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The objective of this study was to identify predictors of sustained psychotic symptoms after methamphetamine (MA) abuse during the course of 6 months from patterns of MA and other substance use, depressive symptoms, family history of psychosis, antisocial personality disorder, and trauma history. A total of 295 individuals with MA abuse and psychotic symptoms seeking psychiatric services were assessed at baseline and then monthly on symptoms and substance use for 6 months. Trajectory analyses revealed two trajectories of the individuals with positive symptoms, with one group presenting with persistent psychotic symptoms (30% of the sample). Those with persistent psychosis were significantly older, had more severe psychotic symptoms, misused MA for more years, had more antisocial personality traits, and had more sustained depressive symptoms. The strongest predictors of belonging to the persistent psychosis group, via logistic regressions, were more severe psychotic symptoms, longer use of MA, and sustained depressive symptoms. Our results highlight the important comorbidities, especially regarding depressive symptoms and persistent psychosis, in individuals seeking psychiatric help after MA abuse. This study also highlights the importance of identifying people with persistent psychosis within MA users to facilitate rapid and effective treatment of co-occurring psychotic disorder.

Background: Methamphetamine psychosis (MAP) is commonly encountered in psychiatric emergency rooms (ERs) in North America, and little is known regarding the specific needs of this clientele. Aims: This study aimed at describing the psychiatric and socioeconomic profiles of individuals with co-occurring methamphetamine abuse and psychosis profiles. Method: Two hundred and ninety-five (295) individuals needing psychiatric help for MAP were assessed regarding their socioeconomic situation, their substance abuse patterns, family histories, past psychiatric diagnoses, childhood trauma, and co-occurring disorders of depression, PTSD and antisocial personality disorder. Results: Eighty-seven percent had a family history of mental illness or substance abuse and close to 70% had a previous diagnosis of a mental illness, although only 21% of a psychotic disorder. Antisocial personality disorder, depression, and post-traumatic stress disorder were highly prevalent in our sample. Cluster analyses on methamphetamine (MA) use revealed two profiles: high users (daily, high quantities and inject MA) and low users. No significant differences between the profiles were found for symptoms, but high users were more likely to have antisocial personality disorder and to have experienced childhood abuse than the low users. Conclusion: The high prevalence of comorbidities in this sample of individuals with MAP suggests that treatments address multiple targets and not only substance misuse and severe mental illness.

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