Department of Drug Dependence, Shenzhen Kangning Hospital, Medicine Division of Shenzhen University, Shenzhen, Guangdong, China.
Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
Int J Psychiatry Clin Pract. 2020 Mar;24(1):31-37. doi: 10.1080/13651501.2019.1676451. Epub 2019 Oct 14.
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. Hospitalised patients with methamphetamine-associated ( = 70) or primary schizophrenic psychosis ( = 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. 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 values < .05). 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 pointsEarly 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.
尽管与甲基苯丙胺相关的精神病很常见，但药物使用的特征如何影响其严重程度和临床病程，以及最佳治疗方法尚未确定。我们解决了这些问题，评估了与甲基苯丙胺相关的精神病的临床特征，并将其与原发性精神病进行了比较。将与甲基苯丙胺相关的住院患者（ = 70）或原发性精神分裂症性精神病患者（ = 70）按性别、年龄和精神病持续时间进行匹配。对与甲基苯丙胺相关的精神病患者的药物使用变量（开始使用年龄、使用甲基苯丙胺的时间）与简明精神病评定量表（BPRS）评分和精神病持续时间的关联进行了检查，并比较了两组的 BPRS 评分。与甲基苯丙胺相关的精神病患者的甲基苯丙胺使用起始年龄与 BPRS 总分和激活分量表评分呈负相关；甲基苯丙胺使用时间与精神病持续时间呈正相关。与甲基苯丙胺相关的精神病组在 BPRS 的敌意-多疑和意志缺失分量表上的得分较低（调整后的 值<.05）。与精神病严重程度相关的甲基苯丙胺使用的早期开始可能表明其对大脑发育的持续影响。药物使用和精神病持续时间的相关性可能表明甲基苯丙胺暴露的累积效应。使用甲基苯丙胺的患者的妄想和阴性症状较轻可能意味着这些患者的社会功能更好。需要进一步的机制研究。要点甲基苯丙胺使用的早期开始与精神病的严重程度有关。甲基苯丙胺使用时间与精神病持续时间相关。与甲基苯丙胺相关的和原发性精神分裂症性精神病在症状上相似。与甲基苯丙胺相关的精神病患者在妄想和阴性症状方面的严重程度较轻。
