Recreational ecstasy/MDMA and other drug users from the UK and Italy: psychiatric symptoms and psychobiological problems

Rationale: Recreational drug use is increasingly widespread amongst young people, but there are concerns that psychoactive drugs may be associated with psychiatric symptoms or psychobiological problems. Objectives: To assess the psychiatric health status of a large, non-clinical sample of young adults from Italy and the UK, and relate it to their use of ecstasy/MDMA and other recreational drugs. Methods: The UEL Recreational Drug Use Questionnaire was completed by 768 young people (mean age 21.7 years) from four European cities. The subjects comprised 150 non-drug users, 185 alcohol/tobacco users, 97 cannabis and alcohol/tobacco users, 102 illicit polydrug but not ecstasy users, 115 light (<20 times) ecstasy polydrug users, and 119 heavy (>20 times) ecstasy polydrug users. The unpaid volunteers completed the SCL-90 self-rating inventory for psychiatric symptoms when off drug, with 30 additional questions covering positive moods and life experiences. Results: Heavy ecstasy polydrug users reported significantly higher scores than non-drug users on several SCL-90 factors, including phobic anxiety, obsessive–compulsive behaviour, anxiety, psychoticism, somatisation, and significantly higher rates of 'loss of sex interest or pleasure'. Self-rated symptom scores increased in line with greater drug use, so that polydrug users who had never taken ecstasy also reported a variety of psychobiological impairments. In contrast, positive moods and life experiences were broadly similar across subgroups. Conclusions: The recreational use of ecstasy/MDMA is associated with a range of psychiatric symptoms and psychobiological problems. However, these problems are not specific to ecstasy users but are also evident in other recreational polydrug users.