Chronic Methamphetamine Psychosis after Long-Term Abstinence in Japanese Incarcerated Patients

Abstract

Eighty female incarcerated subjects who maintained a long-term methamphetamine (Meth) abstinence, but manifested psychosis, were examined for correlations among symptom severity premorbid diathesis, recurrence, and adverse effects of pharmacotherapy. Baseline symptoms were assessed with a 24-item version of the Brief Psychiatric Rating Scale (BPRS) prior to, and 2 weeks after, the commencement of pharmacotherapy. Fifty-four subjects who had abused volatile solvents in their teenage years commenced Meth abuse at a significantly lower age than the rest of the subjects (18.4 vs. 22.5 years old, p < .001). Twenty-nine patients who had attempted suicide in their lives suffered from premorbid psychiatric disorders significantly more often than those who had never attempted suicide (odds ratio = 8.6, 95% confidence interval [CI]= 2.6-27.8, p < .001). Twenty subjects who manifested spontaneous recurrence had a significantly longer abstinence period (17.5 vs. 12.1 months, p = .049), but suffered from premorbid psychiatric disorders significantly less often (odds ratio = .12, 95% CI = .02- .99, p = .031) than those who manifested nonrecurrent-protracted psychosis. Subjects who eventually suffered from extrapyramidal symptoms (EPS) following pharmacotherapy had higher total BPRS scores at the baseline assessment. The present study provides evidence that a subpopulation of Meth abusers suffered from chronic Meth psychosis in long-term abstinence, and also highlights the involvement of affective symptoms in its severity.