First-Rank Symptoms in Methamphetamine Psychosis and Schizophrenia

Abstract

Background: Methamphetamine psychosis (MAP) symptomatology has been described as indistinguishable from that of schizophrenia (SZ), yet research comparing these two disorders on specific psychotic symptoms such as schneiderian first-rank symptoms (FRS) is lacking. We aimed to determine and compare the occurrence and associations of FRS in patients diagnosed with MAP and with SZ. Sampling and Method: Data from SCID-I interviews performed on patients with either a diagnosis of SZ or MAP were compared. We calculated the prevalence of different FRS between MAP and SZ patients and used logistic regression to assess the association between FRS and diagnosis. Results: 102 patients were included in the study (MAP = 33, SZ = 69). Thought broadcasting occurred significantly more often in SZ (42%) than in MAP (24.2%) patients (adjusted OR = 3.02; 95% CI: 1.12-8.15; p = 0.028), while auditory hallucinations (voices conversing) were significantly higher in MAP (48.5%) than in SZ (20.3%) patients (adjusted OR = 0.27; 95% CI: 0.10-0.66; p = 0.004). However, there was no significant difference in the occurrence of one or more FRS in MAP and SZ, with most FRS showing overlap. Conclusions: We found that first-rank auditory hallucinations were more prevalent in MAP, whereas first-rank delusions of thought broadcasting were more prevalent in SZ. However, there was a substantial overlap in MAP and SZ for most FRS. This is consistent with the finding that FRS may have limited diagnostic specificity and that there is significant overlap in the symptoms of MAP and SZ. Future research into the neurobiology of delusions and hallucinations needs to take FRS into account.

Changes in Gray Matter Density, Regional Homogeneity, and Functional Connectivity in Methamphetamine-Associated Psychosis: A Resting-State Functional Magnetic Resonance Imaging (fMRI) Study

“…We found increased GMD in B-AC, B-MSFG, and L-opr-IFG of the MAP group, while decreased GMD was found in the L-opr-IFG and R-MFG of the SCZ group. Although the symptoms of the 2 diseases are quite similar [ 13 ], it is interesting that their GMD exhibited opposite trends in the present study. Our result is contradictory to studies that investigated the role of gray matter volumetric alternations in psychiatric disorders [ 2 , 14 ].…”

Differences in the amplitude of low‐frequency fluctuation between methamphetamine and heroin use disorder individuals: A resting‐state fMRI study

“…Our findings show a similar pattern of decreased activity in the left frontal middle gyrus and increased activity in the right inferior temporal gyrus in the MAUD group compared to the HUD group. Auditory hallucination is a common symptom of MAP, with a higher frequency of auditory hallucination of up to 48.5% found in acute MAP patients (Shelly et al., 2016). Although we did not perform a specialized auditory hallucination assessment, we found that individuals with MAUD have a higher frequency and degree from which to choose options about auditory hallucinations in the SCL‐90.…”

The prevalence and clinical correlates of substance use disorders in patients with psychotic disorders from an Upper-Middle-Income Country

“…Participants from the first cross-sectional study; “Presentation and risk factor in the psychobiology of psychosis” ( N = 86) were selected randomly from inpatients listed as attending pre-discharge inpatients wards. 44 Inclusion criteria included a diagnosis of a psychotic disorder (schizophrenia, schizophreniform disorder, schizoaffective disorder, brief psychotic disorder, substance induced psychotic disorder, psychotic disorder not-otherwise specified) or bipolar I disorder with psychotic features. Diagnoses were based on DSM-IV-TR criteria (diagnostic codes 295.xx, 295.40, 295.70, 298.8, 291.xx, 292.xx, 298.9, 296.xx).…”