Depressive symptoms moderate cannabis use for young adults in a Text-Delivered randomized clinical trial for cannabis use disorder

The importance and complexity of addressing both substance use and mood disorders such as depression within traditional treatment settings is well established. However, little is known about this issue within the context of mHealth treatment. Research is needed to determine if depression interacts with mHealth delivered cannabis use disorder treatment similarly compared traditional treatments.

We examined the moderating effect of depressive symptoms on cannabis use with 96 young adults (ages 18 to 25) enrolled in a text-delivered randomized clinical trial for cannabis use disorder. Participants were followed for three months.

We used a repeated measures general linear model to test if depressive symptoms moderated the treatment's effect on cannabis use. Self-report of past 30-day use and urinalysis of THC metabolites were the outcome measures. Depressive symptoms were measured using the PHQ-2, with scores >3 serving as the clinical cut-point, indicating likely depression disorder.

Participants with sub-threshold depression scores significantly reduced the number of days they used cannabis across all three months of the study. For participants with scores above the clinical cut-point, treatment had no effect on cannabis use. Similarly, participants with sub-threshold depression scores reduced the number of positive urinalysis results at three months. Effect sizes ranged from small to medium.

Results support the importance of simultaneously addressing depressive symptoms and cannabis use when treating young adults using text-delivered counseling. As mHealth interventions continue to demonstrate efficacy in addressing substance use disorders, the integration of mood disorder treatments appears warranted.