A genetic perspective on the proposed inclusion of cannabis withdrawal in DSM-5.
- Authors
- Verweij, K J H; Agrawal, A; Nat, N O; Creemers, H E; Huizink, A C; Martin, N G; Lynskey, M T
- Year
- 2013
- Journal
- Psychological medicine
- PMID
- 23194657
- DOI
- 10.1017/S0033291712002735
- PMCID
- PMC3733446
BACKGROUND: Various studies support the inclusion of cannabis withdrawal in the diagnosis of cannabis use disorder (CUD) in the upcoming DSM-5. The aims of the current study were to (1) estimate the prevalence of DSM-5 cannabis withdrawal (criterion B), (2) estimate the role of genetic and environmental influences on individual differences in cannabis withdrawal and (3) determine the extent to which genetic and environmental influences on cannabis withdrawal overlap with those on DSM-IV-defined abuse/dependence. METHOD: The sample included 2276 lifetime cannabis-using adult Australian twins. Cannabis withdrawal was defined in accordance with criterion B of the proposed DSM-5 revisions. Cannabis abuse/dependence was defined as endorsing one or more DSM-IV criteria of abuse or three or more dependence criteria. The classical twin model was used to estimate the genetic and environmental influences on variation in cannabis withdrawal, along with its covariation with abuse/dependence. RESULTS: Of all the cannabis users, 11.9% met criteria for cannabis withdrawal. Around 50% of between-individual variation in withdrawal could be attributed to additive genetic variation, and the rest of the variation was mostly due to non-shared environmental influences. Importantly, the genetic influences on cannabis withdrawal almost completely (99%) overlapped with those on abuse/dependence. CONCLUSIONS: We have shown that cannabis withdrawal symptoms exist among cannabis users, and that cannabis withdrawal is moderately heritable. Genetic influences on cannabis withdrawal are the same as those affecting abuse/dependence. These results add to the wealth of literature that recommends the addition of cannabis withdrawal to the diagnosis of DSM-5 CUD.
Correlated factor model. Graphical presentation of the parameter estimates and proportions of variance in cannabis withdrawal and abuse/dependence accounted for by genes (heritability; h2), shared and unshared environmental influences. The double-headed arrows represent the genetic, shared and unshared environmental correlations.
| Name | Type |
|---|---|
| addiction | phenotype |
| Adverse reproductive effects local | phenotype |
| age | phenotype |
| aggression | phenotype |
| alcohol | phenotype |
| alcoholism | phenotype |
| anger | phenotype |
| anxiety | phenotype |
| Australian household survey local | cohort |
| Australian Twin Registry | cohort |
| Australian twin sample local | cohort |
| C local | variant |
| cannabis dependence | phenotype |
| cannabis initiation | phenotype |
| cannabis use | phenotype |
| cannabis use disorder | phenotype |
| cannabis withdrawal | phenotype |
| cannabis withdrawal items local | phenotype |
| Caucasian 27-37 cohort local | cohort |
| cigarettes | phenotype |
| Current study sample local | cohort |
| decreased appetite | phenotype |
| Decreased infection resistance local | phenotype |
| depression | phenotype |
| DOS twin cohort local | cohort |
| DOS twins local | cohort |
| drug | drug |
| DSM-5 cannabis withdrawal local | phenotype |
| DSM-5 cannabis withdrawal (Criterion B) local | phenotype |
| DSM-5 withdrawal criterion B local | phenotype |
| DSM-IV | phenotype |
| DSM-IV cannabis abuse/dependence local | phenotype |
| DSM-IV cannabis use disorder local | phenotype |
| DZ same sex twins local | cohort |
| family-based sample | cohort |
| Family-based sample (Ehlers 2010) local | cohort |
| Feeling weak/tired | phenotype |
| Frequent cannabis use | phenotype |
| general population sample | cohort |
| Genetically informative sample local | cohort |
| Genetic influences local | gene |
| hypersomnia | phenotype |
| illicit drug dependence | phenotype |
| illicit drug use | phenotype |
| irritability | phenotype |
| lifetime cannabis use | phenotype |
| lifetime cannabis users local | cohort |
| Lifetime cannabis users local | cohort |
| Lifetime users local | cohort |
| Low energy local | phenotype |
| marijuana | phenotype |
| mental retardation | phenotype |
| mood disorders | phenotype |
| motivation | phenotype |
| nervousness | phenotype |
| nicotine | drug |
| nicotine withdrawal | phenotype |
| nonadditive genetic variance (D) local | variant |
| paranoia | phenotype |
| parental alcoholism | phenotype |
| parental drug problems | phenotype |
| Poor work performance local | phenotype |
| problem cannabis use | phenotype |
| Quantity smoked local | phenotype |
| Respiratory system problems local | phenotype |
| restlessness | phenotype |
| school performance | phenotype |
| sex | phenotype |
| Sleep difficulty local | phenotype |
| Smoking progression local | phenotype |
| smoking withdrawal | phenotype |
| substance use | phenotype |
| Tiredness | phenotype |
| Twin cohort | cohort |
| United States | cohort |
| withdrawal | phenotype |
| yawning | phenotype |
| zygosity group local | cohort |
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In this knowledge base
External
| Title | Authors | Journal | Year | Link |
|---|---|---|---|---|
| Clinical management of cannabis withdrawal. | Connor JP et al. | — | 2022 | → |
| Prevalence of Cannabis Withdrawal Symptoms Among People With Regular or Dependent Use of Cannabinoids: A Systematic Review and Meta-analysis. | Bahji A et al. | — | 2020 | → |
| US Epidemiology of Cannabis Use and Associated Problems. | Hasin DS | — | 2018 | → |
| Cannabis and Depression: A Twin Model Approach to Co-morbidity. | Smolkina M et al. | — | 2017 | → |
| The cannabis withdrawal syndrome: current insights. | Bonnet U et al. | — | 2017 | → |
| The influence of age and gender on the likelihood of endorsing cannabis abuse/dependence criteria. | Delforterie MJ et al. | — | 2015 | → |
| DSM-5 cannabis use disorder: a phenotypic and genomic perspective. | Agrawal A et al. | — | 2014 | → |
| Evaluating the role of a galanin enhancer genotype on a range of metabolic, depressive and addictive phenotypes. | Richardson TG et al. | — | 2014 | → |
| Trauma exposure, posttraumatic stress disorder and risk for alcohol, nicotine, and marijuana dependence in Israel. | Walsh K et al. | — | 2014 | → |
| Truth (validity) and use despite consequences: the DSM-5 substance use disorder unidimensional syndrome. | Hasin D | — | 2014 | → |