Year: 2024
Type: dissertation
Study design: Observational Study
Abstract: Social anxiety disorder (SAD) is a mental health disorder characterized by fear and avoidance of social situations. Considering the reduced availability of conventional therapies, individuals with SAD resort to cannabis use, leading to problematic use.The objective was to understand the pathophysiology of SAD, by evaluating GABA+ and glutamate + glutamine (Glx) imbalances in the dorsomedial prefrontal cortex/anterior cingulate cortex (dmPFC/ACC), dorsolateral prefrontal cortex (dlPFC) and the insula. Moreover, we aimed to determine the motivations and the expectancies of the effects of cannabis use. In the first project, we recruited 26 (age: 25.3 ± 5.0 years; 61.5% female) individuals with SAD and 26 (age: 25.1 ± 4.4 years; 61.5% female) sex-age-matched controls. Using proton magnetic resonance spectroscopy, we found that compared to the controls, both, GABA+ in dlPFC, and Glx in the insula were increased in the participants with SAD. However, no between-group differences were observed in dmPFC/ACC. For the second and third projects, we recruited 26 (age: 27.9 ± 7.3 years; 50.0% female) with SAD and 26 (age: 27.3 ± 6.7 years; 53.8% female) without SAD in a mixed methods study. Both groups were frequent cannabis users. Compared to the controls, cannabis use social and coping motives were higher in the SAD group, while relaxation and tension reduction expectancies were equally found in both groups. Cannabis use continued, despite 57.7% with and 46.2% without SAD developing cannabis use disorder (CUD). However, these findings should be replicated in longitudinal studies due to recall bias. The primary coping strategy for SAD was cannabis use. Moreover, cannabis containing higher amounts of cannabidiol (CBD) was preferred by the SAD group. Healthcare providers were excluded from the discussion about the use. The high costs of legal cannabis led to illegal purchases and obtaining dried cannabis over vaping pens. The three projects warrant the spectroscopic assessment of CBD on the implicated pathophysiological mechanisms of SAD. Considering that cannabis use will resume regardless of healthcare workers disagreeing with its use, special attention should be paid by these medical professionals to how cannabis interacts with prescribed medications or medical conditions in their patients.
Source: TSpace (University of Toronto)
Author: Elsaid, Sonja
Institution: University of Toronto
Language: English
Subfield: Pharmacology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7133037869