Psychiatric disorders in Ecstasy (MDMA) users: a literature review focusing on personal predisposition and drug history

A review of psychiatric case studies from the last 10 years finds that MDMA (Ecstasy) is strongly linked to the onset of psychological disorders and persistent psychiatric symptoms. Only 24% of patients had a previous psychiatric history, and 34% had a psychiatric illness among first-degree relatives. The substantial proportion of patients without such history, along with the temporal relationship between MDMA use and recurring symptoms, suggests a causal role of the drug. Supporting evidence from non-clinical samples shows that Ecstasy users have higher scores on SCL-90 subscales compared to non-users, with heavier users showing more pathology.

Study at a glance

Abstract

Abstract 3,4‐methylenedioxymethamphetamine (MDMA or Ecstasy) has been implicated in the onset of a number of psychological disorders and associated with a number of psychiatric symptoms that have persisted after cessation of the drug. This paper is a review of the published psychiatric case studies from the last 10 years involving MDMA. Only 24% of patients had a previous psychiatric history and 34% had a psychiatric illness amongst first degree relatives. The percentage of patients not having had a personal or family history of psychiatric illness and the temporal relationship between MDMA ingestion and the experience of recurring symptoms strongly suggest a causal relationship between the drug and neuropsychiatric manifestations. Further supporting evidence comes from several studies using non‐clinical samples. Ecstasy users that don't present themselves in healthcare settings as having clinical symptoms have significantly higher scores on certain subscales of the SCL‐90 compared with Ecstasy‐naive controls, with higher pathology scores in heavier Ecstasy users. The full‐blown psychiatric cases may represent the broad end of this problematic spectrum. Copyright © 2001 John Wiley & Sons, Ltd.