Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Nakhon Phanom Rajanagarindra Psychiatric Hospital, Department of Mental Health, Ministry of Public Health, Nakhon Phanom, Thailand.
Drug Alcohol Depend. 2020 May 1;210:107961. doi: 10.1016/j.drugalcdep.2020.107961. Epub 2020 Mar 19.
Cognitive impairment in methamphetamine (MA) users with psychosis may be more severe than that in MA users without psychosis. This study aimed to compare the overall cognitive function and specific cognitive domains between MA users with and without psychosis.
Participants in this cross-sectional study were adult inpatients who used MA within the month prior to admission. The recent use of MA was confirmed using quantitative analysis of hair. We used the Mini International Neuropsychiatric Interview (MINI) - Plus, Psychotic Module to confirm the presence of recent psychosis in the participants who fulfilled the inclusion criteria, excluding the individuals with a lifetime history of schizophrenia. We assessed the severity of depression and MA withdrawal using the Patient Health Questionnaire (PHQ-9) and the Amphetamine Withdrawal Questionnaire. The severity of cognitive impairment was assessed using the Montreal Cognitive Assessment (MoCA). The MoCA total and subtest scores were used to compare participants with and without psychosis.
Participants included 113 MA users with psychosis and 120 MA users without psychosis. Those with psychosis had significantly lower MoCA total, visuaospatial/executive subtest, and abstract subtest scores than those without psychosis (mean differences=-0.8, -0.3, and -0.2, respectively). The association between MA psychosis and the MoCA total scores was still statistically significant after the adjustment for years in education in an ordinal logistic regression analysis.
MA users with psychosis had poorer overall cognitive function than MA users without psychosis. The cognitive impairment is prominent in the domains of visuospatial/executive function and abstraction.
有精神病的甲基苯丙胺（MA）使用者的认知障碍可能比没有精神病的 MA 使用者更严重。本研究旨在比较有精神病和没有精神病的 MA 使用者的整体认知功能和特定认知领域。
本横断面研究的参与者为入院前一个月内使用 MA 的成年住院患者。最近 MA 的使用情况通过毛发的定量分析来确认。我们使用 Mini 国际神经精神访谈 (MINI) - 加，精神病模块来确认符合纳入标准的参与者中最近是否存在精神病，排除有精神分裂症病史的个体。我们使用患者健康问卷 (PHQ-9) 和安非他酮戒断问卷来评估抑郁和 MA 戒断的严重程度。使用蒙特利尔认知评估 (MoCA) 来评估认知障碍的严重程度。MoCA 总分和子测试分数用于比较有和没有精神病的参与者。
参与者包括 113 名有精神病的 MA 使用者和 120 名没有精神病的 MA 使用者。有精神病的人 MoCA 总分、视觉空间/执行子测试和抽象子测试的得分明显低于没有精神病的人（平均差异分别为-0.8、-0.3 和-0.2）。在有序逻辑回归分析中，对受教育年限进行调整后，MA 精神病与 MoCA 总分之间的关联仍然具有统计学意义。
有精神病的 MA 使用者的整体认知功能比没有精神病的 MA 使用者差。认知障碍在视觉空间/执行功能和抽象领域尤为突出。
