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A genetic perspective on the proposed inclusion of cannabis withdrawal in DSM-5

Published online by Cambridge University Press:  30 November 2012

K. J. H. Verweij ,
A. Agrawal ,
N. O. Nat ,
H. E. Creemers ,
A. C. Huizink ,
N. G. Martin  and
M. T. Lynskey
K. J. H. Verweij
Affiliation:
Department of Developmental Psychology, VU University, Amsterdam, The Netherlands
A. Agrawal
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
N. O. Nat
Affiliation:
Department of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
H. E. Creemers
Affiliation:
Department of Developmental Psychology, VU University, Amsterdam, The Netherlands Department of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
A. C. Huizink*
Affiliation:
Department of Developmental Psychology, VU University, Amsterdam, The Netherlands Department of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands Behavioral Science Institute, Radboud University Nijmegen, The Netherlands
N. G. Martin
Affiliation:
Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Queensland, Australia
M. T. Lynskey
Affiliation:
Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
*
*Address for correspondence: Dr A. C. Huizink, VU University, Faculty of Psychology and Education, Department of Developmental Psychology, Transitorium, Van de Boechorststraat 1, 1081 BT Amsterdam, The Netherlands. (Email: [email protected])
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Abstract

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.

Keywords

AbusecannabisdependenceDSM-5geneticstwinswithdrawal
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 8 , August 2013 , pp. 1713 - 1722
Copyright
Copyright © Cambridge University Press 2012 

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