Patients with methamphetamine psychosis admitted to a psychiatric hospital in Japan

Abstract

To examine the clinical characteristics of methamphetamine (MAP) psychosis in Japan, we evaluated 104 patients with MAP psychosis (80 men and 24 women) admitted to the closed psychiatric units of Tokyo Metropolitan Matsuzawa Hospital between 1988 and 1991. There has recently been a steep increase in the number of admissions for MAP psychosis, reflecting the growth of the epidemic of MAP abuse in Japan. Although more than half of the patients were discharged within one month, 16 patients were hospitalized for more than 3 months. Most of the patients showed paranoid psychotic state similar to schizophrenia, consistent with previous reports. Despite the abstinence from MAP and antipsychotic medication, psychotic symptoms tended to persist in some of the patients. The etiological role of MAP psychosis in the development of long-lasting psychotic state was discussed.

The profile of psychiatric symptoms exacerbated by methamphetamine use

“…These findings reinforce the DSM 5 substance-induced psychosis criteria of hallucinations and delusions (American Psychiatric Association, 2013), and they are consistent with past research in showing that delusions in methamphetamine psychosis are primarily persecutory in nature (Akiyama, 2006;Chen et al, 2003;Dore and Sweeting, 2006;Harris and Batki, 2000;Iwanami et al, 1994;Srisurapanont et al, 2003). The affective accompaniment to this psychosis (dominated by depression, suicidality, hostility and self-neglect) is not recognized in the diagnostic criteria for substance-induced psychosis (American Psychiatric Association, 2013) but our results are consistent with Srisurapanont et al (2011), who also found an affective symptom dimension, and other research showing elevated levels of depression among people diagnosed with methamphetamine psychosis relative to other users of the drug (Chen et al, 2003;Lecomte et al, 2013).…”

“…Consistent with these criteria, most studies have noted the prominence of hallucinations and delusions, which are usually persecutory in nature (Akiyama, 2006;Angrist et al, 1974;Angrist and Gershon, 1970;Chen et al, 2003;Connell, 1966;Dore and Sweeting, 2006;Harris and Batki, 2000;Iwanami et al, 1994;Janowsky and Risch, 1979;Mahoney et al, 2008;Medhus et al, 2013;Srisurapanont et al, 2003). However, they fail to distinguish between methamphetamine-induced psychosis and schizophrenia on the remaining symptoms of schizophrenia (Hides et al, 2015;Medhus et al, 2013;Srisurapanont et al, 2003Srisurapanont et al, , 2011, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior, and negative symptoms (e.g., diminished emotional expression or avolition; American Psychiatric Association, 2013).…”

“…However, they fail to distinguish between methamphetamine-induced psychosis and schizophrenia on the remaining symptoms of schizophrenia (Hides et al, 2015;Medhus et al, 2013;Srisurapanont et al, 2003Srisurapanont et al, , 2011, disorganized speech (e.g., frequent derailment or incoherence), grossly disorganized or catatonic behavior, and negative symptoms (e.g., diminished emotional expression or avolition; American Psychiatric Association, 2013). Many studies report affective symptoms in methamphetamine-induced psychosis, including depressed mood (Akiyama, 2006;Hides et al, 2015;Iwanami et al, 1994), suicidal ideation (Akiyama, 2006), mania (Hides et al, 2015) and hostility (Akiyama et al, 2011;McKetin et al, 2008), but it is not clear whether these are core symptoms in methamphetamine psychosis or contemporaneous phenomena. Srisurapanont et al (2011) found evidence of a positive syndrome (delusions, hallucinations and incoherent speech), a negative syndrome (poverty of speech, psychomotor retardation and flattened/incongruous affect) and an anxiety/depression syndrome (Srisurapanont et al, 2011), similar to that seen in people diagnosed with schizophrenia (Srisurapanont et al, 2011).…”

Metabolite Alterations in Basal Ganglia Associated with Methamphetamine-related Psychiatric Symptoms A Proton MRS Study

“…For example, chronic methamphetamine users show psychosis and anxiety following intoxication and withdrawal (Seivewright 2000). In addition, in some individuals, these psychiatric states may be present for months or even years after cessation of methamphetamine use (Sato et al 1992;Iwanami et al 1994;Buffenstein et al 1999;Iyo et al 1999). Although there are growing clinical observations on the neurotoxicology of chronic methamphetamine use, the mechanism by which the residual psychiatric problems arise from chronic methamphetamine use remains unknown.…”

Delusional Problems and Mood Instability in Acute Psychotic Patients Dependent to Methamphetamine named Shishe among Iranian Population

“…In the previous researches, legal and social consequences of methamphetamines have been previously well documented, however its psychological deficits particularly among eastern countries remain neglected. On the other hand, although neurological side effects of these drugs using both animal and human models have been recently received attention, psychological components impairments have been already questioned [10][11][12]. Some studies revealed that exposure to methamphetamines in higher doses plays a crucial role in creating, accelerating and aggravating psychotic symptoms like aggression, depression, hallucination and paranoia in patients with psychosis [13].…”