Gender differences in psychiatric disorders and drug use are well known. Cannabis is the most widely used illegal drug among young people. In recent years, its use has been related to the development of psychiatric pathologies; however, few studies have incorporated the gender perspective as of yet. Men have a higher prevalence using cannabis; however, women show a faster transition from recreational use to compulsive use, higher levels of craving with more relapses, and higher prevalence of dual pathology. Clinical studies clearly show the existence of gender differences in psychiatric symptoms associated with cannabis use. Although these results are not conclusive, they seem to indicate a higher vulnerability of women in the development of psychosis and anxiety, while men seem to be more vulnerable to developing depressive symptoms with long-term cannabis misuses.
Symptom | Population Profile | Results | References |
---|---|---|---|
Psychosis | nonclinical | Cannabis use increases the risk of first-episode psychosis and the development of psychosis more in men than in women (M > F) | [4,84,91] |
Synthetic cannabis use increases the risk of the development of psychosis both in men and in women (M = F) | [92] | ||
Cannabis use is related with an early start of first-episode psychosis both in men and in women (M = F) | [5,84,93,94] | ||
Cannabis use reduces the age of onset of psychosis more in women than in men (F > M) | [4,81,91,95] | ||
Greater intensity of psychotic experiences are associated with cannabis use in women than men (F > M) | [96] | ||
with risk factors for psychosis | Cannabis use is related with a greater severity of general psychiatric pathology in women than men (F > M) and with a greater severity of negative psychotic symptoms in men than women (M > F) | [97] | |
with CUD | Women present more psychotic symptoms than men (F > M) | [89] | |
Women present worse responses to treatment with more relapses than men (F > M) | [86] | ||
with first-episode psychosis | Cannabis use is related with worsening psychological, social and work activity in men than women (M > F) | [83] | |
Cannabis use is related with a severity of clinical symptoms and length of hospitalization period similar in both sexes (M = F) | [3,83,92] | ||
with a cannabis-induced psychotic disorder | Men present a greater intensity and prevalence of positive symptoms than women (M > F) | [4,91,98] | |
Women present a greater intensity and prevalence of negative symptoms than men (F > M) | [86] | ||
Depression | nonclinical | Cannabis use is predictive of depressive symptoms both in men and women (F = M) | [95,96] |
Cannabis use is predictive of depressive symptoms more in women than men (F > M) | [99,100,101,102,103] | ||
Cannabis use is predictive of depressive symptoms with a great severity in men (M > F) | [52,104,105] | ||
Cannabis use increases the development of major depression in men (M > F) | [106] | ||
Cannabis use is related with suicidal ideation both men and women (M = F) | [109] | ||
with a cannabis misuse | Women show more depressive and somatization symptoms than men (F > M) | [85,88,102,107,108] | |
Men show more depressive symptoms at younger ages (M > F), while women do so at later ages (F > M) | [89] | ||
Women show a higher probability of suicide than men in late adolescent (F > M) | [85] | ||
Men with a high frequency of consumption manifest a greater probability of suicidal ideation than women (M > F) | [95,109] | ||
with psychosis | Women cannabis users present greater dysphoria and depression than men (F > M) | [86,97,98] | |
Anxiety | general | Positive relationship between cannabis abuse and generalized anxiety disorder in women and negative relationship between cannabis abuse and panic disorder in men | [111] |
with CUD | Women present greater anxiety than men during abstinence (F > M) |
[95,113] |
Finally, there are few studies that relate cannabis use to the development of anxious symptomatology, as most studies focus on assessing anxiety as a risk factor for its use. In general, women have the highest levels of anxiety and related disorders among adolescents [20][70], the general population [20][81], and psychiatric patients [76][78], with the biggest gender differences found in late adolescents [20]. Specifically, it has been described that the men and women with low stress tolerance are those who show the most problems related to cannabis use, and in particular women who use the drug as a stress-coping mechanism [82], in a manner similar to that previously commented upon [21][20]. Hence, a positive relationship has been found between cannabis abuse and generalized anxiety disorder in women in the general population, while men showed a negative relationship with panic disorder [81]. In addition, women manifest greater anxiety than men in the periods of abstinence [61][83]. As observed with depression, Foster et al. [76] found no relationship between the age of onset of CUD and anxiety problems.
In conclusion, the scientific evidence reveals the existence of gender differences in psychiatric symptoms associated with cannabis use, although the direction of such differences is not always clear [54]. A lack of information in studies about variables such as the THC level in the cannabis used, the frequency of use or the age of onset of cannabis use makes it difficult to know the causes for the conflicting results. Besides, few studies consider the specific characteristics of women diagnosed with dual pathology, although all the data indicate a higher prevalence of drug-associated pathologies and a worse prognosis in women [27]. For this reason, it is necessary to delve deeper into this issue and address gender differences to create more individualized prevention strategies and more effective treatment for dual disorders related with cannabis abuse.
This entry is adapted from 10.3390/brainsci12030388