Pre-morbid characteristics and co-morbidity of methamphetamine users with and without psychosis
Pre-morbid characteristics and co-morbidity of methamphetamine users with and without psychosis
复制标题
DOI：
10.1017/s0033291703008353
复制
发表时间：
2003-11-01
影响因子：
6.9
通讯作者：
Murray, RM
中科院分区：
文献类型：
--
作者：
Chen, CK;Lin, SK;Murray, RM
背景长期使用甲基苯丙胺（MAMP）可导致精神病，但目前尚不清楚为什么有些人会出现精神病症状，而另一些人则长期定期使用MAMP并保持毫发无损。我们着手描述MAMP使用者的特征，并研究病前人格、病前社会功能和其他精神障碍与MAMP精神病的关系。研究对象为台北市某精神病院及某看守所的445名安非他命使用者，并以遗传学诊断访谈法进行评估。他们的父母进行了采访与发病前分裂样和分裂型特质（PSST）和发病前社会适应（PSA）的时间表。比较有和无MAMP精神病终身诊断的MAMP使用者的病前特征和精神病共病。患有精神病的MAMP使用者呈现出模仿精神分裂症阳性症状的临床表现：85%有幻听; 71%有迫害妄想; 63%有参照妄想。与非精神病患者相比，这些MAMP使用者首次使用MAMP的年龄更小，使用MAMP的量更大，平均PSST评分显著更高，重度抑郁症、酒精依赖和反社会人格障碍的发生率更高。早期和大量使用MAMP与精神病风险增加相关。我们的数据也符合这样的观点，即发病前的类神经质/类神经质人格倾向于MAMP使用者发展为精神病，并且人格脆弱性越大，精神病持续的时间越长。
Background. The long-term use of methamphetamine (MAMP) can result in psychosis but it is not clear why some individuals develop psychotic symptoms, while others use MAMP regularly over long periods and remain unscathed. We set out to characterize MAMP users and to examine the relationship of pre-morbid personality, pre-morbid social function and other psychiatric disorders to MAMP psychosis.Method. Four hundred and forty-five amphetamine users were recruited from a psychiatric hospital and a detention centre in Taipei, and were assessed with the Diagnostic Interview for Genetic Studies (DIGS). Their parents were interviewed with the Premorbid Schizoid and Schizotypal Traits (PSST) and the Premorbid Social Adjustment (PSA) schedules. Pre-morbid characteristics and psychiatric co-morbidity were compared between the MAMP users with a lifetime diagnosis of MAMP psychosis and those without.Results. The MAMP users with psychosis presented a clinical picture which mimicked the positive symptoms of schizophrenia: 85% had auditory hallucinations; 71% persecutory delusions; 63% delusions of reference. Compared with their non-psychotic counterparts, these MAMP users were younger at first MAMP use, used larger amounts of MAMP, had a significantly higher mean PSST score, and higher rates of major depressive disorder, alcohol dependence and antisocial personality disorder.Conclusions. Earlier and larger use of MAMP was associated with increased risk of psychosis. Our data are also compatible with the view that pre-morbid schizoid/schizotypal personality predisposes MAMP users to develop psychosis, and that the greater the personality vulnerability, the longer the psychosis will persist.