Attenuated psychotic symptoms in adolescent outpatients with substance use disorders and chronic cannabis and MDMA use
Objectives: Adolescents with substance use disorder (SUD) frequently show chronic use of cannabis and 3,4‐methylenedioxymethamphetamine (MDMA). Attenuated psychotic symptoms (APS) that occurring during adolescence are commonly attributed to the cannabis use in adolescent SUD patients, neglecting the role of other substances abused, such as MDMA. Our study aimed to identify an impact of dual use of both substances and separate role of each substance on the development of APS in adolescent SUD patients.
Methods: We analyzed retrospective self-reports of APS (Prodromal Questionnaire, PQ-16) and past-month amount of cannabis and MDMA use in ‘n’ = 54 adolescent psychiatry outpatients with SUDs and chronic cannabis and MDMA use. Furthermore, we examined the associations of APS with past-month cannabis and MDMA use in stepwise hierarchical regressions while controlling for trauma history, birth complications and gender.
Results: APS were not related to cannabis use (‘B’ = 0.32, ‘p’ = .100), but to MDMA use (‘B’ = 5.54, ‘p’ = .001) and trauma history (‘B’ = 0.64, ‘p’ = .001). Gender (‘B’ = -0.47, ‘p’ = .537) and birth complications (‘B’ = -0.73, ‘p’ = .100) were not associated with APS.
Discussion: Our results indicate that MDMA use additional to cannabis use is associated with APS among adolescent SUD patients. Contrary to our expectations, we did not see an association of cannabis use and APS. We speculate that cannabis increases the risk for psychosis after a longer period of use and in combination with other risk factors, such as trauma history.