Diagnosis and pathogenesis of schizophrenia induced by methamphetamine

简介：甲基苯丙胺（MAP）精神病在我国被认为是与精神分裂症不同的由反复服用MAP引起的精神病。而在欧美，MAP精神病中幻觉和妄想持续的类型被诊断为MAP所致精神分裂症。在欧美和日本的研究者之间存在着争议。1)研究I：通过探索性眼球运动、临床症状评估、精神病期持续时间和精神分裂症候选基因分析，研究MAP是否诱发精神分裂症。在松泽首都医院和22名正常对照组招募9 MAP精神病。本研究采用探索性眼球运动诊断精神分裂症的辅助设备，对精神分裂症与非精神分裂症的鉴别诊断具有75%的敏感性和80%的特异性。如果判别式的D值为负，则判定该主题 关于我们 是精神分裂症，再加上辨别公式，非精神分裂症。9例MAP精神病中6例为D+。D+组的临床症状较D-组严重。D+组的精神病期持续时间较D-组长。神经肽Y的基因，31例进行了reelin、STX检测。各危险等位基因组的D值均高于无危险等位基因组。研究2：对49例在琦玉精神卫生中心登记的MAP精神病患者进行了精神分裂症患者的探索性眼球运动检查。49例MAP精神病中28例为D+，决定为精神分裂症。49例MAP精神病中21例为D-，判定为非精神分裂症。D+组BPRS评分高于D-组。D+组的精神病期持续时间长于D-组。D+组10例患者RSS <7.7。精神病发作期最长，症状最重，GAF值最低。结论研究1、2结果提示MAP精神病患者中存在滥用甲基苯丙胺所致精神分裂症的病例，

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