a Centre for Research on Ageing, Health and Wellbeing , Australian National University , Acton , Australia.
b National Centre for Epidemiology and Population Health , Australian National University , Acton , Australia.
Subst Use Misuse. 2019;54(4):549-559. doi: 10.1080/10826084.2018.1521430. Epub 2019 Jan 29.
The psychiatric symptom profile of methamphetamine-associated psychosis (MAP) has varied considerably across studies of different research designs. We performed a systematic review to examine the available evidence for specific psychotic symptoms associated with MAP, including the clinical course and longitudinal changes in this symptom profile.
Five key electronic databases were searched to identify studies that examined the symptom profile or clinical course of MAP in individuals identified as having MAP. The reporting of specific psychiatric symptoms, and duration of symptoms where available, was recorded for each study.
Ninety-four articles were identified (n = 7387), including case-control (k = 29), cross-sectional (k = 20), experimental (k = 6), case report (k = 29), and longitudinal (k = 20) studies. Persecutory delusions, auditory and visual auditory hallucinations were by far the most commonly reported symptoms (reported in 65-84% of studies). Hostility, conceptual disorganization, and depression were reported in a large proportion of studies (31-53%). Negative symptoms were mostly absent (<20%). The median percentage of participants with persistent psychotic symptoms (>1 month duration) across studies was 25% (excluding case reports).
Persecutory delusions, auditory and visual hallucinations, hostility, depression and conceptual disorganization are central to MAP, whereas negative psychotic symptoms are typically absent. An overrepresentation of institutionalized or male participants may have overemphasized negative symptoms and underreported affective symptoms in past research. Symptoms of MAP may persist beyond one month after drug cessation in some individuals. Clinicians are encouraged to manage affective symptoms in MAP individuals, and monitor for the development of chronic psychotic symptoms.
不同研究设计的 methamphetamine-associated psychosis (MAP) 的精神症状谱差异很大。我们进行了系统回顾，以检查与 MAP 相关的特定精神病症状的现有证据，包括该症状谱的临床过程和纵向变化。
检索了五个主要的电子数据库，以确定研究 MAP 个体的症状谱或临床过程的研究。记录了每篇研究报告的特定精神症状以及症状的持续时间（如有）。
共确定了 94 篇文章（n=7387），包括病例对照研究（k=29）、横断面研究（k=20）、实验研究（k=6）、病例报告研究（k=29）和纵向研究（k=20）。被害妄想、听觉和视觉听觉幻觉是迄今为止最常报告的症状（65-84%的研究报告）。敌意、概念混乱和抑郁在很大一部分研究中报告（31-53%）。阴性症状大多不存在（<20%）。在研究中，持续精神病症状（持续时间>1 个月）的参与者的中位数百分比为 25%（不包括病例报告）。
被害妄想、听觉和视觉幻觉、敌意、抑郁和概念混乱是 MAP 的核心症状，而阴性精神病症状通常不存在。在过去的研究中，机构化或男性参与者的代表性过高可能夸大了阴性症状，而低估了情感症状。在某些个体中，MAP 的症状可能会在停药后持续一个月以上。鼓励临床医生在 MAP 患者中管理情感症状，并监测慢性精神病症状的发展。
