Diagnosis and pathogenesis of schizophrenia induced by methamphetamine

导言：在我国，甲基苯丙胺(MAP)精神病被认为是由于反复服用MAP而引起的，这与精神分裂症是不同的。另一方面，在欧美，在MAP中出现幻觉和妄想症延续的类型被诊断为MAP所致精神分裂症。欧美和日本的调查人员之间存在争议。1)研究一：采用探索性眼球运动、临床症状评估、精神病期长短、精神分裂症候选基因分析等方法调查MAP是否诱发精神分裂症。研究对象为松泽市立医院9例MAP精神病患者和22例正常对照。本研究使用探索性眼动诊断精神分裂症的辅助仪器，对精神分裂症与非精神分裂症的鉴别诊断灵敏度为75%，特异度为80%。如果判别公式的D值为负，则确定对象为…更多的是精神分裂症，歧视公式加上，非精神分裂症。9例MAP精神病患者中有6例为D+。D+组临床症状较D-组严重。D+组的精神病期明显长于D-组。对31例患者进行神经肽Y、reelin、stx基因分析。各危险等位基因携带者的D值均高于无危险等位基因者。研究二：使用探索性眼球运动的精神分裂症辨别器，对在崎玉精神卫生中心记录的49例MAP精神病患者进行检查。49名MAP精神病患者中有28名为D+，并决定患有精神分裂症。49名MAP精神病患者中有21名是D-，并决定不是精神分裂症。D+组BPRS值高于D-组。D+组的精神病期明显长于D-组。D+组中RSS<7.7者10例。精神病程最长，症状最重，GAF值较低。结论研究1和研究2的结果提示，MAP精神病患者中滥用甲基苯丙胺所致精神分裂症患者较少

Introduction : In our country methamphetamine (MAP) psychoses are thought to be caused by repetitive taking in MAP, which are different from schizophrenia. On the other hand, in Europe and America, the type with continuation of hallucination and delusion in the MAP psychoses are diagnosed as schizophrenia induced by MAP. There is a controversy between investigators of Europe and America, and Japan. 1) Study I : It was investigated if there is schizophrenia induced by MAP using exploratory eye movements, evaluation of clinical symptoms, duration of psychotic period, and analysis of schizophrenia candidate genes. Nine MAP psychoses in the Matsuzawa Metropolitan Hospital and 22 normal controls were recruited. The helpful equipment for diagnosis of schizophrenia using exploratory eye movements was used to this study which can discriminated schizophrenia from non-schizophrenia with 75% sensitivity and 80% specificity. If D value of the discrimination formula is minus the subject is decided … More to be schizophrenia, the discrimination formula plus, non-schizophrenia. Six of 9 MAP psychoses was D+. The clinical symptoms was worse in the D+group than in the D-group. The duration of psychotic period was longer in the D+group than the D-group. Genes of neuropeptide Y., reelin, STX were analyzed in 31 cases. The group with each risk alleles was showed higher in D value than the group without risk alleles. Study 2 : Forty nine MAP psychoses, which had recorded in Saitama Mental Health Center, were examined using schizophrenia discriminator with exploratory eye movements. Twenty eight of 49 MAP psychoses were D+ and decided to schizophrenia. Twenty one of 49 MAP psychoses were D- and decided to non-schizophrenia. The value of BPRS was higher in the D+group than in the D-group. The duration of psychotic period was longer in the D+group than in the D-group. Patients with RSS of less than 7 seven were 10 cases in the D+group. They had longest psychotic period, most sever symptoms and lower GAF value. Conclusion Results of study 1 and 2 suggested that there are patients with schizophrenia induced by overuse of methamphetamine in the MAP psychoses Less