International forskning

Mental disorders are no predictors to determine the duration of cannabis-based treatment for chronic pain

Rometsch C, Ott S, Festl-Wietek T, Jurjut AM, Schlisio B, Zipfel S, Stengel A, Herrmann-Werner A.

1University Hospital and Faculty of Medicine, University of Tübingen, Tübingen, Germany
2Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
3Tübingen Institute for Medical Education, University of Tübingen, Tübingen, Germany
4Department of Anesthesiology and Intensive Care Medicine, Tübingen University Hospital, Tübingen, Baden-Württemberg, Germany
5Department for Psychosomatic Medicine, Charité Center for Internal Medicine and Dermatology, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charité – Universitätsmedizin Berlin, Berlin, Germany


Background: Chronic pain (CP), a complex biopsychosocial disorder with a global prevalence of up to 33%, can be treated by following multidisciplinary approaches that may include cannabis-based medicine (CBM). However, because CBM continues to be a new treatment, questions remain regarding the ideal duration for CBM and its psychosocial determinants, including mental comorbidities.

Methods: In a retrospective cross-sectional study involving 46 patients with CP (ICD-10 code F45.4-), three validated instruments-the German Pain Questionnaire, the Depression Anxiety Stress Scale (DASS), and the Marburg Questionnaire of Habitual WellBeing-were used to identify pain-specific psychosocial determinants and mental disorders. Descriptive analyses, a group differences analysis, and a logistic regression analysis were performed using SPSS.

Results: The patients most frequently reported low back pain as the primary location of their CP, and in attributing the condition to tissue damage, most had largely adopted a somatic orientation in conceptualizing their illness. Most had experienced CP for more than 5 years (M = 5.13 years, SD = 1.41) and, as a consequence, faced significant restrictions in their everyday life and exhibited low subjective wellbeing (MFHW median = 4.00, N = 43, Q1: 2.00, Q3: 9.00, range: 0-20). Comorbidities among the patients included depression, (DASS-Depression, median: 11.50, Q1: 7.00, Q3: 16.25), anxiety (DASS-Anxiety, median: 4.50, Q1: 2.75, Q3: 8.00), and stress (DASS-Stress, median: 11.00, Q1: 7.00, Q3: 15.00). Between the two cannabis-based treatments with a course lasting either less or more than a year, the duration of treatment showed no between-group differences in terms of sociodemographic factors, pain-specific factors, conceptualizations of the illness, or mental disorders. Psychosocial determinants such as subjective wellbeing and mental comorbidities were not significant predictors of the duration of cannabis-based treatment.

Conclusion: We found no evidence indicating that the benefits of short-term vs. long-term cannabis-based treatment can be predicted by mental comorbidities or psychosocial factors. However, because CBM may be included in approaches to treat CP, questions about the ideal duration of such treatment remain to be answered.

Keywords: bio-psycho-social model; cannabis; cannabis-based medicine; chronic pain; depression; mental disorders; pain disorder; treatment.