Abstract
ObjectiveTo investigate the clinical features, prescribing patterns and outcomes of psychiatric inpatients admitted with methamphetamine-induced psychosis.MethodA cross-sectional, descriptive pilot study was conducted between March 2014 and August 2014 at three South African Mental Health Care Act designated hospitals prior to admission to a psychiatric hospital. Patients with methamphetamine-related psychotic symptoms according to the DSM-5 criteria were eligible. Structured face-to-face interviews were conducted and the Brief Psychiatric Rating Scale was employed as a measure of current psychopathology.ResultsFifty-six participants were included. Positive psychotic symptoms (e.g. hallucinations) were more prominent than negative symptoms (e.g. affective blunting). Almost half the participants (43%) had previous episodes of methamphetamine-induced psychosis. Within this group, all had defaulted on the prescribed treatment prior to admission. Only 29% of the participants had received prior formal substance-use rehabilitation as treatment for their disorder. High rates of comorbid cannabis and alcohol use (51%) were recorded. Most of the participants required transfer to specialist psychiatric hospitals. The amounts of methamphetamine used were not a predictor of the persistence of psychosis; however, the pattern of use was.ConclusionClinical features correspond with other international findings. The currently employed model of sequential, non-integrated psychiatric and substance use treatment in this setting appears ineffective.
Highlights
Methamphetamine abuse is a global problem, with the Western Cape, South Africa, having emerged as a region with one of the highest levels of its use.[1]
Methamphetamine-related psychiatric problems, especially methamphetamineinduced psychosis, places a significant burden on psychiatric inpatient services.[3]. Despite this increase in admissions for methamphetamine-induced psychosis, there have been no local studies examining the clinical characteristics, treatment modalities or outcomes of patients admitted with methamphetamine-induced psychosis
The overall impetus for this pilot study came from the increasing prevalence and resulting public health problem posed by illicit methamphetamine use
Summary
Methamphetamine abuse is a global problem, with the Western Cape, South Africa, having emerged as a region with one of the highest levels of its use.[1]. The preferred method of methamphetamine use varies by geographical region and has changed over time.[4] In South Africa, methamphetamine is generally smoked in a glass pipe called a ‘lolly’ or ‘pop-eye’, or using a straw and the globe of a light bulb (Weich L., 2015, Personal communication). Smoking methamphetamine leads to a very fast uptake of this lipophilic drug in the brain, amplifying methamphetamine’s addiction potential.[5] Adverse health consequences include both medical and psychiatric symptoms, such as anxiety, depression, suicidal ideation, aggression and psychosis.[6] The potential for methamphetamine to induce a psychotic state is well established and is considered one of the most serious outcomes of use.[7,8]
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Schedule a callMore From: The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa
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