McGuire P K, Cope H, Fahy T A
Institute of Psychiatry, London.
Br J Psychiatry. 1994 Sep;165(3):391-5. doi: 10.1192/bjp.165.3.391.
3,4-methylenedioxymethamphetamine (MDMA or 'Ecstasy') has become one of the most widely used illicit substances in the UK. Little is known of the psychiatric morbidity which may be associated with its use. We have examined this association by collecting a series of psychiatric cases in which MDMA use was a prominent feature.
Patients presenting between 1990 and 1992 with psychiatric symptoms which developed in the context of MDMA use (n = 13) were interviewed, and their psychiatric, medical and drug history, sociodemographic background and mental state were examined in detail. The psychopathology of cases with psychosis (n = 8) was assessed with the Present State Examination and compared with that of substance-naïve psychotic controls (n = 40).
Eight patients presented with psychotic syndromes, two experienced visual illusions, hallucinations and palinopsia, one had panic attacks, one suffered from depression, and one described chronic depersonalisation and derealisation. The psychopathology of the patients with psychoses was very similar to that of controls.
Use of MDMA may be associated with a broader spectrum of psychiatric morbidity than heretofore suspected. Cases with psychosis may be clinically similar to psychotic patients with no history of substance use.
3,4-亚甲基二氧甲基苯丙胺（摇头丸或“迷幻药”）已成为英国使用最广泛的非法物质之一。人们对其使用可能相关的精神疾病知之甚少。我们通过收集一系列以使用摇头丸为突出特征的精神病例来研究这种关联。
对1990年至1992年间出现与使用摇头丸相关的精神症状的患者（n = 13）进行访谈，并详细检查他们的精神、医学和用药史、社会人口学背景及精神状态。用现况检查评估有精神病的病例（n = 8）的精神病理学，并与未使用过药物的精神病对照者（n = 40）进行比较。
8名患者出现精神病综合征，2名经历视幻觉、幻觉和形象幻觉，1名有惊恐发作，1名患有抑郁症，1名描述有慢性人格解体和现实解体。患有精神病的患者的精神病理学与对照者非常相似。
使用摇头丸可能与比迄今所怀疑的更广泛的精神疾病相关。患有精神病的病例在临床上可能与无药物使用史的精神病患者相似。
