Advertisement

Current Addiction Reports

, Volume 6, Issue 1, pp 21–33 | Cite as

The Relationship Between Dissociative Experiences and Cannabis Use: a Systematic Review

  • Lucia SideliEmail author
  • Marta Di Forti
  • Laura Ferraro
  • Simonetta Montana
  • Giada Tripoli
  • Diego Quattrone
  • Marco Colizzi
  • Daniele La Barbera
  • Caterina La Cascia
Dissociation and Addictive Behaviors (J Billieux and A Schimmenti, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Dissociation and Addictive Behaviors

Abstract

Purpose of Review

This systematic review aimed to investigate the relation between cannabis use and dissociation.

Recent Findings

Four analytical and 14 descriptive cross-sectional studies were included. There is no variation in the rates of cannabis use among individuals with dissociative experiences compared with the general population. In addition, the prevalence of dissociative disorders in subjects using cannabis is not different from those not using cannabis. The majority of the studies employed inadequate sampling procedures and a concurrent or retrospective assessment of the two variables, which might have increased the risk of bias, and only a few of them controlled for potential confounders.

Summary

The limited number of eligible studies, combined with the heterogeneity of study design and methodological limitations, do not support the association between cannabis and dissociative experiences and prevent from any inference about the direction of causality.

Keywords

Cannabis Marijuana Dissociation Depersonalization Out-of-body experiences Dissociative experience scale 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    United Nations Office on Drugs and Crime. World drug report 2016. United Nations publication, Sales No. E.16.XI.7, Vienna, 2016. https://www.unodc.org/doc/wdr2016/WORLD_DRUG_REPORT_2016_web.pdf. Accessed 15 Nov. 2018.
  2. 2.
    European Monitoring Centre for Drugs and Drug Addiction. European Drug Report: trends and developments, 2014. http://www.emcdda.europa.eu/system/files/publications/963/TDAT14001ENN.pdf. Accessed 15 Nov. 2018.
  3. 3.
    European Monitoring Centre for Drugs and Drug Addictions. Statistical Bullettin 2017, 2017. http://www.emcdda.europa.eu/data/stats2017_en. Accessed 20 Oct. 2017.
  4. 4.
    World Health Organization. The health and social effects of nonmedical cannabis use, 2016. http://who.int/substance_abuse/publications/msbcannabis.pdf. Accessed 15 Nov. 2018.
  5. 5.
    Manrique-Garcia E, Zammit S, Dalman C, Hemmingsson T, Andreasson S, Allebeck P. Prognosis of schizophrenia in persons with and without a history of cannabis use. Psychol Med. 2014;44:2513–21.CrossRefGoogle Scholar
  6. 6.
    Van Os J, Bak M, Hanssen M, Bijl RV, De Graaf R, Verdoux H. Cannabis use and psychosis: a longitudinal population-based study. Am J Epidemiol. 2002;156:319–27.CrossRefGoogle Scholar
  7. 7.
    •• Di Forti M, Marconi A, Carra E, et al. Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study. Lancet Psychiatry. 2015;2:233–8 Relevant study assessing the impact of cannabis use on psychosis. CrossRefGoogle Scholar
  8. 8.
    Murray RM, Quigley H, Quattrone D, Englund A, Di Forti M. Traditional marijuana, high-potency cannabis and synthetic cannabinoids: increasing risk for psychosis. World Psychiatry. 2016;15:195–204.CrossRefGoogle Scholar
  9. 9.
    Murray RM, Englund A, Abi-Dargham A, Lewis DA, Di Forti M, Davies C, et al. Cannabis-associated psychosis: neural substrate and clinical impact. Neuropharmacology. 2017;124:89–104.CrossRefGoogle Scholar
  10. 10.
    Fattore L, Fratta W. Beyond THC: the new generation of cannabinoid designer drugs. Front Behav Neurosci. 2011;5:60.CrossRefGoogle Scholar
  11. 11.
    Large M, Sharma S, Compton MT, Slade T, Nielssen O. Cannabis use and earlier onset of psychosis: a systematic meta-analysis. Arch Gen Psychiatry. 2011;68:555–61.CrossRefGoogle Scholar
  12. 12.
    Moore THM, Zammit S, Lingford-Hughes A, Barnes TRE, Jones PB, Burke M, et al. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 2007;370:319–28.CrossRefGoogle Scholar
  13. 13.
    •• Marconi A, Di Forti M, Lewis CM, Murray RM, Vassos E. Meta-Analysis of the association between the level of cannabis use and risk of psychosis. Schizophr Bull. 2016;42:1262–9 Important review analysing the effect of cannabis use on psychosis and the dose-response relationship. CrossRefGoogle Scholar
  14. 14.
    Di Forti M, Sallis H, Allegri F, et al. Daily use, especially of high-potency cannabis, drives the earlier onset of psychosis in cannabis users. Schizophr Bull. 2014;40:1509–17.CrossRefGoogle Scholar
  15. 15.
    Lev-Ran S, Roerecke M, Le Foll B, George TP, McKenzie K, Rehm J. The association between cannabis use and depression: a systematic review and meta-analysis of longitudinal studies. Psychol Med. 2014;44:797–810.CrossRefGoogle Scholar
  16. 16.
    Degenhardt L, Hall W, Lynskey M. Exploring the association between cannabis use and depression. Addiction. 2003;98:1493–504.CrossRefGoogle Scholar
  17. 17.
    • Feingold D, Weiser M, Rehm J, Lev-Ran S. The association between cannabis use and mood disorders: a longitudinal study. J Affect Disord. 2015;172:211–8 Relevant study using a massive sample representative of adult population of US and a longitudinal design to investigate causal association between cannabis use and mood disorders. CrossRefGoogle Scholar
  18. 18.
    Chen CY, Lin KM. Health consequences of illegal drug use. Curr Opin Psychiatry. 2009;22:287–92.CrossRefGoogle Scholar
  19. 19.
    Crippa JA, Zuardi AW, Martín-Santos R, Bhattacharyya S, Atakan Z, McGuire P, et al. Cannabis and anxiety: a critical review of the evidence. Hum Psychopharmacol. 2009;24:515–23.CrossRefGoogle Scholar
  20. 20.
    Kedzior KK, Laeber LT. A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population—a meta-analysis of 31 studies. BMC Psychiatry. 2014;14:136.CrossRefGoogle Scholar
  21. 21.
    • Feingold D, Weiser M, Rehm J, Lev-Ran S. The association between cannabis use and anxiety disorders: Results from a population-based representative sample. Eur Neuropsychopharmacol. 2016;26:493–505 Relevant study using a massive sample representative of adult population of US and a longitudinal design to investigate causal association between cannabis use and anxiety disorders. CrossRefGoogle Scholar
  22. 22.
    Notzon DP, PavlicovaM,Glass A,Mariani JJ, MahonyAL, Brooks DJ, Levin FR (2016) ADHD is highly prevalent in patients seeking treatment for cannabis use disorders. J Atten Disord. 1087054716640109.Google Scholar
  23. 23.
    Elkins IJ, McGue M, Iacono WG. Prospective effects of attention-deficit/hyperactivity disorder, conduct disorder, and sex on adolescent substance use and abuse. Arch Gen Psychiatry. 2007;64:1145–52.CrossRefGoogle Scholar
  24. 24.
    Estévez N, Dey M, Eich-Höchli D, Foster S, Gmel G, Mohler-Kuo M. Adult attention-deficit/hyperactivity disorder and its association with substance use and substance use disorders in young men. Epidemiol Psychiatr Sci. 2016;25:255–66.CrossRefGoogle Scholar
  25. 25.
    Kolla NJ, van der Maas M, Toplak ME, Erickson PG, Mann RE, Seeley J, et al. Adult attention deficit hyperactivity disorder symptom profiles and concurrent problems with alcohol and cannabis: sex differences in a representative, population survey. BMC Psychiatry. 2016;16:50.CrossRefGoogle Scholar
  26. 26.
    Bonn-Miller MO, Vujanovic AA, Feldner MT, Bernstein A, Zvolensky MJ. Posttraumatic stress symptom severity predicts marijuana use coping motives among traumatic event-exposed marijuana users. J Trauma Stress. 2007;20:577–86.CrossRefGoogle Scholar
  27. 27.
    •• Kevorkian S, Bonn-Miller MO, Belendiuk K, Carney DM, Roberson-Nay R, Berenz EC. Associations among trauma, posttraumatic stress disorder, cannabis use, and cannabis use disorder in a nationally representative epidemiologic sample. Psychol Addict Behav. 2015;29:633–8 Large epidemiological survey investigating the relationship between trauma, PTSD and cannabis use disorders. CrossRefGoogle Scholar
  28. 28.
    Kilpatrick DG, Acierno R, Saunders B, Resnick HS, Best CL, Schnurr PP. Risk factors for adolescent substance abuse and dependence: data from a national sample. J Consult Clin Psychol. 2000;68:19–30.CrossRefGoogle Scholar
  29. 29.
    Cougle JR, Bonn-Miller MO, Vujanovic AA, Zvolensky MJ, Hawkins KA. Posttraumatic stress disorder and cannabis use in a nationally representative sample. Psychol Addict Behav. 2011;25:554–8.CrossRefGoogle Scholar
  30. 30.
    Chilcoat HD, Breslau N. Posttraumatic stress disorder and drug disorders: testing causal pathways. Arch Gen Psychiatry. 1998;55:913–7.CrossRefGoogle Scholar
  31. 31.
    Vlahov D, Galea S, Resnick H, Ahern J, Boscarino JA, Bucuvalas M, et al. Increased use of cigarettes, alcohol, and marijuana among Manhattan, New York, residents after the September 11th terrorist attacks. Am J Epidemiol. 2002;155:988–96.CrossRefGoogle Scholar
  32. 32.
    Stéphane P, Emmanuel S, Jean-Yves R. Toxic psychoses as pharmacological models of schizophrenia. Curr Psychiatr Rev. 2005;1:23–32.CrossRefGoogle Scholar
  33. 33.
    Ghodse AH. Cannabis psychosis. Br J Addict. 1986;81:473–8.CrossRefGoogle Scholar
  34. 34.
    Sanz C, Tagliazucchi E, Erowid E, Erowid F, Tagliazucchi E. The experience elicited by hallucinogens presents the highest similarity to dreaming within a large database of psychoactive substance reports. Front Neurosci. 2018;12:7.CrossRefGoogle Scholar
  35. 35.
    Medford N, Baker D, Hunter E, Sierra M, Lawrence E, Phillips ML, et al. Chronic depersonalization following illicit drug use: a controlled analysis of 40 cases. Addiction. 2003;98:1731–6.CrossRefGoogle Scholar
  36. 36.
    Keshavan MS, Lishman WA. Prolonged depersonalization following cannabis abuse. Br J Addict. 1986;81:140–2.CrossRefGoogle Scholar
  37. 37.
    Simeon D, Kozin DS, Segal K, Brenna L. Is depersonalization disorder initiated by illicit drug use any different? A survey of 394 adults. J Clin Psychiatry. 2009;70:1358–64.CrossRefGoogle Scholar
  38. 38.
    Goldstein A, Wekerle C, Tonmyr L, Thornton T, Waechter R, Pereira J, et al. The relationship between post-traumatic stress symptoms and substance use among adolescents involved with child welfare: implications for emerging adulthood. Int J Ment Heal Addict. 2011;9:507–24.CrossRefGoogle Scholar
  39. 39.
    Bulai I, Enea V. Dissociation and alexithymia in a Romanian sample of substance abuse patients. J Subst Abus. 2016;21:646–51.Google Scholar
  40. 40.
    Núñez LA, Gurpegui M. Cannabis-induced psychosis: a cross-sectional comparison with acute schizophrenia. Acta Psychiatr Scand. 2002;105:173–8.CrossRefGoogle Scholar
  41. 41.
    Rottanburg D, Ben-Arie O, Robins AH, Teggin A, Elk R. Cannabis-associated psychosis with hypomanic features. Lancet. 1982;320:1364–6.CrossRefGoogle Scholar
  42. 42.
    Ahmed N, Ansari MA, Rehman RU. Psychiatric morbidity in psychoactive substance users—a multicentre study in Hyderabad. J Liaquat Univ Med Heal Sci. 2011;10:15–8.Google Scholar
  43. 43.
    Najavits LM, Walsh M. Dissociation, PTSD, and substance abuse: an empirical study. J Trauma Dissociation. 2012;13:115–26.CrossRefGoogle Scholar
  44. 44.
    Simeon D, Knutelska M, Nelson D, Guralnik O. Feeling unreal: a depersonalization disorder update of 117 cases. J Clin Psychiatry. 2003;64:990–7.CrossRefGoogle Scholar
  45. 45.
    Wenzel K, Bernstein DP, Handelsman L, Rinaldi P, Ruggiero J, Higgins B. Levels of dissociation in detoxified substance abusers and their relationship to chronicity of alcohol and drug use. J Nerv Ment Dis. 1996;184:220–7.CrossRefGoogle Scholar
  46. 46.
    Ames SL, Sussman S, Dent CW, Stacy AW. Implicit cognition and dissociative experiences as predictors of adolescent substance use. Am J Drug Alcohol Abuse. 2005;31:129–62.CrossRefGoogle Scholar
  47. 47.
    Barratt MJ, Cakic V, Lenton S. Patterns of synthetic cannabinoid use in Australia. Drug Alcohol Rev. 2013;32:141–6.CrossRefGoogle Scholar
  48. 48.
    Halikas JA, Goodwin DW, Guze SB. Marihuana use a survey of regular users. JAMA. 1971;217:692–4.Google Scholar
  49. 49.
    Luke DP, Kittenis M. A preliminary survey of paranormal experiences with psychoactive drugs. J Parapsychol. 2005;69:305–27.Google Scholar
  50. 50.
    Michal M, Duven E, Giralt S, Dreier M, Müller KW, Adler J, et al. Prevalence and correlates of depersonalization in students aged 12–18 years in Germany. Soc Psychiatry Psychiatr Epidemiol. 2015;50:995–1003.CrossRefGoogle Scholar
  51. 51.
    Pekala RJ, Kumar VK, Marcano G. Hypnotic susceptibility, dissociation, and marijuana use: a relationship between high hypnotic susceptibility, marijuana use, and dissociative ability. Dissociation Prog Dissociative Disord. 1995;8:112–9.Google Scholar
  52. 52.
    Tolmunen T, Maaranen P, Hintikka J, Kylmä J, Rissanen ML, Honkalampi K, et al. Dissociation in a general population of Finnish adolescents. J Nerv Ment Dis. 2007;195:614–7.CrossRefGoogle Scholar
  53. 53.
    Wilkins LK, Girard TA, Cheyne JA. Ketamine as a primary predictor of out-of-body experiences associated with multiple substance use. Conscious Cogn. 2011;20:943–50.CrossRefGoogle Scholar
  54. 54.
    Briere J. Trauma symptom checklist for children. Odessa: Psychological Assessment Resources; 1996.Google Scholar
  55. 55.
    Carlson EB, Putnam FW. An update on the dissociative experiences scale. Dissociation. 1993;6:16–27.Google Scholar
  56. 56.
    Bagby RM, Taylor GJ, Parker JDA, Dickens SE. The development of the Toronto structured interview for alexithymia: item selection, factor structure, reliability and concurrent validity. Psychother Psychosom. 2006;75:25–39.CrossRefGoogle Scholar
  57. 57.
    World Health Organization. The ICD-9 classification of mental and behavioural disorders. Geneva: World Health Organization; 1978.Google Scholar
  58. 58.
    APA. Diagnostic and statistical manual for mental disorders-III-R. Washington DC: American Psychiatric Association; 1987.Google Scholar
  59. 59.
    Spitzer RL, Endicott J, Robins E. Research diagnostic criteria: rational and reliability. Arch Gen Psychiatry. 1978;35:773–82.CrossRefGoogle Scholar
  60. 60.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders IV. Washington, DC: American Psychiatric Association; 1994.Google Scholar
  61. 61.
    Spitzer RL, Williams JBW, Gibbon M, First MB. The structured clinical interview for DSM-III-R (SCID): I: history, rationale, and description. Arch Gen Psychiatry. 1992;49:624–9.  https://doi.org/10.1001/archpsyc.1992.01820080032005.CrossRefGoogle Scholar
  62. 62.
    First MB, Gibbon M, Spitzer RL, Williams JBW. Structured clinical interview for DSM-IV-TR Axis I Disorders. New York: Biometrics Research, New York State Psychiatric Institute; 1997.Google Scholar
  63. 63.
    Bernstein EM, Putnam FW. Development, reliability, and validity of a dissociation scale. The journal of nervous and mental disease. J Nerv Ment Dis. 1986;174:115–67.CrossRefGoogle Scholar
  64. 64.
    Sierra M, Berrios GE. The Cambridge despersonalization scale: a new instrument for the measurement of despersonalization. Psychiatry Res. 2000;93:153–64.CrossRefGoogle Scholar
  65. 65.
    World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: World Health Organization; 1992.Google Scholar
  66. 66.
    Armstrong JG, Putnam FW, Carlson EB, Libero DZ, Smith SR. Development and validation of a measure of adolescent dissociation: the adolescent dissociative experiences scale. J Nerv Ment Dis. 1997;185:491–7.CrossRefGoogle Scholar
  67. 67.
    Haberstick BC, Young SE, Zeiger JS, Lessem JM, Hewitt JK, Hopfer CJ. Prevalence and correlates of alcohol and cannabis use disorders in the United States: results from the national longitudinal study of adolescent health. Drug Alcohol Depend. 2014;136:158–61.CrossRefGoogle Scholar
  68. 68.
    Faulkner B, Goldstein AL, Wekerle C. Pathways from childhood maltreatment to emerging adulthood. Child Maltreat. 2014;19:219–32.CrossRefGoogle Scholar
  69. 69.
    • Mills R, Kisely S, Alati R, Strathearn L, Najman JM. Child maltreatment and cannabis use in young adulthood: a birth cohort study. Addiction. 2017;112:494–501 Longitudinal study investigating the relationship between childhood adversities and cannabis use. CrossRefGoogle Scholar
  70. 70.
    • Abajobir AA, Najman JM, Williams G, Strathearn L, Clavarino A, Kisely S. Substantiated childhood maltreatment and young adulthood cannabis use disorders: a pre-birth cohort study. Psychiatry Res. 2017;256:21–31 Longitudinal study investigating the relationship between childhood adversities and cannabis use.CrossRefGoogle Scholar
  71. 71.
    Scher D, Twaite JA. The relationship between child sexual abuse and alexithymic symptoms in a population of recovering adult substance abusers. J Child Sex Abus. 1999;8:25–40.CrossRefGoogle Scholar
  72. 72.
    Evren C, Sar V, Evren B, Semiz U, Dalbudak E, Cakmak D. Dissociation and alexithymia among men with alcoholism. Psychiatry Clin Neurosci. 2008;62:40–7.CrossRefGoogle Scholar
  73. 73.
    Schäfer I, Langeland W, Hissbach J, Luedecke C, Ohlmeier MD, Chodzinski C, et al. Childhood trauma and dissociation in patients with alcohol dependence, drug dependence, or both—a multi-center study. Drug Alcohol Depend. 2010;109:84–9.CrossRefGoogle Scholar
  74. 74.
    Craparo G, Ardino V, Gori A, Caretti V. The relationships between early trauma, dissociation, and alexithymia in alcohol addiction. Psychiatry Investig. 2014;11:330–5.CrossRefGoogle Scholar
  75. 75.
    Schimmenti A, Bifulco A. Toward a better understanding of the relationship between childhood trauma and psychiatric disorders: measurement and impact on addictive behaviors. Psychiatry Investiga. 2015;12:415–6.CrossRefGoogle Scholar
  76. 76.
    Caretti V, Gori A, Craparo G, Giannini M, Iraci-Sareri G, Schimmenti A. A new measure for assessing substance-related and addictive disorders: the addictive behavior questionnaire (ABQ). J Clin Med. 2018;7:194.CrossRefGoogle Scholar
  77. 77.
    Weil AT. Adverse reactions to marihuana: classification and suggested treatment. N Engl J Med. 1970;282:997–1000.CrossRefGoogle Scholar
  78. 78.
    Melges FT, Tinklenberg JR, Hollister LE, Gillespie HK. Temporal disintegration and depersonalization during marihuana intoxication. Arch Gen Psychiatry. 1970;23:204–10.CrossRefGoogle Scholar
  79. 79.
    Mathew RJ, Wilson WH, Humphreys D, Lowe JV, Weithe KE. Depersonalization after marijuana smoking. Biol Psychiatry. 1993;33:431–41.CrossRefGoogle Scholar
  80. 80.
    Mathew RJ, Wilson WH, Chiu NY, Turkington TG, Degrado TR, Coleman RE. Regional cerebral blood flow and depersonalization after tetrahydrocannabinol administration. Acta Psychiatr Scand. 1999;100:67–75.CrossRefGoogle Scholar
  81. 81.
    Roesler TA, Dafler CE. Chemical dissociation in adults sexually victimized as children: alcohol and drug use in adult survivors. J Subst Abus Treat. 1993;10:537–43.CrossRefGoogle Scholar
  82. 82.
    Langeland W, Draijer N, Van den Brink W. Trauma and dissociation in treatment-seeking alcoholics: towards a resolution of inconsistent findings. Compr Psychiatry. 2002;43:195–203.CrossRefGoogle Scholar
  83. 83.
    Steiner J. Psychic retreats- patholocial organisations in psychotic, neurotic, and borderline patients. London: Routledge; 1993.Google Scholar
  84. 84.
    Schimmenti A, Caretti V. Psychic retreats or psychic pits?: unbearable states of mind and technological addiction. Psychoanal Psychol. 2010;27:115–32.CrossRefGoogle Scholar
  85. 85.
    Michal M, Glaesmer H, Zwerenz R, Knebel A, Wiltink J, Brähler E, et al. Base rates for depersonalization according to the 2-item version of the Cambridge depersonalization scale (CDS-2) and its associations with depression/anxiety in the general population. J Affect Disord. 2011;128:106–11.CrossRefGoogle Scholar
  86. 86.
    Wing JK, Cooper JESN. Present State Examination (PSE). Measurement and classification of psychiatric symptoms; an instruction manual for the PSE and Catego Program. London: Cambridge University Press; 1974.Google Scholar
  87. 87.
    Steinberg M. Interviewer’s guide to the structured clinical interview for DSM-IV dissociative disorders (SCID-D). Arlington: American Psychiatric Pub; 1994.Google Scholar
  88. 88.
    McLellan AT, Kushner H, Metzger D, Peters R, Smith I, Grissom G, et al. The fifth edition of the addiction severity index. J Subst Abus Treat. 1992;9:199–213.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lucia Sideli
    • 1
    • 2
    Email author
  • Marta Di Forti
    • 1
    • 3
  • Laura Ferraro
    • 1
  • Simonetta Montana
    • 1
  • Giada Tripoli
    • 2
  • Diego Quattrone
    • 3
  • Marco Colizzi
    • 2
  • Daniele La Barbera
    • 1
  • Caterina La Cascia
    • 1
  1. 1.Section of Psychiatry, Department of Experimental Biomedicine and Clinical NeuroscienceUniversity of PalermoPalermoItaly
  2. 2.Department of Psychosis Studies, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK
  3. 3.Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUK

Personalised recommendations