Longitudinal clinical course following pharmacological treatment of methamphetamine psychosis which persists after long-term abstinence
Longitudinal clinical course following pharmacological treatment of methamphetamine psychosis which persists after long-term abstinence
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DOI：
10.1196/annals.1369.012
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发表时间：
2006-01-01
期刊：
影响因子：
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通讯作者：
Akiyama, Kazufumi
中科院分区：
文献类型：
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作者：
Akiyama, Kazufumi
本文调查了32例接受精神科会诊的甲基苯丙胺（METH）精神病女性监禁患者的临床症状及其药物治疗后的纵向临床病程。患者的甲基苯丙胺滥用时间从2年到31年不等。共有31例患者在自我注射METH后5-31个月戒断时发生精神病。这31例患者中有9例出现精神病复发。主要症状有幻听29例，被害妄想29例，思维广播24例，幻视22例，抑郁情绪29例，自杀意念22例。患者表现出精神病和抑郁症状，尽管开始服用抗精神病药和抗抑郁药，但仍持续数月以上。简明精神病评定量表（BPRS）总评分和代表阳性症状和抑郁/焦虑维度的BPRS子量表评分改善所需的时间长度之间存在显著相关性。根据阳性和抑郁/焦虑症状的严重程度，三组患者在药物治疗期间的抑郁症表现出明显差异。锥体外系症状的平均程度与抗精神病药物的平均日剂量和改善BPRS分量表阳性症状维度所需的治疗时间显著相关。这些结果表明，精神病性和情感性症状参与METH精神病的治疗反应和预后。
The present article investigated clinical symptoms and their longitudinal clinical course following pharmacological treatment in 32 female incarcerated patients suffering from methamphetamine (METH) psychosis who were referred to psychiatric consultation. The length of METH-abuse periods of the patients ranged from 2 to 31 years. A total of 31 patients suffered from psychosis at abstinence after 5-31 months from the self-injection of METH. Nine of these 31 patients experienced episodes of psychotic relapse. The following symptoms were observed: auditory hallucination (29 cases), delusion of persecution (29 cases), thought broadcasting (24 cases), visual hallucination (22 cases), depressive mood (29 cases), and suicidal idea (22 cases). Patients exhibited symptoms of psychosis and depression, which persisted for more than several months despite commencement of administration of antipsychotics and antidepressants. There were significant correlations among length of periods required for improvement in total Brief Psychiatric Rating Scale (BPRS) scores, and BPRS subscale scores representing positive symptoms and depression/anxiety dimensions. Three groups of patients, according to severity of positive and depressive/anxiety symptoms, showed apparent differences in prognoses during pharmacological treatment. Average degree of extrapyramidal symptoms significantly correlated with average daily dose of antipsychotics and length-of-treatment period required for improvement in BPRS subscale scores representing positive symptom dimension. These results suggest that both psychotic and affective symptoms are involved in therapeutic response and prognosis of METH psychosis.