The use of ecstasy is associated with emotional health problems, such as depression, psychotic symptoms, and anxiety disorders. But it's not clear whether emotional problems are a consequence of using ecstasy or emotional problems lead to ecstasy use.

Researchers in the Netherlands investigated whether use of ecstasy is preceded by symptoms of behavioural and emotional problems in childhood and early adolescence.

They assessed ecstasy use in 1580 individuals from childhood into adulthood. The first assessment took place in 1983, before ecstasy appeared as a recreational drug in the Netherlands. Use of the drug was then assessed 14 years later, providing a unique opportunity to investigate if a pathway from behavioural and emotional problems leading to ecstasy use exists.

Individuals with signs of anxiety and depression in 1983 showed an increased risk of starting to use ecstasy.

Ecstasy's effects are supposed to include enhanced feelings of bonding with other people, euphoria, or relaxation, say the authors. Individuals with signs of anxiety or depression may be particularly susceptible to these positive effects and may therefore use ecstasy to relieve their symptoms.

However, long term exposure to ecstasy may result in increased depressive symptoms. Individuals with signs of anxiety or depression in childhood are at risk of using ecstasy and may develop depressive symptoms. This may explain part of the link that has been found between ecstasy use and later depression in other studies, add the authors.

Other factors not tested in this study may account for the increased tendency to use ecstasy in some individuals. They include the social environment, novelty seeking, or substance use of parents.

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Contact: Emma Dickinson
edickinson@bmj.com
44-207-383-6529
BMJ-British Medical Journal
23-Feb-2006