Abstract
Methamphetamine dependence may be associated with a range of psychiatric disorders. However, relatively few studies have systematically examined these disorders and possible risk factors. This study used a structured diagnostic interview to assess the prevalence and pattern of co-morbid psychiatric disorders in individuals with methamphetamine dependence; and identified risk factors for this comorbidity. One hundred adult volunteers with a diagnosis of methamphetamine dependence and without co-morbid medical disorders were consecutively recruited from three drug rehabilitation centres. Each volunteer was assessed with a socio-demographic questionnaire and evaluated for psychiatric comorbidity using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). A regression model was used to determine predictors of psychiatric comorbidity. Co-morbid psychiatric disorders were present in 36.0 % of the sample; these included mood disorders (16.0 %), psychotic disorders (13.0 %) and anxiety disorders (7.0 %). One in four of these disorders were assessed as being substance-induced. Independent predictors of psychiatric comorbidity included being male (OR = 10.04, 95 % C.I = 2.07–48.63, p = 0.004), younger (OR = 0.87, 95 % C.I = 0.77–0.99, p = 0.04), and having a previous psychiatric disorder (OR = 18.45, 95 % C.I = 3.81–89.33, p < 0.001). Mood, psychotic, and anxiety disorders are common in individuals with methamphetamine dependence. Risk factors for such comorbidity can be identified. These findings underscore the need for an integrated model of care addressing both substance use disorders and psychiatric comorbidity.
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References
Copeland AL, Sorenson JL (2001) Differences between methamphetamine users and cocaine users in treatment. Drug Alcohol Depend 62:91–95
Dalmau A, Bergman B, Brismar B (1999) Psychotic disorders among inpatients with abuse of cannabis, amphetamine and opiates. Do dopaminergic stimulants facilitate psychiatric illness? Eur Psychiatry 14:366–371
Diehl DJ, Gershon S (1992) The role of dopamine in mood disorders. Compr Psychiatry 33(2):115–120
Farrell M, Marsden J, Ali R, Ling W (2002) Methamphetamine: drug use and psychoses becomes a major public health issue in the Asia Pacific region. Addiction 97:771–772
First MB, Gibbon M, Spitzer RL, Williams JB (2002) Structured clinical interview for DSM-IV-TR axis I disorders. Biometrics Research Department, New York State Psychiatric Institute, 1051 Riverside Drive – Unit 60, New York 10032
Glasner-Edwards S, Marinelli-Casey P, Hillhouse M et al (2009) Depression among methamphetamine users: association with outcomes from the methamphetamine treatment project at 3-year follow-up. J Nerv Ment Disord 197:225–231
Glasner-Edwards S, Mooney LJ, Marinelli-Casey P et al (2010a) Psychopathology in methamphetamine-dependent adults 3 years after treatment. Drug Alcohol Rev 29(1):12–20
Glasner-Edwards S, Mooney LJ, Marinelli-Casey P et al (2010b) Anxiety disorders among methamphetamine dependent adults: association with post-treatment functioning. Am J Addict 19:385–390
Herman AA, Stein DJ, Seedat S, Heeringa SG, Moomal H, Williams DR (2009) The South African Stress and Health (SASH) study: 12-month and lifetime prevalence of common mental disorders. S Afr Med J 99:339–344
Kalechstein AD, Newton TF, Longshore D et al (2000) Psychiatric comorbidity of methamphetamine dependence in a forensic sample. J Neuropsychiatry Clin Neurosci 12:480–484
Katz G, Durst R, Shufman E, Bar-Hamburger R, Grunhaus L (2008) Substance abuse in hospitalized psychiatric patients. Isr Med Assoc J 10:672–675
Lee N, Johns L, Jenkinson R, Johnston J, Connolly K et al (2007) Clinical treatment guidelines for alcohol and drug clinicians. No 14: methamphetamine dependence and treatment. Turning Point Alcohol and Drug Centre Inc., Fitzroy
McGregor C, Srisurapanont M, Jittiwutikarn J, Laobhripatr S et al (2005) The nature, time course and severity of methamphetamine withdrawal. Addiction 100:1320–1329
McKetin R, McLaren J, Lubman DI, Hides L (2006) The prevalence of psychotic symptoms among methamphetamine users. Addiction 101(10):1473–1478
Moos RH, Nichol AC, Moos BS (2002) Risk factors for symptom exacerbation among treated patients with substance use disorders. Addiction 97:75–85
Murphy DL, Goodwin FK, Brodie KH, Bunney WE (1973) L-dopa, dopamine and hypomania. Am J Psychiatry 130:79–82
Parry C, Myers B, Plüddemann A (2004) Drug policy for methamphetamine use urgently needed. S Afr Med J 94:964–965
Plüddemann A, Myers BJ, Parry CDH (2008) Surge in treatment admissions related to methamphetamine use in Cape Town, South Africa: implications for public health. Drug Alcohol Rev 27:185–189
Rounsaville BJ, Anton SF, Carroll K, Budde D et al (1991) Psychiatric diagnoses of treatment-seeking cocaine abusers. Arch Gen Psychiatry 48:43–51
SACENDU (South African Community Epidemiology Network on Drug Use) (2010) Monitoring alcohol and drug abuse treatment admissions in South Africa. SACENDU Report, Phase 27
SACENDU (South African Community Epidemiology Network on Drug Use) (2012) Monitoring alcohol and drug abuse treatment admissions in South Africa. SACENDU Res Brief 15(2):1–15
Salo R, Flower K, Kielstein A, Leamon MH et al (2011) Psychiatric comorbidity in methamphetamine dependence. Psychiatr Res 186(2–3):356–361
Semple SJ, Zians J, Strathdee SA, Patterson TL (2007) Psychosocial and behavioural correlates of depressed mood among female methamphetamine users. J Psychoactive Drugs Supplement 4:353–366
Sheehan DV, Lecrubier Y, Sheehan KH, Janavs J (1997) The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability. Eur Psychiatry 12:232–241
Shoptaw S, Peck J, Reback CJ, Rotheram-Fuller E (2003) Psychiatric and substance dependence co-morbidities, sexually transmitted diseases, and risk behaviours among methamphetamine-dependent gay and bisexual men seeking outpatient drug abuse treatment. J Psychoactive Drugs 35(Suppl 1):161–168
SPSS 20.0 (2012) SPSS Inc., 233 South Wacker Drive, 11th floor, Chicago, IL 606066412
Tost H, Alam T, Meyer-Lindenberg A (2010) Dopamine and psychosis: theory, pathomechanisms and intermediate phenotypes. Neurosci Biobehav Rev 34(5):689–700
UNODC (United Nations Office on Drugs and Crime) (2005) Patterns and trends in amphetamine-type stimulants in East Asia and the Pacific: findings from the 2004 regional ATS questionnaire. UNODC, Regional Centre for East Asia and the Pacific, Bangkok
Vos PJ, Cloete KJ, le Roux A, Kidd M, Jordann GP (2010) A retrospective review of trends and clinical characteristics of methamphetamine-related acute psychiatric admissions in a South African context. Afr J Psychiatry 13:390–394
Weiss RD, Mirin SM, Michael JL, Sollogub AC (1986) Psychopathology in chronic cocaine abusers. Am J Drug Alcohol Abuse 12:17–29
Williams DR, Herman A, Stein DJ, Heeringa SG, Jackson PB et al (2008) Twelve-month mental disorders in South Africa: prevalence, service use and demographic correlates in the population-based South African Stress and Health Study. Psychol Med 38(2):211–220
Zorick T, Nestor L, Miotto K, Sugar C et al (2010) Withdrawal symptoms in abstinent methamphetamine-dependent subjects. Addiction 105:1809–1818
Zweben JE, Cohen JB, Christian D, Galloway GP et al (2004) Psychiatric symptoms in methamphetamine users. Am J Addict 13(2):181–190
Acknowledgements
The authors thank all the volunteers who participated in this study. We equally appreciate the cooperation of the staff of Delft South Matrix clinic, Kensington Treatment Centre and Sultan Bahu Drug Treatment Centre.
Taiwo Akindipe received financial aid from the Methamphetamine Research fund of Department of Psychiatry, University of Cape town.
The Medical Research Council of South Africa funded Don Wilson and Dan Stein.
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Akindipe, T., Wilson, D. & Stein, D.J. Psychiatric disorders in individuals with methamphetamine dependence: prevalence and risk factors. Metab Brain Dis 29, 351–357 (2014). https://doi.org/10.1007/s11011-014-9496-5
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DOI: https://doi.org/10.1007/s11011-014-9496-5