Methamphetamine-associated psychosis: links to drug use characteristics and similarity to primary psychosis

Abstract

Objectives: Despite the prevalence of methamphetamine-associated psychosis, how characteristics of drug use affect the severity and clinical course, and its optimal treatments have not been established. We addressed these questions, assessing clinical features of methamphetamine-associated psychosis, and compared it with primary psychosis.

Methods: Hospitalised patients with methamphetamine-associated (n = 70) or primary schizophrenic psychosis (n = 70) were matched on sex, age and duration of psychosis. Association of drug use variables (age at initiation, duration of methamphetamine use) with the Brief Psychiatric Rating Scale (BPRS) scores and psychosis duration were examined for patients with methamphetamine-associated psychosis, and the groups were compared on the BPRS scores.

Results: Methamphetamine use initiation age correlated negatively with the BPRS total score and the Activation subscale score; methamphetamine use duration correlated positively with psychosis duration. Methamphetamine-associated psychosis group scored lower on the Hostility-Suspiciousness and Anergia subscales of the BPRS (adjusted p values < .05).

Conclusions: Association of early initiation of methamphetamine with psychosis severity may suggest a lasting effect on brain development. Correlation of drug use and psychosis durations may suggest a cumulative effect of methamphetamine exposure. Less severe paranoia and negative symptoms in the methamphetamine-using group could implicate better social functioning of these patients. Further mechanistic studies are warranted.

Key points

• Early initiation of methamphetamine use is associated with psychosis severity.

• Methamphetamine use duration associates with psychosis duration.

• Methamphetamine-associated and primary schizophrenic psychoses were similar in symptoms.

• Methamphetamine psychosis patients were less severe in paranoia and negative symptoms.

Keywords:

• Psychosis
• methamphetamine
• psychotic symptoms
• schizophrenia
• drug use

Acknowledgments

We express our gratitude to the staff working in the Medical Records Office of Shenzhen Kangning Hospital, for their help and assistance in medical records searching.

Disclosure statement

No potential conflict of interest was reported by the authors.

Contributors

Mei Yang and Tiebang Liu designed the protocol. Mei Yang and Chuanqing Yang collected the data and did the analyses. Mei Yang and Edythe D. London prepared the manuscript. Edythe D. London and Tiebang Liu made extensive revision and contributed to the data interpretation. All authors read and approved the final version.

Additional information

Funding

This work was supported by the Science and Technology Plan Project (Knowledge Innovation) of Shenzhen Municipality [JCYJ20160429185634596, JCYJ20180306171005516] to Mei Yang, the Basic Research Project (Discipline Layout) of Shenzhen Science and Technology Innovation Committee [JCYJ20170413101017457] to Tiebang Liu. Dr. London was supported from endowments by the Thomas P. and Katherine K. Pike Chair in Addiction Studies, and the Marjorie M. Greene Trust. The funding sources did not have any role in study design, the collection, analysis and interpretation of data, the writing of the report, or in the decision to submit the paper for publication.