Patterns of marijuana use among psychiatry patients with depression and its impact on recovery

Abstract

Background Depression is associated with substance-related problems that worsen depression-related disability. Marijuana is frequently used by those with depression, yet whether its use contributes to significant barriers to recovery in this population has been understudied. Method Participants were 307 psychiatry outpatients with depression; assessed at baseline, 3-, and 6-months on symptom (PHQ-9 and GAD-7), functioning (SF-12) and past-month marijuana use for a substance use intervention trial. Longitudinal growth models examined patterns and predictors of marijuana use and its impact on symptom and functional outcomes. Results A considerable number of (40.7%; n = 125) patients used marijuana within 30-days of baseline. Over 6-months, marijuana use decreased (B = −1.20, p < .001), but patterns varied by demographic and clinical characteristics. Depression (B = 0.03, p < .001) symptoms contributed to increased marijuana use over the follow-up, and those aged 50+ (B = 0.44, p < .001) increased their marijuana use compared to the youngest age group. Marijuana use worsened depression (B = 1.24, p < .001) and anxiety (B = 0.80, p = .025) symptoms; marijuana use led to poorer mental health (B = −2.03, p = .010) functioning. Medical marijuana (26.8%; n = 33) was associated with poorer physical health (B = −3.35, p = .044) functioning. Limitations Participants were psychiatry outpatients, limiting generalizability. Conclusions Marijuana use is common and associated with poor recovery among psychiatry outpatients with depression. Assessing for marijuana use and considering its use in light of its impact on depression recovery may help improve outcomes.

Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States

“…Evidence suggests that efforts to selfmanage depression with cannabis are increasing [71][72][73][74][75] (also Aaron L. Sarvet, MPH, written communication, January 2, 2018) despite lack of evidence that cannabinoids are effective for this purpose 76,77 ; prospectively, cannabis worsens the course of depressive disorders. 78 The likelihood of treatment for depression is reduced in those with SUDs. 79 However, dual-focused treatment is more effective when 2 disorders are present.…”

Cannabis Use among People with Mental Illness: Clinical and Socio-Demographic Characteristics

“…Study which assessed cannabis use among psychiatry outpatients with depression (at baseline and at 6 months of treatment), has shown that 40.7% of patients with depression used cannabis when assessed at baseline which then decreased significantly over 6 months of treatment. The study also revealed that cannabis has significantly Open Journal of Psychiatry worsened the symptoms of depression and led to poorer mental and physical functioning [9].…”

An overview of the adverse effects of cannabis use for Canadian physicians

“…In addition, cannabis users with pre-existing depression may experience increased suicidal ideation [103], although conflicting findings showing no increase in suicidal ideation have also been reported [104]. Similar to the findings in individuals with pre-existing anxiety, cannabis use in patients with preexisting depression is associated with worse recovery of symptoms and outcomes [105].…”