title: Clinical features of methamphetamine-induced paranoia and preliminary genetic association with DBH-1021C→T in a Thai treatment cohort.
abstract: OBJECTIVE
  To explore the clinical features of methamphetamine-induced paranoia (MIP) and associations between MIP and a genetic polymorphism in dopamine β-hydroxylase (DBH-1021C→T).
  
  
  METHODS
  Retrospective analysis of clinical presentation and genetic association by χ(2) test and logistic regression analysis.
  
  
  METHODS
  A Thai substance abuse treatment center.
  
  
  METHODS
  A total of 727 methamphetamine-dependent (MD) individuals.
  
  
  METHODS
  Clinical: Semi-Structured Assessment for Drug Dependence and Alcoholism (SSADDA) and the Methamphetamine Experience Questionnaire (MEQ). Genetic: DBH-1021C→T.
  
  
  RESULTS
  Forty per cent of individuals (289 of 727; 39.8%) with MD had MIP. Within-binge latency to MIP onset occurred more rapidly in the most recent compared with initial MIP episode (P = 0.02), despite unchanging intake (P = 0.89). Individuals with MIP were significantly less likely to carry lower (TT/CT) compared with higher (CC) activity genotypes (34.3 versus 43.3%; χ(2) 1  = 5, P = 0.03). DBH effects were confirmed [odds ratio (OR) = 0.7, P = 0.04] after controlling for associated clinical variables (MD severity, OR = 3.4, P < 0.001; antisocial personality disorder, OR = 2.2, P < 0.001; alcohol dependence, OR = 1.4, P = 0.05; and nicotine dependence, OR = 1.4, P = 0.06). TT/CT carriers were more likely to initiate cigarette smoking (OR = 3.9, P = 0.003) and probably less likely to be dependent on alcohol (OR = 0.6, P = 0.05).
  
  
  CONCLUSIONS
  Among methamphetamine-dependent individuals, paranoia appears to occur increasingly rapidly in the course of a session of methamphetamine use. Severity of methamphetamine dependence and antisocial personality disorder predicts methamphetamine-induced paranoia. The genetic polymorphism in dopamine β-hydroxylase is associated with methamphetamine-induced paranoia and influences smoking initiation.
authors: Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors: Rasmon
authors: R
authors: Kalayasiri
authors: Viroj
authors: V
authors: Verachai
authors: Joel
authors: J
authors: Gelernter
authors: Apiwat
authors: A
authors: Mutirangura
authors: Robert T
authors: RT
authors: Malison
mesh_terms: D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000235:genetics* / Q000534:rehabilitation; D004299:Dopamine beta-Hydroxylase / Q000235:genetics*; D005260:Female; D056726:Genetic Association Studies; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D005838:Genotype; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000633:toxicity*; D008875:Middle Aged; D010259:Paranoid Disorders / Q000139:chemically induced* / Q000235:genetics*; D012150:Polymorphism, Restriction Fragment Length / Q000235:genetics*; D011605:Psychoses, Substance-Induced / Q000235:genetics* / Q000534:rehabilitation; D013785:Thailand; D055815:Young Adult
chemical_list: D008694:Methamphetamine; D004299:Dopamine beta-Hydroxylase
keywords: DBH; gene; methamphetamine; paranoia; psychosis; smoking