[The clinical course of chronic methamphetamine psychoses]

3 cases with chronic methamphetamine psychoses (MAP-P) were studied from the clinical psychiatric point of view and discussed: 1.) The average time of occurrence of psychotic symptoms in our 3 cases after beginning of MAP abuse was two or three years. 2.) Although the psychotic states (often schizophrenia-like) were stable for a short time, the symptoms recurred promptly after reinjection of a small amount of MAP, unspecific stress or drinking sake (flashback phenomenon). The recurrence may happen even after several years. 3.) In cases of chronic MAP-P disturbances of consciousness are rare. Chronic process of MAP-P cases may show acute transient disturbances of consciousness (flashback phenomenon). 4.) The change of affects and behaviour ranges between irritable and indifferent attitudes. While there are close connections between the disturbance of feeling and change of personality (Wesensänderung), it is very difficult to decide whether premorbid character traits are dominant or there is a change of personality or emotional disturbance. 5.) About acute psychic symptoms which are responsible for recurrence of MAP-P, MAP-abusers make the experience that their intimate personal affairs are overlooked and become public (uncovered defensive experiences). In chronic cases of MAP-P we often meet patients with hypertrophic self-feeling or delusion of grandeur predominant in the symptomatology. 6.) In our cases sensations were amalgamated into each other and there were hallucinatory experiences without clear division between them. 7.) In chronic cases the auditory hallucinations criticized or censured the patients for their behaviour. Thought echoing (Gedankenlautwerden) was found. We found signs of mind reading (Gedankenausbreitung).