HIV Insight: The Profile of Psychiatric Symptoms Exacerbated by Methamphetamine Use

HIGHLIGHTS

Methamphetamine use was associated with a dose-related exacerbation of positive psychotic, affective and psychomotor symptoms.
We found evidence of a latent symptom profile, comprised of positive psychotic and affective symptoms, that aligned with a diagnosis of substance-induced psychosis.
Methamphetamine use did not significantly increase the severity of negative symptoms of schizophrenia.

BACKGROUND:

Methamphetamine use can produce symptoms almost indistinguishable from schizophrenia. Distinguishing between the two conditions has been hampered by the lack of a validated symptom profile for methamphetamine-induced psychiatric symptoms. We use data from a longitudinal cohort study to examine the profile of psychiatric symptoms that are acutely exacerbated by methamphetamine use.

METHODS:

164 methamphetamine users, who did not meet DSM-IV criteria for a lifetime primary psychotic disorder, were followed monthly for one year to assess the relationship between days of methamphetamine use and symptom severity on the 24-item Brief Psychiatric Rating Scale. Exacerbation of psychiatric symptoms with methamphetamine use was quantified using random coefficient models. The dimensions of symptom exacerbation were examined using principal axis factoring and a latent profile analysis.

RESULTS:

Symptoms exacerbated by methamphetamine loaded on three factors: positive psychotic symptoms (suspiciousness, unusual thought content, hallucinations, bizarre behavior); affective symptoms (depression, suicidality, guilt, hostility, somatic concern, self-neglect); and psychomotor symptoms (tension, excitement, distractibility, motor hyperactivity). Methamphetamine use did not significantly increase negative symptoms. Vulnerability to positive psychotic and affective symptom exacerbation was shared by 28% of participants, and this vulnerability aligned with a past year DSM-IV diagnosis of substance-induced psychosis (38% vs. 22%, χ²_(df1)=3.66, p=0.056).

CONCLUSION:

Methamphetamine use produced a symptom profile comprised of positive psychotic and affective symptoms, which aligned with a diagnosis of substance-induced psychosis, with no evidence of a negative syndrome.

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By: McKetin R1, Dawe S2, Burns RA3, Hides L4, Kavanagh DJ4, Teesson M5, McD Young R4, Voce A3, Saunders JB6.

1National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australia. Electronic address: rebecca.mcketin@curtin.edu.au.
2School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia.
3Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australia.
4Centre for Youth Substance Abuse Research, School of Psychology and Counselling, and Institute of Health & Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
5National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia.
6Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Queensland, Australia; Disciplines of Psychiatry and Addiction Medicine, Faculty of Medicine, University of Sydney, New South Wales, Australia.
Drug Alcohol Depend. 2016 Jan 30. pii: S0376-8716(16)00046-6. doi: 10.1016/j.drugalcdep.2016.01.018