Journal Article

Pre-morbid characteristics and co-morbidity of methamphetamine users with and without psychosis

CHEN, C.-K., HSIAO, C.-C., LIN, S.-K., CHIANG, Y.-L., SHAM, P. C., REE, S.-C., MURRAY, R. M., BALL, D., LEE, C.-H., LOH, E.-W.

2003

Overview

Background. The long-term use of methamphetamine (MAMP) can result in psychosis but it is not clear why some individuals develop psychotic symptoms, while others use MAMP regularly over long periods and remain unscathed. We set out to characterize MAMP users and to examine the relationship of pre-morbid personality, pre-morbid social function and other psychiatric disorders to MAMP psychosis. Method. Four hundred and forty-five amphetamine users were recruited from a psychiatric hospital and a detention centre in Taipei, and were assessed with the Diagnostic Interview for Genetic Studies (DIGS). Their parents were interviewed with the Premorbid Schizoid and Schizotypal Traits (PSST) and the Premorbid Social Adjustment (PSA) schedules. Pre-morbid characteristics and psychiatric co-morbidity were compared between the MAMP users with a lifetime diagnosis of MAMP psychosis and those without. Results. The MAMP users with psychosis presented a clinical picture which mimicked the positive symptoms of schizophrenia: 85% had auditory hallucinations; 71% persecutory delusions; 63% delusions of reference. Compared with their non-psychotic counterparts, these MAMP users were younger at first MAMP use, used larger amounts of MAMP, had a significantly higher mean PSST score, and higher rates of major depressive disorder, alcohol dependence and antisocial personality disorder. Conclusions. Earlier and larger use of MAMP was associated with increased risk of psychosis. Our data are also compatible with the view that pre-morbid schizoid/schizotypal personality predisposes MAMP users to develop psychosis, and that the greater the personality vulnerability, the longer the psychosis will persist.

• Publisher: Cambridge University Press
• Subject: Adjustment / Adolescent / Adult / Alcoholism / Alcoholism - diagnosis / Alcoholism - epidemiology / Alcoholism - psychology / Amphetamine-Related Disorders - diagnosis / Amphetamine-Related Disorders - epidemiology / Amphetamine-Related Disorders - psychology / Amphetamines / Antisocial behavior / Antisocial personality disorder / Antisocial Personality Disorder - diagnosis / Antisocial Personality Disorder - epidemiology / Antisocial Personality Disorder - psychology / Auditory hallucinations / Biological and medical sciences / Causality / Central Nervous System Stimulants - toxicity / Comorbidity / Delusions / Depressive Disorder, Major - diagnosis / Depressive Disorder, Major - epidemiology / Depressive Disorder, Major - psychology / Depressive personality disorders / Detention / Detention centers / Disease Susceptibility - psychology / Disorders / Drug abuse / Drug toxicity and drugs side effects treatment / Female / Genetics / Hallucinations / Hospitals, Psychiatric / Humans / Interviews / Male / Medical diagnosis / Medical research / Medical sciences / Mental depression / Mental disorders / Methamphetamine / Methamphetamine - toxicity / Morbidity / Persecutory ideation / Personality / Personality Assessment / Personality disorders / Pharmacology. Drug treatments / Premorbid / Prisons / Psychiatric Status Rating Scales / Psychiatry / Psychoses / Psychoses, Substance-Induced - diagnosis / Psychoses, Substance-Induced - epidemiology / Psychoses, Substance-Induced - psychology / Psychosis / Psychotic symptoms / Risk Factors / Schizoid Personality Disorder - diagnosis / Schizoid Personality Disorder - epidemiology / Schizoid Personality Disorder - psychology / Schizophrenia / Schizophrenia - chemically induced / Schizophrenia - diagnosis / Schizophrenia - epidemiology / Schizophrenic Psychology / Schizotypal personality disorders / Social Adjustment / Social function / Symptoms / Taiwan / Toxicity: nervous system and muscle