Primary and substance-induced psychotic disorders in methamphetamine users

Abstract

Primary and substance-induced psychotic disorders in methamphetamine users, Psychiatry Research, http://dx

The profile of psychiatric symptoms exacerbated by methamphetamine use

“…They were volunteers who self-identified as regular (monthly) methamphetamine users who were recruited through needle and syringe programs, word of mouth, and advertisements in magazines from Brisbane (n = 92), Melbourne (n = 49) and Sydney (n = 23), Australia (Hides et al, 2015). We excluded 24 participants who had a lifetime primary psychotic disorder, 7 who were not followed up, 4 who did not report methamphetamine use at follow-up, and 2 who had missing data on covariates.…”

“…The BPRS yields inter-rater reliability of 0.83 (Ventura et al, 1993) and this was 0.97 for the total BPRS score in the larger cohort from which this sample was drawn (Hides et al, 2015).…”

“…Consistent with these criteria, most studies have noted the prominence of hallucinations and delusions, which are usually persecutory in nature (Akiyama, 2006;Angrist et al, 1974;Angrist and Gershon, 1970;Chen et al, 2003;Connell, 1966;Dore and Sweeting, 2006;Harris and Batki, 2000;Iwanami et al, 1994;Janowsky and Risch, 1979;Mahoney et al, 2008;Medhus et al, 2013;Srisurapanont et al, 2003). However, they fail to distinguish between methamphetamine-induced psychosis and schizophrenia on the remaining symptoms of schizophrenia (Hides et al, 2015;Medhus et al, 2013;Srisurapanont et al, 2003Srisurapanont et al, , 2011, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior, and negative symptoms (e.g., diminished emotional expression or avolition; American Psychiatric Association, 2013). Many studies report affective symptoms in methamphetamine-induced psychosis, including depressed mood (Akiyama, 2006;Hides et al, 2015;Iwanami et al, 1994), suicidal ideation (Akiyama, 2006), mania (Hides et al, 2015) and hostility (Akiyama et al, 2011;McKetin et al, 2008), but it is not clear whether these are core symptoms in methamphetamine psychosis or contemporaneous phenomena.…”

“…However, they fail to distinguish between methamphetamine-induced psychosis and schizophrenia on the remaining symptoms of schizophrenia (Hides et al, 2015;Medhus et al, 2013;Srisurapanont et al, 2003Srisurapanont et al, , 2011, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior, and negative symptoms (e.g., diminished emotional expression or avolition; American Psychiatric Association, 2013). Many studies report affective symptoms in methamphetamine-induced psychosis, including depressed mood (Akiyama, 2006;Hides et al, 2015;Iwanami et al, 1994), suicidal ideation (Akiyama, 2006), mania (Hides et al, 2015) and hostility (Akiyama et al, 2011;McKetin et al, 2008), but it is not clear whether these are core symptoms in methamphetamine psychosis or contemporaneous phenomena. Srisurapanont et al (2011) found evidence of a positive syndrome (delusions, hallucinations and incoherent speech), a negative syndrome (poverty of speech, psychomotor retardation and flattened/incongruous affect) and an anxiety/depression syndrome (Srisurapanont et al, 2011), similar to that seen in people diagnosed with schizophrenia (Srisurapanont et al, 2011).…”

“…Up to half of regular methamphetamine users have a comorbid psychiatric disorder, including 40% with major depression and 20% with a primary psychotic disorder (Glasner-Edwards et al, 2008;Hides et al, 2015;McKetin et al, 2011). Symptoms from these disorders can conflate the psychiatric symptom profile seen in people who use methamphetamine, making it difficult to identify diagnostic boundaries when making cross-sectional comparisons of symptom profiles.…”