Lecomte Tania, Mueser Kim T, MacEwan William, Thornton Allen E, Buchanan Tari, Bouchard Vanessa, Goldner Elliot, Brink Johann, Lang Donna, Kang Shimi, Barr Alasdair M, Honer William G
*Département de Psychologie, Université de Montréal, Montreal, Quebec, Canada; †Center for Psychiatric Rehabilitation, Boston University, Massachusetts; ‡Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada; §Department of Psychology, and; ∥Faculty of Health Sciences, University of Simon Fraser, Burnaby, British Columbia, Canada; ¶Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada; and #Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada.
J Nerv Ment Dis. 2013 Dec;201(12):1085-9. doi: 10.1097/NMD.0000000000000059.
The objective of this study was to identify predictors of sustained psychotic symptoms after methamphetamine (MA) abuse during the course of 6 months from patterns of MA and other substance use, depressive symptoms, family history of psychosis, antisocial personality disorder, and trauma history. A total of 295 individuals with MA abuse and psychotic symptoms seeking psychiatric services were assessed at baseline and then monthly on symptoms and substance use for 6 months. Trajectory analyses revealed two trajectories of the individuals with positive symptoms, with one group presenting with persistent psychotic symptoms (30% of the sample). Those with persistent psychosis were significantly older, had more severe psychotic symptoms, misused MA for more years, had more antisocial personality traits, and had more sustained depressive symptoms. The strongest predictors of belonging to the persistent psychosis group, via logistic regressions, were more severe psychotic symptoms, longer use of MA, and sustained depressive symptoms. Our results highlight the important comorbidities, especially regarding depressive symptoms and persistent psychosis, in individuals seeking psychiatric help after MA abuse. This study also highlights the importance of identifying people with persistent psychosis within MA users to facilitate rapid and effective treatment of co-occurring psychotic disorder.
本研究的目的是从甲基苯丙胺（MA）及其他物质使用模式、抑郁症状、精神病家族史、反社会人格障碍和创伤史中，确定MA滥用后6个月内持续性精神病症状的预测因素。共有295名有MA滥用和精神病症状且寻求精神科服务的个体在基线时接受评估，然后在6个月内每月对症状和物质使用情况进行评估。轨迹分析揭示了有阳性症状个体的两种轨迹，其中一组表现为持续性精神病症状（占样本的30%）。患有持续性精神病的个体年龄显著更大，有更严重的精神病症状，滥用MA的时间更长，有更多的反社会人格特质，且有更持续的抑郁症状。通过逻辑回归分析，属于持续性精神病组的最强预测因素是更严重的精神病症状、更长时间的MA使用和持续的抑郁症状。我们的研究结果突出了在MA滥用后寻求精神科帮助的个体中重要的共病情况，尤其是关于抑郁症状和持续性精神病。本研究还强调了在MA使用者中识别出患有持续性精神病的人的重要性，以便为同时出现的精神病性障碍提供快速有效的治疗。
