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Re: Clubbers’ mental health risk

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This statement is being issued as a corrective to some of the regrettable, sensationalist and inaccurate coverage that has recently occurred regarding the Mixmag drug use data concerning clubbers’ drug use. A press release was issued that was not seen by any of the researchers and which contained some factual inaccuracies that were incorporated into the coverage of the study findings.

See the following URL for an example.

The study researchers are Adam Winstock, Luke Mitcheson and Neil Hunt. Contrary to what the press release says Adam Winstock does not work at the University of Kent and never has. Until recently he worked at the National Addiction Centre, Institute of Psychiatry and is in the process of moving to Australia to take up a post as a Clinical Director. Luke Mitcheson works at the South London and Maudsley NHS Trust. Neil Hunt works at the University of Kent.

The Mixmag survey is a self completion questionnaire that readers elect to complete and send to a Freepost address. The provisional analyses on which the press release is based are drawn from responses from 988 clubbers from 2001. According to their press release, Mixmag has an estimated readership of 600,000 so on this basis only about 1 out of every 60 readers completed the questionnaire.

It seems likely that people who take the trouble to complete and post a questionnaire may well be more drug-involved in some way: either more enthusiastic about their drugs or having had aversive experiences that they want to share with other people for altruistic reasons. For this reason we believe it is highly unlikely that the sample is representative of the average clubber. This is of great importance when interpreting data such as drug problem data and mental health data and means that the findings cannot be generalised to the general population of clubbers. This sample seems more likely to consist of a ‘hard core’ of clubbers.

The Press release from Mixmag said:

“Clubbers 25 per cent more likely to have mental disorder”

“Mixmag asked survey respondents to complete a standard mental health questionnaire used by psychiatrists to diagnose psychological disorders.”

“One in four of the survey respondents had the potentially to develop a serious psychiatric disorder, compared with the UK average of one in five.”

“Mixmag respondents are also twice as likely to have seen a doctor about a mental health problem than the rest of the population. Half of those asked about depression. (Many scientists believe that ecstasy use can lead to depression).”

In fact the tool that was used was the GHQ 12 which is not a diagnostic tool and the study does not provide any confirmation of whether respondents have a mental disorder. We are unable to say that any respondents have a mental disorder.

32% of the sample scored more 4 or more on the GHQ 12 (a cut off point used to indicate poorer wellbeing) whereas the “Comparative Review and Assessment of Key Health State Measures of the General Population” (available from found an overall rate of 17% for 16-24 year olds in 1995 scoring this level.

Mixmag may have derived the 25% figure from some preliminary codings that didn’t use the same cut-point as the ‘Comparative Review and Assessment of Key Health State Measures of the General Population’. However it was derived, the 25% figure appears to be wrong anyway. In fact the proportion of respondents with higher GHQ12 scores is almost double that of the nearest age-equivalent group in the general population.

We don’t know where the quote about depression came from as there were no questions about what people talked to their doctor about so there is no data to substantiate this claim.

We did get some striking responses to the following questions for the whole sample. However, they are all about lifetime experience and the first three questions do not allow any conclusions to be drawn about causation or the sequence of events.

Ever seen a doctor about a mental health problem? 21.9%
Ever been referred to a psychiatrist? 10.9%
Ever deliberately harmed yourself? 12.1%
Ever sought help from a drug service or some other type of expert? 13.0%
Ever sought help from elsewhere? 17.6%

The Press release from Mixmag also said:

“an estimated one and a half million young people still take E every weekend”

We don’t know where this figure comes from. It is certainly not the research and should not be attributed to this or us. This study design does not enable us to estimate population prevalence of ecstasy use.

We hope this may be helpful to anyone who has seen the coverage and is surprised by it (as we were).

There’s a lesson in here somewhere.

Neil Hunt

(on behalf of the Mixmag Research Group)

Neil Hunt, Lecturer in Addictive Behaviours
Kent Institute of Medicine and Health Sciences Research and Development Centre
University of Kent at Canterbury Canterbury
Kent CT2 7PD

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