Pre-morbid characteristics and co-morbidity of methamphetamine users with and without psychosis.
BACKGROUND
The long-term use of methamphetamine (MAMP) can result in psychosis but it is not clear why some individuals develop psychotic symptoms, while others use MAMP regularly over long periods and remain unscathed. We set out to characterize MAMP users and to examine the relationship of pre-morbid personality, pre-morbid social function and other psychiatric disorders to MAMP psychosis.


METHODS
Four hundred and forty-five amphetamine users were recruited from a psychiatric hospital and a detention centre in Taipei, and were assessed with the Diagnostic Interview for Genetic Studies (DIGS). Their parents were interviewed with the Premorbid Schizoid and Schizotypal Traits (PSST) and the Premorbid Social Adjustment (PSA) schedules. Pre-morbid characteristics and psychiatric co-morbidity were compared between the MAMP users with a lifetime diagnosis of MAMP psychosis and those without.


RESULTS
The MAMP users with psychosis presented a clinical picture which mimicked the positive symptoms of schizophrenia: 85% had auditory hallucinations; 71% persecutory delusions; 63% delusions of reference. Compared with their non-psychotic counterparts, these MAMP users were younger at first MAMP use, used larger amounts of MAMP, had a significantly higher mean PSST score, and higher rates of major depressive disorder, alcohol dependence and antisocial personality disorder.


CONCLUSIONS
Earlier and larger use of MAMP was associated with increased risk of psychosis. Our data are also compatible with the view that pre-morbid schizoid/schizotypal personality predisposes MAMP users to develop psychosis, and that the greater the personality vulnerability, the longer the psychosis will persist.
Chen
C K
CK
Department of Psychiatry, Chang Gung Memorial Hospital, Taiwan.
Lin
S K
SK
Sham
P C
PC
Ball
D
D
Loh
E W
EW
Hsiao
C C
CC
Chiang
Y L
YL
Ree
S C
SC
Lee
C H
CH
Murray
R M
RM
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D019969:Amphetamine-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015984:Causality; D000697:Central Nervous System Stimulants / Q000633:toxicity; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004198:Disease Susceptibility / Q000523:psychology; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000633:toxicity; D010552:Personality Assessment; D011330:Prisons; D011569:Psychiatric Status Rating Scales; D011605:Psychoses, Substance-Induced / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D012557:Schizoid Personality Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D012559:Schizophrenia / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D013624:Taiwan
D000697:Central Nervous System Stimulants; D008694:Methamphetamine