Psychopathology in methamphetamine‐dependent adults 3 years after treatment

Abstract

Introduction and Aims Although psychiatric symptoms are frequently obser ved in methamphetamine (MA) users, little is known about the prevalence of psychiatric disorders in MA-dependent individuals. This is the first study to examine the association of psychiatric disorders with substance use and psychosocial functioning in a large sample of MA users 3 years after treatment. We predicted that psychiatric diagnoses and severity would be associated with substance use and poorer overall functioning over the 3 year post-treatment course. Design and Methods Participants (N = 526) received psychosocial treatment for MA dependence as part of the Methamphetamine Treatment Project and were reassessed for psychosocial functioning and substance use at a mean of 3 years after treatment initiation. DSM-IV psychiatric diagnoses were assessed at follow-up using the Mini-International Neuropsychiatric Inter view. Psychosocial functioning was assessed using the Addiction Severity Index. Results Overall, 48.1% of the sample met criteria for a current or past psychiatric disorder other than a substance use disorder. Consistent with prior reports from clinical samples of cocaine users, this rate was largely accounted for by mood disorders, anxiety disorders and antisocial personality. Those with an Axis I psychiatric disorder evidenced increased MA use and greater functional impairment over time relative to those without a psychiatric disorder. Discussion and Conclusions This initial investigation of psychiatric diagnoses in MA users after treatment indicates elevated rates of Axis I and II disorders in this population and underscores the need for integrated psychiatric assessment and inter vention in drug abuse treatment settings. [Glasner-Edwards S, Mooney LJ, Marinelli-Casey P, Hillhouse M, Ang A, Rawson RA, The Methamphetamine Treatment Project Corporate Authors. Psychopathology in methamphetamine-dependent adults 3 years after treatment.

Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6: analysis of three-year follow-up data and predictive validity

“…Our results are not in line with previous findings suggesting that mental health problems and problematic substance use among dually diagnosed individuals either in psychosocial treatment or in no treatment remain stable or increased over time (Glasner-Edwards et al, 2010;Margolese et al, 2006;Moss et al, 2010). Rather, the results seem to indicate that natural recovery does occur.…”

Predictors of depression outcomes among abstinent methamphetamine-dependent individuals exposed to an exercise intervention

“…5 In individuals with substance use disorders, concomitant depression decreases the likelihood of achieving abstinence and predicts more frequent relapses both during and after treatment. 6,7 Studies have shown that among MA-dependent individuals, depressive symptoms tend to be most prominent in early recovery; the risk of relapse is therefore also thought to be particularly high in early recovery.…”

Stimulant use disorders and psychosis: prevalence, correlates and impacts

“…However the requirements of a treatment trial limit the extent to which the MTP can be used to understand the prevalence or impact of stimulant use disorders in people with serious mental health disorders such as psychoses. Follow up studies of the MTP cohort showed that nearly half of those followed up had significant psychopathology, including significant rates of depression, anxiety, and antisocial personality disorder (Glasner-Edwards et al, 2010b;Glasner-Edwards et al, 2008a;Glasner-Edwards et al, 2009;Glasner-Edwards et al, 2010a). Significant rates of psychotic experiences were also described: at three-year follow up 4.9% had a current psychotic disorder (Glasner-Edwards et al, 2010b) and 13% met criteria for a past psychotic disorder (Glasner-Edwards et al, 2008b).…”

“…Follow up studies of the MTP cohort showed that nearly half of those followed up had significant psychopathology, including significant rates of depression, anxiety, and antisocial personality disorder (Glasner-Edwards et al, 2010b;Glasner-Edwards et al, 2008a;Glasner-Edwards et al, 2009;Glasner-Edwards et al, 2010a). Significant rates of psychotic experiences were also described: at three-year follow up 4.9% had a current psychotic disorder (Glasner-Edwards et al, 2010b) and 13% met criteria for a past psychotic disorder (Glasner-Edwards et al, 2008b). However, the MTP excluded participants initially meeting DSM-IV criteria for dependence on any other substance (such as alcohol or cannabis) or having other psychiatric conditions requiring immediate care or precluding a focus on treatment of methamphetamine dependence.…”

“…First, some studies have examined clinical samples of people seeking treatment for specific problems of amphetamine dependence. This includes a group of studies from the UCLA Methamphetamine Treatment Project (MTP ), a randomised trial of clinical interventions for methamphetamine dependence conducted over 8 sites in California and other US states (Glasner-Edwards et al, 2010a;Glasner-Edwards et al, 2008b;Rawson et al, 2004;Glasner-Edwards et al, 2010b;Glasner-Edwards et al, 2009;Gonzales et al, 2011;Glasner-Edwards et al, 2008a;Zweben et al, 2004). The MTP recruited more than 1000 people meeting DSM-IV criteria for methamphetamine dependence (Zweben et al, 2004), and is the largest trial of clinical intervention for this condition.…”