Analysis of psychiatric evaluation and neurocognitive functions in patients with cannabis use disorder diagnosis

Objective: Our study aims to investigate the role of cannabis use in depression, anxiety, impulsivity, alexithymia, attention deficit hyperactivity symptoms, and the effects of cannabis use on neurocognitive functions. Materials and Methods: In the study, 47 patients who were diagnosed with cannabis use disorder according to DSM-5 and 47 healthy participants were evaluated. Patients who meet the criteria for; having a 'cannabis use disorder' in clinical psychiatric examination, beeing between the ages of 18-65, having written and verbal acknowledgment of him or herself, lack of any psychotic symptoms to disrupt the evaluation of truth, lack of mental retardation and not using cannabis, synthetic cannabinoids or any other substances in last 10 days were included in the our study. There were no participants describing clinical withdrawal symptoms, and withdrawal symptoms were not detected in any of them. Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Adults Attention Deficit Clinical Assessment Scale, the Adolescent Attention Deficit Self-Report Scale (ASRS), the Toronto Alexithymia Scale (TAS-20), the Barratt Impulsivity Scale-11 (BIS-11), Wechsler Memory Scale (WMS-R), Trail Making Test (TMT) and Stroop Tests were applied to the participants and the results were evaluated by using SPSS 17.0 programme. Findings: The mean scores of HAM-D, HAM-A total and subscales, AT DE and ASRS total and subscales, TAS-20 (TAS total, TAS-IDE, TAS-COM), BDI-11 total and subscales were significantly higher than the control group (p <0.05). For the WMS-R test; a significant impairment was observed in patients with cannabis use compared to the control group, except in the WMS-V, WMS-III and WMS-I subsections (p <0.05). For the Stroop test, except the Stroop 4 spontaneous correction number and Stroop 3 subdivisions, patients with cannabis use performed worse at a significant level. Likewise, the group of patients with cannabis use showed significantly worse performance than the control group, at all stages of the Trail Making Test (TMT). Patients with the diagnose of potential ADHD according to the ASRS-A score, the cannabis using group showed significantly worse performance in the Stroop 4, Stroop time difference and TMT-A tests (p <0.05). Moreover, contrary to the expectations, cannabis-synthetic cannabinoids users showed better performance values at all stages of Stroop and Trail Making Test compared to the patients who use cannabis but not synthetic cannabinoids. Discussion and Results: In our study; we found that cannabis use was significantly correlated with increased depression, anxiety symptom levels, high alexithymia, impulsivity and attention deficit hyperactivity symptom levels, and degree of impairment in neurocognitive functions. Cannabis use accompanying psychiatric conditions has been associated with a more severe psychopathology level, worse functionality and prognosis, as well as more non-conformal behavior patterns. In the etiological studies performed, it has been observed that some certain factors (such as behavioral, environmental, neurobiological factors) follow a bidirectional course that explaining the relationship between cannabis use and accompanying psychiatric conditions, but a definite distinction has not been determined yet. In the literature, in addition to the findings of many other studies which similar findings were obtained with our findings in our study, some studies have also shown that cannabis use is not related to any psychiatric condition. We think that there is a significant relationship between cannabis use and initiation, development and outcome stages of comorbid psychiatric conditions. As a result, more comprehensive research methods are needed in order to clarify the relationship between cannabis use and accompanying psychiatric conditions. Key words: Cannabis, depression, anxiety, alexithymia, impulsivity, attention deficit, neurocognitive functions.