order to reduce drug-related harm among regular ecstasy users.
authors.affiliation: National Drug Research Institute, Curtin University of Technology, Perth, Australia. j.george@curtin.edu.au
authors.forename: Jessica
authors.initials: J
authors.lastname: George
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Kinner
authors.forename: Raimondo
authors.initials: R
authors.lastname: Bruno
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.forename: Matthew
authors.initials: M
authors.lastname: Dunn
mesh_terms: D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications / Q000523:psychology*; D001315:Australia; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology*; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D018817:N-Methyl-3,4-methylenedioxyamphetamine