UNLABELLED: Little is known about the association between cannabis abuse/dependence, comorbid alcohol and substance use, depression, suicidal ideation and suicidal behavior. OBJECTIVES: To establish the lifetime occurrence of depression, suicidal ideation and suicidal behavior in a group of very heavy cannabis users seeking treatment and to investigate the significance of a range of social, family and contextual factors with special emphasis on alcohol. STUDY GROUP: 119 subjects recruited from 19 different substance treatment centers in Denmark. METHODS: Structured questionnaires and assessment for psychiatric disorders using Schedules of Clinical Assessment in Neuropsychiatry (SCAN), and Beck Depression Inventory (BDI-II). Lifetime use and dependence of substances was established using parts of Addiction Severity Index (ASI), parts of Composite International Diagnostic Interview (CIDI) and Alcohol Use Disorders Identification Tests (AUDIT). RESULTS: Lifetime depression (46%), suicidal ideation (42%), and suicidal behavior (23%) were highly frequent. These problems were more common among females and related to adverse childhood experiences and parental alcoholism, while it could not be demonstrated that comorbid alcohol or other drug use increased the risk. Parental alcoholism remained significantly related to depression (p < .009), suicidal ideation (p < .001), and suicidal behavior (p < .03) after adjustment for a range of possible confounders using logistic regression. Physical abuse during childhood was associated with suicidal ideation (p < .01) and reporting an 'all in all bad childhood' was associated with suicidal behavior (p < .03) adjusting for the same control variables. CONCLUSIONS: Depression, suicidal ideation and suicidal behavior are common phenomena among heavy cannabis users predicted from factors related to childhood and parental alcoholism.
UNLABELLED: Little is known about the association between cannabis abuse/dependence, comorbid alcohol and substance use, depression, suicidal ideation and suicidal behavior. OBJECTIVES: To establish the lifetime occurrence of depression, suicidal ideation and suicidal behavior in a group of very heavy cannabis users seeking treatment and to investigate the significance of a range of social, family and contextual factors with special emphasis on alcohol. STUDY GROUP: 119 subjects recruited from 19 different substance treatment centers in Denmark. METHODS: Structured questionnaires and assessment for psychiatric disorders using Schedules of Clinical Assessment in Neuropsychiatry (SCAN), and Beck Depression Inventory (BDI-II). Lifetime use and dependence of substances was established using parts of Addiction Severity Index (ASI), parts of Composite International Diagnostic Interview (CIDI) and Alcohol Use Disorders Identification Tests (AUDIT). RESULTS: Lifetime depression (46%), suicidal ideation (42%), and suicidal behavior (23%) were highly frequent. These problems were more common among females and related to adverse childhood experiences and parental alcoholism, while it could not be demonstrated that comorbid alcohol or other drug use increased the risk. Parental alcoholism remained significantly related to depression (p < .009), suicidal ideation (p < .001), and suicidal behavior (p < .03) after adjustment for a range of possible confounders using logistic regression. Physical abuse during childhood was associated with suicidal ideation (p < .01) and reporting an 'all in all bad childhood' was associated with suicidal behavior (p < .03) adjusting for the same control variables. CONCLUSIONS:Depression, suicidal ideation and suicidal behavior are common phenomena among heavy cannabis users predicted from factors related to childhood and parental alcoholism.