Primary and substance-induced psychotic disorders in methamphetamine users

Area of Science:

• Psychiatry
• Addiction Medicine
• Public Health

Background:

• Methamphetamine (MA) use is associated with significant psychiatric morbidity.
• Understanding the prevalence and characteristics of psychotic disorders in MA users is crucial for targeted interventions.
• Needle and syringe programs (NSPs) serve as a key point of contact for individuals with substance use disorders.

Purpose of the Study:

• To investigate the rates of primary psychotic disorders (PPD) and substance-induced psychotic disorders (SIPDs) among MA users accessing NSPs.
• To identify demographic and clinical differences between MA users with PPDs, SIPDs, and no psychotic disorder.
• To examine the relationship between age of MA use onset and the development of SIPDs.

Main Methods:

• A cross-sectional study of 198 MA users reporting recent MA use.
• Psychiatric diagnoses were established using the Psychiatric Research Interview for DSM-IV Substance and Mental Disorders (PRISM-IV).
• Assessment of current psychiatric symptoms and substance use patterns.

Main Results:

• Over half of participants (51%) met criteria for a lifetime psychotic disorder.
• The majority of lifetime psychotic disorders were SIPDs (80%), with a smaller proportion of PPDs (20%).
• A current psychotic disorder was present in 39% of participants, predominantly SIPDs (79%). Younger age of MA use onset was associated with increased risk of lifetime SIPD.

Conclusions:

• MA users accessing NSPs exhibit a high prevalence of psychotic disorders, with SIPDs being the most common diagnosis.
• Early initiation of weekly MA use is a significant risk factor for developing SIPDs.
• Despite similar symptom severity, individuals with PPDs were more likely to have accessed psychiatric treatment compared to those with SIPDs.