title: Sex Differences in Methamphetamine Use and Dependence in a Thai Treatment Center.
abstract: Males and females who use methamphetamine (MA) differ in sociodemographics, MA diagnoses, comorbidities, and brain activity. The objective of this study was to investigate sex differences in the characteristics of MA use and dependence in patients at a Thai substance treatment center.
  
  
  
  Demographic, MA use, and diagnostic data for 782 MA users were obtained by using the Semi-Structured Assessment for Drug Dependence and Alcoholism-Thai version. Categorical comparisons of males (n = 413, 53%) and females (n = 369, 47%) were made by chi-square test. Factors significantly differentiating men and women with respect to MA-dependence were identified by logistic regression analysis controlling for demographic, diagnostic, and MA use variables.
  
  
  
  Males admitted to residential drug treatment for MA use had an earlier age of onset for both MA use (17.7 ± 4.1 vs 19.7 ± 6.2 years; t = -5.3, P < 0.001) and dependence (20.4 ± 5.2 vs 22.2 ± 6.4 years; t = -3.6, P < 0.001). Females were more likely than males to be MA-dependent (79% vs 60%; χ1 = 33.7, P < 0.001), and to experience MA withdrawal (65.3% vs 48.9%; χ1 = 21.4, P < 0.001), withdrawal-related hypersomnia (77.2% vs 64.8%; χ1 = 14.5, P < 0.001), fatigue (77.5% vs 70.3%; χ1 = 5.2, P = 0.02), and psychomotor retardation (64.5% vs 57.0%; χ1 = 4.5, P = 0.03). Similarly, females had heavier (eg, largest daily amount [χ1 = 12.4, P < 0.001), more frequent (χ1 = 5.1, P = 0.02]) and greater lifetime episodes of MA use (χ1 = 24.1, P < 0.001) than males. After controlling for such variables by logistic regression, being female remained a significant factor influencing the occurrence of MA-dependence (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.8-4.1, P < 0.001). Shared associated factors (or comorbidities) for MA-dependence in both sexes included nicotine dependence (in males: OR 4.1, 95% CI 2.4-7.0, P < 0.001; and in females: OR 2.4, 95% CI 1.3-4.4, P = 0.007), greater lifetime episodes of MA use (in males: OR 3.5, 95% CI 1.9-6.4, P < 0.001; and in females: OR 5.9, 95% CI 3.1-11.4, P < 0.001), and more frequent use (in males: OR 5.1, 95% CI 2.8-9.1, P < 0.001; and in females: OR 3.6, 95% CI 1.9-6.9, P < 0.001). Comorbid antisocial personality disorder predicted MA-dependence in males only (OR 3.7, 95% CI 1.6-8.6, P = 0.002).
  
  
  
  The current study highlights both common (eg, nicotine dependence and severity of MA use) and sex-specific differences (eg, MA use/dependence characteristics and comorbidities), including sex itself, with respect to MA-dependence in a Thai treatment cohort.
authors.affiliation: Department of Psychiatry (TR, RK), King Chulalongkorn Memorial Hospital; Department of Psychiatry (TR, RK), Faculty of Medicine, Chulalongkorn University, Bangkok; Princess Mother National Institute on Drug Abuse and Treatment (Thanyarak Institute) (VV), Thailand Ministry of Public Health, Pathumthani, Thailand; and Department of Psychiatry (JG, RTM), Yale School of Medicine, New Haven, CT.
authors.forename: Teerayuth
authors.initials: T
authors.lastname: Rungnirundorn
authors.forename: Viroj
authors.initials: V
authors.lastname: Verachai
authors.forename: Joel
authors.initials: J
authors.lastname: Gelernter
authors.forename: Robert T
authors.initials: RT
authors.lastname: Malison
authors.forename: Rasmon
authors.initials: R
authors.lastname: Kalayasiri
mesh_terms: D000328:Adult; D017668:Age of Onset; D019969:Amphetamine-Related Disorders / Q000150:complications / Q000453:epidemiology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D015897:Comorbidity; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology* / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D012114:Residential Treatment; D012737:Sex Factors; D013375:Substance Withdrawal Syndrome / Q000453:epidemiology* / Q000209:etiology; D013785:Thailand / Q000453:epidemiology; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine