Apathy and Anhedonia in Adult and Adolescent Cannabis Users and Controls Before and During the COVID-19 Pandemic Lockdown

Background: COVID-19 lockdown measures have caused severe disruptions to work and education and prevented people from engaging in many rewarding activities. Cannabis users may be especially vulnerable, having been previously shown to have higher levels of apathy and anhedonia than non-users. Methods: In this survey study, we measured apathy and anhedonia, before and after lockdown measures were implemented, in n=256 adult and n =200 adolescent cannabis users and n =170 adult and n=172 adolescent controls. Scores on the Apathy Evaluation Scale (AES) and Snaith-Hamilton Pleasure Scale (SHAPS) were investigated with mixed-measures ANCOVA, with factors user group, age group, and time, controlling for depression, anxiety, and other drug use. Results: Adolescent cannabis users had significantly higher SHAPS scores before lockdown, indicative of greater anhedonia, compared with adolescent controls (P = .03, eta(2)(p)= .013). Contrastingly, adult users had significantly lower scores on both the SHAPS (P< .001, eta(2)(p)= .030) and AES (P< .001, eta(2)(p) =.048) after lockdown compared with adult controls. Scores on both scales increased during lockdown across groups, and this increase was significantly smaller for cannabis users (AES: P = .001, eta(2)(p) =.014; SHAPS: P=.01, eta(2)(p) =.008). Exploratory analyses revealed that dependent cannabis users had significantly higher scores overall (AES: P < .001, eta(2)(p)= .037; SHAPS: P < .001, eta(2)(p)=.029) and a larger increase in scores (AES: P=.04, eta(2)(p) =.010; SHAPS: P= .04, eta(2)(p)=.010), compared with non-dependent users. Conclusions: Our results suggest that adolescents and adults have differential associations between cannabis use as well as apathy and anhedonia. Within users, dependence may be associated with higher levels of apathy and anhedonia regardless of age and a greater increase in levels during the COVID-19 lockdown.