Examining the effects of sustained cannabis abstinence on affective symptoms in people with cannabis use disorder
Notice bibliographique
Résumé
Introduction: Cannabis is often used to cope with affective symptoms, such as depression or anxiety. In Canada, 43% of people who used cannabis in 2023 perceived that cannabis use was beneficial to their mental health, while only 8% thought that it was harmful. Paradoxically, longitudinal studies suggest that cannabis use is associated with the development and maintenance of affective symptoms. It is therefore crucial to understand if cannabis abstinence benefits affective symptoms. Previous studies found that depressive and anxiety symptoms improved with 28 days of cannabis abstinence. However, most of these studies included participants with psychiatric/medical comorbidities or were conducted in adolescents. Studies that did include participants without comorbidities failed to include an adequate control group. Therefore, to determine if these findings extend to adults without comorbidities, we aimed to investigate the effects of 28 days of cannabis abstinence on depressive and anxiety symptoms in adults with cannabis use disorder (CUD) with no comorbidities using an appropriate control group. Given that previous research did not assess the effect of sex on changes in affective symptoms, our exploratory aim was to compare the trajectory of depressive and anxiety symptoms during 28 days of cannabis abstinence between males and females.Methods: We recruited adults (N=25; 18-55 years old) with CUD, a positive cannabis urine toxicology, and no current DSM-5 disorders (other than CUD) or medical comorbidities. Participants were randomized using a 3:2 ratio to a cannabis abstinence arm (AB, n=16) or a non-abstinent (cannabis-as-usual control) arm (NA, n=9), respectively. Depressive symptoms were assessed weekly with the Hamilton-Depression Rating Scale. Anxiety was assessed weekly using the state subscale of the State Trait Anxiety Inventory. Cannabis abstinence was determined with the Timeline Follow Back, a self-report interview, and was encouraged using contingency management and weekly behavioural support.Results: Fourteen of the 16 participants (88%) in AB self-reported 28 days of cannabis abstinence. Relative to NA, depressive (F(4,84)=1.83, p=.15) and anxiety (F(4, 84)=.79, p=.47) symptoms did not significantly change during abstinence in AB. Further, the effect of sex on the trajectory of depressive (F(4, 36)=0.22, p=.93) and anxiety (F(4, 48=.46, p=.60) symptoms was not significant. Due to the study being underpowered, we also outlined the general pattern observed in the data. Among AB depressive symptoms increased from baseline to day 7, peaked at day 7, and then returned to baseline levels by day 28. Additionally, when parsed according to sex, females experienced a greater increase in depressive symptoms from baseline to day 7 than males. Conversely, anxiety symptoms decreased from baseline to day 28 in both AB and NA, and no sex differences were observed in anxiety symptoms.Conclusion: In this preliminary study, severity of depressive, but not anxiety, symptoms increased from baseline to 7 days before returning to baseline levels by day 28 in people with CUD who underwent 28 days of cannabis abstinence. The peak in depressive symptoms at day 7 may reflect transient cannabis withdrawal effects. Further, females experienced a greater increase in depressive symptoms than males during the first week of cannabis abstinence, suggesting that females may be more vulnerable to relapse during the first week of cannabis abstinence. Importantly, our findings indicate that affective symptoms do not get worse after 28 days of cannabis abstinence which provides evidence that cannabis use does not benefit or improve affective symptoms. Future studies should biochemically verify self-reported cannabis abstinence and include larger samples
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».