Profiles of individuals seeking psychiatric help for psychotic symptoms linked to methamphetamine abuse – baseline results from the MAPS (methamphetamine and psychosis study)

Abstract

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.

Predictors of Persistent Psychotic Symptoms in Persons With Methamphetamine Abuse Receiving Psychiatric Treatment

“…It could also be explained by early social isolation caused by disruptive childhood conduct behaviors, leading to a poorer social network that is unlikely to help when someone starts becoming psychotic. This result reflects the sample of individuals seeking psychiatric help in our studyVmost were polysubstance users, living in the margin of society as indicated by low employment and unstable housing (Lecomte et al, 2010)V and for whom many ''antisocial'' behaviors are considered survival behaviors on the streets. Polysubstance abuse and childhood abuse were not more prevalent in either psychosis subgroup but were highly prevalent in the sample as a whole (96% and 56%, respectively), also reflecting the important comorbidities found in our sample.…”

“…Depression is common in individuals with MA dependence without psychosis, with rates varying from 13% (Salo et al, 2011) to as high as 64% (Conway et al, 2006). In the MA users with concurrent psychotic symptoms in this sample, the rates were even higher, with 67% scoring as clinically depressed at baseline (Lecomte et al, 2010). Extensive research documents that psychosis and depression are strongly linked, with depression being a consistent syndrome across the long-term course of schizophrenia (Häfner et al, 2008).…”

“…Contrary to many other studies that focused on single-drug users and excluded individuals with previous psychiatric diagnoses, our sample was more ecologically representative of the individuals who abuse MA and who seek psychiatric help for psychotic symptoms. As such, we cannot infer that the psychotic symptoms were linked to only MA abuse, and a primary psychosis may have been present in some users, although MA was considered the drug of choice for most of our sample (Lecomte et al, 2010).…”

The impact of age, HIV serostatus and seroconversion on methamphetamine use

“…DSM-IV diagnoses of childhood and current Antisocial Personality Disorder (ASPD) and Attention Deficit/Hyperactivity Disorder (ADHD) was assessed using modules of the Diagnostic Interview Schedule (DIS) (23). We assessed for these conditions given that they may affect methamphetamine-using behaviors (24-26). …”

Antisocial personality disorder predicts methamphetamine treatment outcomes in homeless, substance-dependent men who have sex with men

“…ASPD the most common comorbid personality disorder amongst substance abusers (Craig, 2000; Fridell, Hesse, & Billsten, 2006; Verheul, 2001), and people with ASPD have more current and lifetime substance use than people without ASPD (Mueser et al, 2006). Additionally, diagnosis of ASPD is associated with heavier methamphetamine use among users (Lecomte et al, 2010), and among individuals who do seek treatment for their substance abuse, individuals with ASPD are more likely to recidivate into heavy drug use after treatment (Fridell, et al, 2006). …”