Notre objectif était double : évaluer l’estime de soi, les stratégies de coping et le soutien social perçu chez des adolescents et des jeunes adultes dépendants au cannabis, comparativement à des sujets tout-venant ; chez les patients, mettre en correspondance ces dimensions adaptatives avec les modalités de consommation de substances.

Des questionnaires évaluant l’estime de soi globale et sociale, les stratégies de coping et le soutien social perçu ont été complétés par 43 patients et 50 témoins. Les modalités de consommation étaient investiguées lors d’un entretien clinique.

Les analyses révèlent que les patients présentent des scores différents de ceux des témoins et plusieurs associations significatives sont retrouvées entre les modalités d’usage et les scores aux échelles cliniques.

Nos résultats témoignent d’un déficit des ressources personnelles et de la perception des ressources environnementales chez ces jeunes patients dépendants au cannabis. De plus, le recours privilégié à certains styles de coping pourrait contribuer au développement et au maintien des usages de produits psychoactifs.

Self-esteem, coping strategies and perceived social support play a role in the adaptive functioning of the human being: they allow the adjustment of the subject to his/her environment. These dimensions could be protective factors regarding multiple risks associated with adolescent development, and particularly substance use. Thus our objective was twofold: to evaluate self-esteem, coping strategies and perceived social support in adolescents and young adults with a cannabis dependence in comparison with subjects from the general population; to establish the correspondence between these psychological dimensions and the patients’ substance use pattern.

Data from 43 young patients (36 males; mean age=19.6±3), consulting for their cannabis dependence, and 50 young adults from the general population (39 males; mean age=19.7±3.4) were included. Participants completed the Rosenberg Self-Esteem Inventory, the Social Self-Esteem Inventory of Lawson, the Coping Inventory for Stressful Situation of Endler & Parker, and the Perceived Social Support Questionnaire of Sarason. The MINI was administered to evaluate cannabis abuse or dependence; a semi-structured clinical interview was given to determine psychoactive substance use.

Between-group comparisons (two independent sample t-tests) showed that the patients had significantly lower scores on global (P=0.002) and social (P=0.035) self-esteem, task-oriented coping (P<0.001) and both availability and satisfaction regarding perceived social support (respectively P=0.029 and P<0.001). Conversely, patients had significantly higher scores on emotion-focused coping subscale (P=0.003). Logistic regressions showed that the satisfaction regarding social support and task-oriented coping scores were the more powerful to distinguish the patients from the controls (respectively β=1.16, P=0.043 and β=1.06, P=0.015). Unvaried linear regression analyses revealed a negative association between the age of first cannabis use and the avoidant-social coping score (P=0.025), and positive associations between the length of daily cannabis use and emotion-focused coping score (P=0.028), and frequency of cannabis use and global self-esteem scores (P=0.028). Moreover, polysubstance misuse is associated with low distraction-avoidant coping scores. No association was found between clinical scores and tobacco and alcohol uses variables.

These results suggest that cannabis dependent patients may present a lack in individual and interpersonal resources. This clinical study underscores the potential contribution of maladaptive coping to the development or maintenance of substance use in young adulthood.