Collins AC, Lekkas D, Struble CA, et al. From mood to use: Using ecological momentary assessments to examine how anhedonia and depressed mood impact cannabis use in a depressed sample. Psychiatry Res. 2024;339:116110. doi:10.1016/j.psychres.2024.116110
This study examined the associations between major depressive disorder (MDD) symptoms and cannabis use (CU). Specifically, the relationships between two hallmark MDD symptoms, depressed mood, and anhedonia, and CU were analyzed. Participants (n=55) were adult android users who self-reported CU during the study period and met the criteria for current (past 30 days) MDD and did not have a history of mania symptoms, active suicidal thoughts or behaviors, or psychoses. Participants completed three ecological momentary assessments (EMAs) a day for 90 days. EMAs included a mobile-friendly version of the Patient Health Questionnaire-9 (PHQ-9). Once a week participants completed an assessment for CU (The Timeline FollowBack). Predictive modeling was used to assess the relationship between reported depressed mood and anhedonia on weekly and daily CU in patients with MDD. The current findings suggested that the relationship between anhedonia and CU varies based on the timeframe and whether individuals are higher or lower cannabis users. Lower levels of anhedonia predicted greater weekly CU, in higher (more frequent, n=24) consumers, but not low consumers (n=29). While there was no clear association at the daily level, higher levels of anhedonia were associated with some CU on the same or next day. Taken together, the anhedonia results suggest that CU may be used to cope with anhedonia and to derive pleasure from CU, facilitating daily consumption. Higher levels of depressed mood were associated with more frequent CU during the same and next week in higher, but not low consumers. Depressed mood was not correlated with CU on the same or next day. Additional analyses revealed lower levels of depressed mood were associated with some CU on the same or next day, but the data was insufficient to determine the frequency or volume of CU. These findings may suggest that depressed mood is temporarily alleviated by CU which in turn is interrupted by a withdrawal cycle and triggers a pattern of increased CU. Future research should aim to replicate and expand upon these findings in a larger and more diverse sample to illuminate the clinical implications of this work further.