Professor in Clinical Psychology, Lives Lived Well Chair of Alcohol, Drugs and Mental Health, Centre for Youth Substance Abuse Research, School of Psychology, The University of Queensland, Australia.
Research Fellow, Centre for Youth Substance Abuse Research, School of Psychology, The University of Queensland, Australia.
Br J Psychiatry. 2021 Jul;219(1):361-367. doi: 10.1192/bjp.2019.263.
Methamphetamine has been consistently associated with positive psychotic symptoms, but little is known about whether the reverse also occurs.
This study determined whether the relationship between methamphetamine use and positive psychotic symptoms is bidirectional over 12 months. The impact of lifetime psychotic disorders and methamphetamine dependence on these relationships was also examined.
A total of 201 regular (at least monthly) primary methamphetamine users were recruited from free needle and syringe programmes in three Australian cities. Data on the frequency of methamphetamine and other drug use (from Timeline Followback inteviews) and the severity of positive psychotic symptoms (using the Brief Psychiatric Rating Scale) in the past 2 weeks were collected in 12 contiguous monthly face-to-face interviews (mean of 9.14/11 (s.d. = 3.16) follow-ups completed). Diagnoses were derived using the Psychiatric Research Interview for DSM-IV Substance and Mental Disorders.
The mean age of participants was 31.71 years (s.d. = 8.19) and 39% (n = 77) were women. At baseline 55% (n = 110) were dependent on methamphetamine and 51% (n = 102) had a lifetime psychotic disorder. Cross-lagged dynamic panel models found a significant bidirectional relationship between psychotic symptoms and methamphetamine use (Comparative Fit Index (CFI) = 0.94, standardised root mean square residual (SRMR) = 0.05, root mean square error of approximation (RMSEA) = 0.05, 95% CI 0.04-0.06). The magnitude of the relationship in each direction was similar, and the presence of methamphetamine dependence or a lifetime psychotic disorder did not have an impact on results.
A dynamic, bidirectional relationship between methamphetamine and psychotic symptoms of similar magnitude in each direction was found over 1 year. This suggests integrated treatments that target methamphetamine, psychotic symptoms and their interrelationship may be of most benefit.
甲基苯丙胺一直与阳性精神病症状相关，但人们对其是否存在相反的关系知之甚少。
本研究旨在确定在 12 个月内，使用甲基苯丙胺与阳性精神病症状之间的关系是否是双向的。同时，还研究了终身精神病障碍和甲基苯丙胺依赖对这些关系的影响。
共招募了来自澳大利亚三个城市的 201 名定期（至少每月一次）原发性甲基苯丙胺使用者（使用纳洛酮解毒针剂和注射器方案）。在 12 个连续的每月面对面访谈中（平均完成 9.14/11 次访谈（标准差=3.16）），收集了过去 2 周内甲基苯丙胺和其他药物使用频率（使用时间线回溯访谈）和阳性精神病症状严重程度（使用简明精神病评定量表）的数据。使用精神疾病诊断与统计手册第四版的精神障碍和物质使用障碍的精神病研究访谈得出诊断。
参与者的平均年龄为 31.71 岁（标准差=8.19），39%（n=77）为女性。基线时，55%（n=110）依赖于甲基苯丙胺，51%（n=102）有终身精神病障碍。交叉滞后动态面板模型发现精神病症状和甲基苯丙胺使用之间存在显著的双向关系（比较拟合指数（CFI）=0.94，标准化根均方残差（SRMR）=0.05，近似均方根误差（RMSEA）=0.05，95%置信区间 0.04-0.06）。每个方向的关系强度相似，甲基苯丙胺依赖或终身精神病障碍的存在并不影响结果。
在 1 年内发现了甲基苯丙胺和阳性精神病症状之间动态的、双向的、强度相似的关系。这表明，针对甲基苯丙胺、精神病症状及其相互关系的综合治疗可能最有益。
