Mental Health Problems in Ecstasy Users: Was It Actually the Cannabis?

A study combining cross-sectional and longitudinal data found that psychological symptoms in ecstasy users were predominantly attributable to concurrent cannabis use, not ecstasy itself.

Daumann, Jörg et al.·Psychopharmacology·2004·Moderate EvidenceLongitudinal Cohort
RTHC-00163Longitudinal CohortModerate Evidence2004RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Longitudinal Cohort
Evidence
Moderate Evidence
Sample
Not reported

What This Study Found

At baseline, ecstasy users reported significantly more psychological complaints than controls. However, when the analysis accounted for concurrent drug use, self-reported psychopathology was mainly associated with regular cannabis use rather than ecstasy use.

The 18-month follow-up strengthened this finding: subjects who had stopped using ecstasy showed no different symptom levels from those who continued, while subjects who regularly used cannabis during the follow-up period reported more anxiety, interpersonal sensitivity, and obsessive-compulsive behavior than cannabis-abstinent users. Higher levels of depression, anxiety, phobic anxiety, paranoid ideation, and obsessive-compulsive behavior were all significantly correlated with the duration of regular cannabis use during the follow-up period.

Key Numbers

Sixty ecstasy users and 30 controls at baseline. 38 ecstasy users at 18-month follow-up. Anxiety, interpersonal sensitivity, obsessive-compulsive behavior, depression, phobic anxiety, and paranoid ideation all correlated with cannabis use duration.

How They Did This

This study combined cross-sectional and longitudinal designs. At baseline, 60 recreational ecstasy users and 30 matched controls completed self-rating scales for impulsivity, sensation seeking, and psychological complaints. At 18-month follow-up, 38 of the original ecstasy users were re-examined.

Why This Research Matters

Much of the research attributing psychiatric symptoms to ecstasy use had not adequately controlled for concurrent cannabis use. This study demonstrated that cannabis, not ecstasy, was the primary driver of psychological complaints in this population. This has implications for both drug policy messaging and clinical assessment of polydrug users.

The Bigger Picture

This finding that cannabis rather than ecstasy drove psychiatric symptoms in polydrug users added to concerns about cannabis and mental health. It also highlighted the importance of controlling for polydrug use in substance abuse research, a methodological point that applies broadly across the field.

What This Study Doesn't Tell Us

The sample was relatively small and self-selected. Self-reported symptom measures may not capture clinical diagnoses. Cannabis users may differ from non-users in ways not captured by the study, introducing confounding. The 18-month follow-up had some attrition.

Questions This Raises

  • ?Are the psychiatric effects of cannabis reversible after cessation in polydrug users?
  • ?How much ecstasy research has been confounded by uncontrolled cannabis use?

Trust & Context

Key Stat:
Cannabis abstinence, not ecstasy abstinence, predicted symptom remission
Evidence Grade:
This is a study combining cross-sectional and 18-month longitudinal data with appropriate controls, providing moderate-level evidence.
Study Age:
Published in 2004. The importance of controlling for cannabis use in polydrug research has been increasingly recognized since.
Original Title:
Self-reported psychopathological symptoms in recreational ecstasy (MDMA) users are mainly associated with regular cannabis use: further evidence from a combined cross-sectional/longitudinal investigation.
Published In:
Psychopharmacology, 173(3-4), 398-404 (2004)
Database ID:
RTHC-00163

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-ControlFollows or compares groups over time
This study
Cross-Sectional / Observational
Case Report / Animal Study

Follows a group of people over time to track how outcomes develop.

What do these levels mean? →

Frequently Asked Questions

Do ecstasy users have more mental health problems?

They often report more symptoms, but this study found those symptoms were mainly associated with concurrent cannabis use, not ecstasy itself. When cannabis use was accounted for, ecstasy use had little additional impact on psychological complaints.

Can stopping cannabis improve mental health symptoms in polydrug users?

In this study, abstinence from cannabis during the 18-month follow-up predicted improvement in psychological symptoms, while continuing or stopping ecstasy made no significant difference.

Read More on RethinkTHC

Cite This Study

RTHC-00163·https://rethinkthc.com/research/RTHC-00163

APA

Daumann, Jörg; Hensen, Gernot; Thimm, Bastian; Rezk, Markus; Till, Bianca; Gouzoulis-Mayfrank, Euphrosyne. (2004). Self-reported psychopathological symptoms in recreational ecstasy (MDMA) users are mainly associated with regular cannabis use: further evidence from a combined cross-sectional/longitudinal investigation.. Psychopharmacology, 173(3-4), 398-404.

MLA

Daumann, Jörg, et al. "Self-reported psychopathological symptoms in recreational ecstasy (MDMA) users are mainly associated with regular cannabis use: further evidence from a combined cross-sectional/longitudinal investigation.." Psychopharmacology, 2004.

RethinkTHC

RethinkTHC Research Database. "Self-reported psychopathological symptoms in recreational ec..." RTHC-00163. Retrieved from https://rethinkthc.com/research/daumann-2004-selfreported-psychopathological-symptoms-in

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.