'Body dysmorphic disorder (BDD) is a debilitating disorder characterized by an excessive pre-occupation with an imagined or very slight defect in one's physical appearance. Despite the overall success of cognitive behavioural therapy (CBT) in treating BDD, some people do not seem to benefit as much from this approach. Those with high overvalued ideation (OVI), for instance, have been shown to not respond well with CBT.'
Taillon, A. , O'Connor, K. , Dupuis, G. , & Lavoie, M. (2013). Inference-based therapy for body dysmorphic disorder. Clinical Psychology & Psychotherapy, 20(1), 67-76.
Serotonin, psilocybin and body dysmorphic disorder: A case report
Journal of Clinical Psychopharmacology, 1996 16(2):188-189
Karl R. Hanes, PhD touches upon the use of marijuana in this context: "The present case adds to the literature suggesting that body dysmorphic disorder, which appears to be closely related to obsessive-compulsive disorder, may be tied to a disruption in the serotonergic system. The qualitative effects of marijuana, a possible 5-HT antagonist, and psilocybin in a patient who responded to fluoxetine appear rather intriguing, since psilocybin compounds psilocybin and psilocin are closely related to serotonin biogenetically and the psychotropic effects of these substances, which include gross changes in body image, have been linked to their affinity for the 5-HT neurotransmitter system"
That's amazing to know. I didn't think to search among those parameters as my sights were toward a psychological change rather than chemical. Thank you.
Please note that marijuana is not a real pharmaceutical since there are many different substances in it, in varying concentrations. Would be better to test a single agent in a known dose. For people prone to mental illness, marijuana may provoke psychosis and lead to the degenerative brain disorder, schizophrenia. I do not think we know what ingredient in the plant is responsible for these unwanted effects.
Psychometrics associated with cannabis use is too much in its infancy to conclude cannabinoids lead to degenerative brain disorders. Research correspond some negative effect among young users during brain development but is not conclusive on whether other variables come into play. While psychosis and other mental disorders may be exacerbated with cannabis use in some patients, there is no research that can conclusively state thus far that cannabinoids and marijuana in either its natural state and/or in separated chemical ones produce these negative results. Until we are able to legally test these agents individually, marijuana shall unfortunately never be considered a real pharmaceutical.
You are fortunate not to have met an affected patient. In the people I know there is no doubt as to the role of MJ in their psychopathology.
I am sorry to hear about your patients. In every type of licit and illicit drug contain elements that will cause harm to some portion of the public. Let's say call it alpha level .05. Are your patients with regard to their psychopathology a norm or a deviant result of MJ use? Compared to the general population of MJ users, are your patients above or under the .05 marker? I'm not trying to reduce your patients to a statistic but without being able to know the history of your patients, there is little I can really infer from the situation other than I hope they get better.
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