A new German psychiatric study reported on Yahoo! News says Mental Illness Often Predates Ecstasy Use. However, although there are other reasons to question the often-reported association between Ecstasy use and neuronal damage, I don’t think this study is one. The methodology involved interviewing subjects twice at a 3.5-year interval. Quite simply, the finding that most had had psychiatric disturbance before ecstasy use would be expected, given that ecstasy use increased during the interval of the study and that psychiatric illness is more prevalent than ecstasy use. Given these two facts, most of those with psychiatric illness who reported that they had used ecstasy by the end of the study would have reported that they had not during their initial interview. The fact that the prevalence of ‘mental illness’ was higher in ecstasy users than in nonusers is misleading, and probably attributable to the fact that they apparently sought any DSM-IV (the official ‘bible’ of all psychiatric diagnoses, from the American Psychiatric Association) diagnoses. Some diagnosable conditions should not properly be called mental illnesses, and furthermore other substance use disorders, which are DSM-IV diagnoses, should probably have been excluded, as these will surely have a nonrandom association with reported ecstasy use.