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Published on: January 22, 2016
Clinical Course of Methamphetamine-Induced Psychotic Disorder in a 3-Month Follow-Up
Sakineh Javadian1, Amir Shabani2, Seyed Vahid Shariat3,2
1Department of Psychiatry, Iran University of Medical Sciences, Tehran, Iran.
Objective:
To assess the clinical course of patients with methamphetamine-induced psychotic disorder (MIPD) and any possible predictors of the clinical course in a 3-month follow-up.
Methods:
This prospective cohort study included 50 patients (7 female, 43 male) with MIPD and was performed from September 2014 to October 2015. Patients were assessed during hospitalization and in a follow-up visit 3 months later. Diagnoses were made using interviews based on the Structured Clinical Interview for DSM-IV Axis I Disorders. Positive, negative, manic, and depressive symptoms were the main outcome measures that were assessed using the Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Young Mania Rating Scale, and Hamilton Depression Rating Scale, respectively. Paired t test and regression analysis were used to analyze the data.
Results:
Forty-six patients (92%) were reassessed at follow-up. More than half of the patients relapsed to methamphetamine use, did not adhere to treatment, and were functionally impaired. Positive, negative, and manic symptoms, but not depressive symptoms, improved in abstinent patients (P < .001, P = .001, P < .001, and P = .395, respectively). The best predictor of depressive and negative symptoms at follow-up was the patients' respective baseline scores; but positive and manic symptoms were best predicted by reuse of methamphetamine during follow-up.
Conclusions:
Various symptom categories do not always change in the same direction during the course of the disorder, especially depressive symptoms that do not improve with abstinence but aggravate with frequency of methamphetamine use. Negative symptoms at baseline also seem to have a possible role in prediction of methamphetamine reuse in patients with MIPD. Physicians should be advised to independently address all of the symptom categories of their patients with MIPD at each follow-up visit.
Insights
Methamphetamine-induced psychotic disorder (MIPD) often persists, with many patients relapsing and experiencing functional impairment. Depressive symptoms worsen with continued methamphetamine use, highlighting the need for individualized treatment approaches.
Area of Science:
- Psychiatry
- Neuroscience
- Addiction Medicine
Background:
- Methamphetamine-induced psychotic disorder (MIPD) is a significant clinical challenge.
- Understanding the long-term clinical course and predictors of MIPD is crucial for effective management.
Purpose of the Study:
- To evaluate the 3-month clinical course of patients diagnosed with MIPD.
- To identify predictors of the clinical course in MIPD patients.
Main Methods:
- Prospective cohort study of 50 patients with MIPD.
- Clinical assessments during hospitalization and at a 3-month follow-up.
- Symptom severity measured using standardized scales (e.g., for positive, negative, manic, depressive symptoms).
Main Results:
- 92% of patients were reassessed at follow-up; over half relapsed to methamphetamine use.
- Abstinent patients showed improvement in positive, negative, and manic symptoms, but not depressive symptoms.
- Methamphetamine reuse predicted positive and manic symptoms; baseline scores predicted negative and depressive symptoms.
Conclusions:
- Symptom trajectories in MIPD vary, with depressive symptoms worsening with continued use.
- Baseline negative symptoms may predict relapse.
- Clinicians must address all symptom categories independently at each follow-up for comprehensive MIPD management.
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