Clinical features, course and treatment of methamphetamine-induced psychosis in psychiatric inpatients

Abstract

BackgroundOver the past few years, methamphetamine-induced psychosis (MIP) has increased in Iran, accounting for a significant percentage of psychiatry hospital admissions. The present study was conducted with an aim to investigate clinical symptoms, and course and treatment methods of MIP inpatients in Shafa Psychiatry Hospital in northern Iran.MethodsParticipants were 152 MIP inpatients. Brief Psychiatric Rating Scale (BPRS) subscales of suspiciousness, unusual thought content; hallucinations and hostility were used to measure psychiatric symptoms. Data regarding suicide and homicide and violence were also obtained through interviews with the inpatients and their family. Based on their lengths of recovery time, the inpatients were categorized into 3 clinical groups. These inpatients received their usual treatments and were monitored for their psychiatric symptoms and clinical course of illness. The data were analyzed by descriptive statistics.ResultsThe most frequent psychiatric symptoms were violence (75.6 %), intimate partner violence (61.2 %), delusions of persecution (85.5 %), delusions of reference (38.5 %), delusions of grandiosity (32.9 %), delusions of infidelity (30.2 %), auditory hallucinations (51.3 %), visual hallucinations (18.4 %), suicidal thoughts (14.5 %), homicidal thoughts (3.9 %), suicide attempts (10.5 %) and homicide attempts (0.7 %). Recovery from psychotic symptoms in 31.6 % of the inpatients took more than one month. 46.1% of the inpatients were treated with Risperidone and 37.5 % with Olanzapine. Persecutory delusion and auditory hallucination were the most frequent persistent psychotic symptoms. 20.8 % of the inpatients with duration of psychosis more than one month were treated with electroconvulsive therapy (ECT) along with antipsychotics.ConclusionAll forms of violence are highly frequent in MIP inpatients. Our finding agrees with many other studies suggesting that recovery from MIP can take more than a month. Initial promising findings were found regarding the efficacy of Electroconvulsive therapy in MIP patients.

Methamphetamine-induced psychosis: Clinical features, treatment modalities and outcomes

“…Similar to other studies on methamphetamine-induced psychosis, participants in this study were mostly male, single and unemployed. 8 , 14 , 24 Interestingly, most had obtained some level of secondary schooling, which differs from other international findings where the majority of participants had either limited schooling or were illiterate. 8 , 14 Similar to international findings, high rates of concomitant use of other substances was recorded.…”

“… 8 , 14 , 24 Interestingly, most had obtained some level of secondary schooling, which differs from other international findings where the majority of participants had either limited schooling or were illiterate. 8 , 14 Similar to international findings, high rates of concomitant use of other substances was recorded. 8 , 14 The most common patterns of use were either daily or weekend-binge patterns.…”

“… 8 , 14 Similar to international findings, high rates of concomitant use of other substances was recorded. 8 , 14 The most common patterns of use were either daily or weekend-binge patterns. All participants had used methamphetamine via inhalation.…”

“…Although substantial literature has been accumulated from other countries, 8 , 11 , 14 no South African study has specifically described the clinical features, treatment or outcomes of patients admitted to acute psychiatric services with methamphetamine-induced psychosis. The examination of the clinical features of substance-induced psychotic disorders in the acute setting is important as it can potentially identify differentiating clinical features independent from the effects of illness course and chronic treatment.…”

Are Dose and Duration of Methamphetamine Abuse Associated with Psychotic Symptoms?

“…Regarding the high prevalence rate of amphetamine abuse in Iran especially among youth population and distinguishing the risk factors of methamphetamine associated psychosis while reducing harmful consequences (18,19), we aimed to investigate the relationship between the rate and severity of methamphetamine associated psychotic symptoms with duration and dose of methamphetamine in Iranian abusers.…”