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[Comorbidity in 207 cannabis users in a specific outpatient setting].
Encephale. 2015 Jun; 41 Suppl 1:S7-12.E

Abstract

BACKGROUND

Health care seeking for a problematic use of cannabis is in progress in France.

OBJECTIVES

The aim is to assess the addictive and psychiatric comorbidity in cannabis users seen in the specific setting at the Lariboisière hospital.

METHOD

Two hundred and seven cannabis users were included from January 2004 to December 2009. Twelve-month and lifetime diagnosis of abuse and dependence (cannabis, alcohol, cocaine/crack) (DSM-IV), current and lifetime mood disorders, anxiety disorders, eating disorders and psychotic disorders were assessed (Mini-International Neuropsychiatric Interview). Logistic regression analyses identified adjusted odds ratios associated with the gender and the health care seeking (P=0.01).

RESULTS

One hundred and forty-seven men (71%) and 60 women (29%), 29.3±8.6 years (15.2-51.6 years). Most of the outpatients ask for health care themselves (59.7%), whereas 19.4% are asked to seek health care by relatives (19.4%) or because of an academic, health or justice injunction (20.4%). In total, 49.3% of the outpatients are single, 35.7% are cohabitating, 9.3% are married and 6.3% are separated/divorced. About 20.4% of the outpatients are students, 35.7% have a professional activity, 19% are jobless, 2.4% are impaired, 0.5% are retired, at home and 12.1% do not have an official income. Twelve-month and lifetime prevalence of abuse/dependence are: cannabis (10.1/82.1% and 8.7/88.4%), alcohol (9.7/8.7% and 19.3/18.8%), cocaine/crack (2.4/3.4% and 4.8/11.6%). The mean duration of cannabis dependence for the current dependent users is 8.4±5.8 years. The mean number of "joints" during the last 6 months is 6±4.3, the mean amount of cannabis per week is 12.5±11.3g. About 51.3% of the dependent users report externalized and/or internalized disorders at school during childhood and adolescence. In total, 19.4% of the dependent users have a suicide attempt history and 18.9% have a psychiatric hospitalisation history, more frequently women (P<0.01 and P=0.02). About 73.8% have a psychologist or psychiatrist care history. In total, 38.1% of users have at least one current mood disorder, females more frequently than males (P<0.001). Current and lifetime prevalence of mood disorders are: major depressive disorder (MDD) (29.1% and 57.1%); current dysthymia (20.3%); hypomania (1.9 and 6.7%); mania (2.9 and 12.8%). Females have more frequently than males current and lifetime MDD (P<0.001). About 53.2% of users have at least one current anxiety disorder, females more frequently than males (P<0.001). Current and lifetime prevalence of anxiety disorders are: panic disorder (10 and 16.4%); agoraphobia (13.9 and 17.4%); social phobia (26.9 and 32.8%); obsessive-compulsive disorder (9.5 and 12.9%); post-traumatic stress disorder (PTSD) (6.5 and 16.4%); current generalized anxiety disorder (26.8%). Females have more frequently current and lifetime: agoraphobia (P=0.01 and P<0.001); PTSD (P<0.001); current social phobia (P=0.049). Current and lifetime eating disorders prevalence are: anorexia (0 and 1.5%); bulimia (4 and 8%); females more frequently have bulimia (P=0.02 and P<0.001). In total, 4.8% have a psychotic disorder. Adjusted odds ratios of associated variables to gender (women/men) are lifetime MDD OR=4.71 [2.1-10.61] (P<0.001) and later age of onset of cannabis abuse OR=1.1 [1.04-1.17] (P=0.002). Adjusted odds ratios associated with personal health care seeking compared to a non personal motivated health care seeking are the numbers of criteria of 12-month cannabis dependence OR=1.26 [1.06-1.51] (P=0.009) and age OR=1.07 [1.03-1.12] (P=0.002).

CONCLUSION

Our survey confirms the high mood and anxiety disorders comorbidity in cannabis dependent users seen in a specific setting and underlines the need to evaluate those disorders.

Authors+Show Affiliations

Service de psychiatrie d'adultes, groupe hospitalier Saint-Louis, Lariboisière, Fernand-Widal (AP-HP), 2, rue Ambroise-Paré, 75010 Paris, France; Consultation cannabis ECIMUD, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1144, université Paris Descartes, UMR-S 1144, 75006 Paris, France; Université Paris Diderot, UMR-S 1144, 75013 Paris, France. Electronic address: eric.guillem@lrb.aphp.fr.Service de psychiatrie d'adultes, groupe hospitalier Saint-Louis, Lariboisière, Fernand-Widal (AP-HP), 2, rue Ambroise-Paré, 75010 Paris, France.Service de psychiatrie d'adultes, groupe hospitalier Saint-Louis, Lariboisière, Fernand-Widal (AP-HP), 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1144, université Paris Descartes, UMR-S 1144, 75006 Paris, France; Université Paris Diderot, UMR-S 1144, 75013 Paris, France.Service de psychiatrie d'adultes, groupe hospitalier Saint-Louis, Lariboisière, Fernand-Widal (AP-HP), 2, rue Ambroise-Paré, 75010 Paris, France; Inserm U1144, université Paris Descartes, UMR-S 1144, 75006 Paris, France; Université Paris Diderot, UMR-S 1144, 75013 Paris, France.

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

25123065

Citation

Guillem, E, et al. "[Comorbidity in 207 Cannabis Users in a Specific Outpatient Setting]." L'Encephale, vol. 41 Suppl 1, 2015, pp. S7-12.
Guillem E, Arbabzadeh-Bouchez S, Vorspan F, et al. [Comorbidity in 207 cannabis users in a specific outpatient setting]. Encephale. 2015;41 Suppl 1:S7-12.
Guillem, E., Arbabzadeh-Bouchez, S., Vorspan, F., & Bellivier, F. (2015). [Comorbidity in 207 cannabis users in a specific outpatient setting]. L'Encephale, 41 Suppl 1, S7-12. https://doi.org/10.1016/j.encep.2014.06.004
Guillem E, et al. [Comorbidity in 207 Cannabis Users in a Specific Outpatient Setting]. Encephale. 2015;41 Suppl 1:S7-12. PubMed PMID: 25123065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Comorbidity in 207 cannabis users in a specific outpatient setting]. AU - Guillem,E, AU - Arbabzadeh-Bouchez,S, AU - Vorspan,F, AU - Bellivier,F, Y1 - 2014/08/12/ PY - 2013/04/25/received PY - 2014/03/03/accepted PY - 2014/8/16/entrez PY - 2014/8/16/pubmed PY - 2016/5/14/medline KW - Abus KW - Abuse KW - Cannabis KW - Comorbidité KW - Consultation spécialisée KW - Demande de soins KW - Dependence KW - Dual diagnosis KW - Dépendance KW - Specific setting KW - Treatment seeking SP - S7 EP - 12 JF - L'Encephale JO - Encephale VL - 41 Suppl 1 N2 - BACKGROUND: Health care seeking for a problematic use of cannabis is in progress in France. OBJECTIVES: The aim is to assess the addictive and psychiatric comorbidity in cannabis users seen in the specific setting at the Lariboisière hospital. METHOD: Two hundred and seven cannabis users were included from January 2004 to December 2009. Twelve-month and lifetime diagnosis of abuse and dependence (cannabis, alcohol, cocaine/crack) (DSM-IV), current and lifetime mood disorders, anxiety disorders, eating disorders and psychotic disorders were assessed (Mini-International Neuropsychiatric Interview). Logistic regression analyses identified adjusted odds ratios associated with the gender and the health care seeking (P=0.01). RESULTS: One hundred and forty-seven men (71%) and 60 women (29%), 29.3±8.6 years (15.2-51.6 years). Most of the outpatients ask for health care themselves (59.7%), whereas 19.4% are asked to seek health care by relatives (19.4%) or because of an academic, health or justice injunction (20.4%). In total, 49.3% of the outpatients are single, 35.7% are cohabitating, 9.3% are married and 6.3% are separated/divorced. About 20.4% of the outpatients are students, 35.7% have a professional activity, 19% are jobless, 2.4% are impaired, 0.5% are retired, at home and 12.1% do not have an official income. Twelve-month and lifetime prevalence of abuse/dependence are: cannabis (10.1/82.1% and 8.7/88.4%), alcohol (9.7/8.7% and 19.3/18.8%), cocaine/crack (2.4/3.4% and 4.8/11.6%). The mean duration of cannabis dependence for the current dependent users is 8.4±5.8 years. The mean number of "joints" during the last 6 months is 6±4.3, the mean amount of cannabis per week is 12.5±11.3g. About 51.3% of the dependent users report externalized and/or internalized disorders at school during childhood and adolescence. In total, 19.4% of the dependent users have a suicide attempt history and 18.9% have a psychiatric hospitalisation history, more frequently women (P<0.01 and P=0.02). About 73.8% have a psychologist or psychiatrist care history. In total, 38.1% of users have at least one current mood disorder, females more frequently than males (P<0.001). Current and lifetime prevalence of mood disorders are: major depressive disorder (MDD) (29.1% and 57.1%); current dysthymia (20.3%); hypomania (1.9 and 6.7%); mania (2.9 and 12.8%). Females have more frequently than males current and lifetime MDD (P<0.001). About 53.2% of users have at least one current anxiety disorder, females more frequently than males (P<0.001). Current and lifetime prevalence of anxiety disorders are: panic disorder (10 and 16.4%); agoraphobia (13.9 and 17.4%); social phobia (26.9 and 32.8%); obsessive-compulsive disorder (9.5 and 12.9%); post-traumatic stress disorder (PTSD) (6.5 and 16.4%); current generalized anxiety disorder (26.8%). Females have more frequently current and lifetime: agoraphobia (P=0.01 and P<0.001); PTSD (P<0.001); current social phobia (P=0.049). Current and lifetime eating disorders prevalence are: anorexia (0 and 1.5%); bulimia (4 and 8%); females more frequently have bulimia (P=0.02 and P<0.001). In total, 4.8% have a psychotic disorder. Adjusted odds ratios of associated variables to gender (women/men) are lifetime MDD OR=4.71 [2.1-10.61] (P<0.001) and later age of onset of cannabis abuse OR=1.1 [1.04-1.17] (P=0.002). Adjusted odds ratios associated with personal health care seeking compared to a non personal motivated health care seeking are the numbers of criteria of 12-month cannabis dependence OR=1.26 [1.06-1.51] (P=0.009) and age OR=1.07 [1.03-1.12] (P=0.002). CONCLUSION: Our survey confirms the high mood and anxiety disorders comorbidity in cannabis dependent users seen in a specific setting and underlines the need to evaluate those disorders. SN - 0013-7006 UR - https://www.unboundmedicine.com/medline/citation/25123065/[Comorbidity_in_207_cannabis_users_in_a_specific_outpatient_setting]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-7006(14)00155-9 DB - PRIME DP - Unbound Medicine ER -