Relationship between gender and psychotic symptoms in cocaine-dependent and methamphetamine-dependent participants

Abstract

Background It has been well documented that cocaine and methamphetamine use can lead to the onset of psychotic symptoms similar to schizophrenia. However, the research and literature on gender differences and stimulant-induced psychosis have been mixed. Objective The primary aim of this study was to investigate gender differences in the reporting of psychotic symptoms in cocaine-versus methamphetamine-dependent individuals. Methods Participants were recruited from the Los Angeles, California, community via radio and newspaper advertisements. All met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for cocaine or methamphetamine dependence, and all reported either methamphetamine or cocaine as their primary drug of abuse. During a screening interview, participants answered questions from the Psychotic Symptom Assessment Scale, which characterizes various types of psychotic symptoms during drug use (“while high”) or during periods of nonuse (“while abstinent”). Results Participants included 42 cocaine-dependent individuals (27 men, 15 women) and 43 methamphetamine-dependent individuals (25 men, 18 women). Among cocaine users, there were no significant differences between men and women with regard to ethnicity, years of use, route of administration, and amount used in the past week, though they differed significantly with regard to age (P = 0.029). In the “while abstinent” condition, women were significantly more likely than men to report experiencing auditory hallucinations (13% vs 0%, respectively; P = 0.050) and tactile hallucinations (20% vs 0%; P = 0.016), whereas men were more likely to report delusions of grandeur (48% vs 6%; P = 0.006). During the “while high” condition, women were significantly more likely than men to report delusions of grandeur (13% vs 0%, respectively; P = 0.050), tactile hallucinations (33% vs 0%; P = 0.001), and olfactory hallucinations (13% vs 0%; P = 0.050). Among methamphetamine users, there were no significant differences between men and women with regard to age, ethnicity, years of use, route of administration, or amount used in the past week. In the “while abstinent” condition, women were significantly more likely than men to report feeling that something was wrong with the way a part of their body looked (72% vs 32%, respectively; P = 0.009), olfactory hallucinations (39% vs 8%; P = 0.010) and dressing inappropriately (22% vs 0%; P = 0.010). During the “while high” condition, women were more likely than men to report delusions of grandeur (33% vs 16%, respectively; P = 0.030), paranoia (50% vs 16%; P = 0.017), and tactile hallucinations (61% vs 32%; P = 0.050). Conclusions The findings of the present study revealed that cocaine- and methamphetamine-dependent women were more likely than their male counterparts to report experiencing various psychotic symptoms. This information may be useful for clinicians and mental health professionals, who should take these symptoms into account as potential barriers that may impede effective treatment.

Predictors of methamphetamine psychosis: History of ADHD-relevant childhood behaviors and drug exposure

“…We also failed to detect gender differences related to psychosis in this sample. These findings are inconsistent with others who have reported that MA dependent women were more likely than their male counterparts to report experiencing various psychotic symptoms (Mahoney et al, 2010). Additional studies in a larger community based sample are needed to explore these issues further.…”

A comprehensive review of auditory verbal hallucinations: lifetime prevalence, correlates and mechanisms in healthy and clinical individuals

“…More often than not this is a state of paranoia, such that the person believes they hear footsteps and are being followed by spies, as an example. AVH have also been documented in cocaine users after the high has subsided (i.e., during abstinence), with this condition significantly more likely to occur in women compared to men (Mahoney et al, 2010). The reason for this difference between the sexes is still yet to be investigated.…”

The neurochemical consequences of methamphetamine self-administration in male and female rats

“…Drug craving was also significantly correlated with depression and anxiety measures in male METH users but not females (Hartwell et al, 2016). Increased rates of depression, psychosis, and suicide have also been reported in females compared to males (Glasner-Edwards et al, 2008AB; Mahoney et al, 2010). Female METH users also reported a greater severity of drug use and psychological burden than their male counterpart (Simpson et al, 2016), further demonstrating the importance of investigating gender differences in METH users.…”