Abstract

Objective: Cannabis is the most widely used illicit substance in the world. The development of cannabis use disorder is often responsible for anxiety-depressive disorders. Dimensions such as self-esteem could therefore be considered as protective factors. The aim of our study was to evaluate the level of dependence, self-esteem, the presence of anxiety or depression in subjects consulting at the detoxification center of Sfax, Tunisia for cannabis withdrawal and to determine the interrelationships of these entities with the characteristics of addiction.

Material and methods: We conducted a cross-sectional study with a descriptive and analytical purpose. It was carried out within the Tunisian association for the fight against sexually transmitted diseases and AIDS (ATLMST SIDA) of Sfax, Tunisia, during the period extending between September 15, 2020 and October 1, 2021.Users have been assessed on the basis of a clinical information sheet and a set of psychometric tests exploring cannabis dependence (CAST), anxiety-depression (HADS) and self-esteem (RSES).

Results: For our study, we identified 38 patients for whom the median age was 26 years and the sex ratio (M/F) was 8.5. A total of 36 patients (94.7%) had problematic cannabis use at the time of the study. Anxiety and depression were respectively noted in 24 (63.2%) and 16 (42.1%) participants. Self-esteem was assessed as low in 14 subjects (36.8%). Anxiodepressive disorders were correlated with the advanced age at the onset of the medical care, with an antidepressant type desired effect, with the complications of consumption as well as with the use of other psychoactive substances. Associations have also been found between self-esteem and the high amount and daily frequency of cannabis use, an antidepressant-like desired effect, concentration and memory disorders, poor therapeutic compliance, consumption of other psychoactive substances as well as anxiodepressive disorders.

Conclusions: Faced with this psychological burden borne by heavy cannabis users, the authorities should consider preventive interventions from adolescence through the encouragement of community life and the learning of social skills.