Drug-induced Psychosis Research Articles

Living on a razor's edge: Experiences of mothers caring for a son on synthetic cannabinoids in Malta.

Various studies have explored collectively the experiences of carers of individuals using illicit substances. Yet such experiences vary by gender, by relationship status to the substance user, by type of drug taken and whether the substance user lives within the same household. A hermeneutic phenomenological design was undertaken with five mothers of sons on synthetic cannabinoids (SC). These sons were receiving community mental health care following admission to hospital for episodes of drug-induced psychosis. Interview data were collected between August and October 2019. The transcribed texts were analysed using interpretative phenomenological analysis and interpreted using the Common-sense model. The superordinate theme 'Living on a Razor's edge' was extracted and consisted of two themes: 'A living Calvary' and 'Fighting a Lone battle'. The findings highlight the intense psycho-emotional suffering of the mothers, who experienced anxiety and fear relating to their welfare and that of the family; helplessness at not being able to communicate their concerns to their son and shame triggered by the judgmental attitude of others. Carers primarily associated the effects of SC such as psychotic episodes, to their sons being vulnerable individuals with mental health challenges rather than due to their drug habit. The mothers expressed feeling isolated as they could not turn to any family member or friends for support. The highly volatile and impulsive nature of their son further introduced a wedge between the female carer and her spouse, children, extended family and friends. Caring for a son on SC has a significant psycho-emotional and social impact on the mothers as informal carers. Hence, there is a need for a person-centred care approach to be provided, in which the shared understandings of the mothers narratives are explored and where their needs and concerns are integrated and addressed within a care plan.

The Comparison Between Positive and Negative Symptoms Severity in Prolonged Methamphetamine-induced Psychotic Disorder and Schizophrenia.

This study aims to compare the positive and negative symptoms of schizophrenia in patients who had psychotic symptoms more than one month after discontinuation of methamphetamine abuse. These factors were analyzed by the positive and negative syndrome scale (PANSS) questionnaire. Sixty participants were selected from patients referred to Iran Psychiatric Hospital with psychotic symptoms (delusions or hallucinations, disorganized behavior, and speech). The control group was 30 patients with schizophrenia based on a semi-structured interview according to DSMIV-TR (SCID). Thirty patients with a prolonged methamphetamine-induced psychotic disorder were also placed in the case group. For both groups of patients, questionnaires of PANSS, Brief Psychiatric Rating Scale (BPRS), and Global Assessment Of Functioning (GAF) were filled out after obtaining the companions' consent. The scale scores were compared between groups. We used the Mann-Whitney and the Chi-square test to evaluate the mean values of PANSS, BPRS, and GAF scores between the two groups. here was an insignificant difference in positive and general pathology scores between the two groups, but the total score of negative symptoms in the schizophrenia group was significantly higher than in the group of prolonged methamphetamine psychotic disorders (P=0.034). Average scores of uncooperativeness (0.008), difficulty in abstract thinking (0.004), motor retardation (0.002), unusual thought content (0.001), and hostility (0.011) in the schizophrenia group were significantly higher than those in the prolonged methamphetamine psychosis. The results showed that most of the disturbances in patients with schizophrenia might be more influenced by the expression of cognitive disabilities than those with methamphetamine psychosis. The difference in negative symptom scores suggests that schizophrenia and prolonged methamphetamine psychotic disorder can be two different disorders. General and positive symptoms scores don't have significant differences.Negative symptoms are much more in schizophrenia.Uncooperativeness, unusual thought content and, motor retardation have more scores in schizophrenia. In clinical practice, Schizophrenia and prolonged methamphetamine-induced psychotic disorder have some similar mental presentations. Additionally, in scientific literature, there is scarce evidence about these similarities. In this regard, this research was designed to investigate the aforementioned obscurity. Determination of similarities and differences between them helps us to address these disorders in terms of treatment and follow-up and awareness of their prognosis of them. This research is a case-control study in which we examine positive and negative psychotic symptoms in schizophrenia and prolonged methamphetamine-induced psychotic disorder. Researchers investigated psychotic symptoms with positive and negative syndrome scale (PANSS), brief psychiatric rating scale (BPRS), and global assessment of functioning (GAF) questionnaires. Moreover, results demonstrate general and positive symptoms scores don't have many differences but negative symptoms are much more in patients with schizophrenia than in patients with a prolonged methamphetamine-induced psychotic disorder. Also, other features like uncooperativeness, unusual thought content, motor retardation, difficulty in abstract thinking, and hostility have higher scores in schizophrenia than the others. In conclusion, this research showed that these disorders are two distinct disorders with some similarities in positive symptoms but not in all features. So, some studies can be designed about why there are similarities between them?

Diagnostic Significance of Schneiderian First Rank Symptoms

Schizophrenia is considered to be the heartland of psychiatry and core of its clinical practice. There have been disagreements regarding its diagnostic criteria. Schneiderian first rank symptoms have been given much importance ill international classification systems. Prevalence of first rank symptoms has been reported to be from 28% to 73%. This study was done to estimate the prevalence of first rank symptoms in schizophrenia in patients presenting in outpatients departments of Mayo hospital Lahore and Institute of mental health Lahore. 168 patients were studied. Fifty patients were suffering from schizophrenia. Twenty-live patients each were suffering from mania and psychotic depression. Fifty patients had neurotic (disorders and 18 patients were suffering from drug-induced psychosis. ICD-10 was used as diagnostic criteria and Mellor’s definitions of first rank symptoms were used. Prevalence of first rank symptoms in schizophrenia was found to be 56%. Very few patients from other diagnostic categories had first rank symptoms. Prevalence of first rank symptoms in schizophrenia is lower than reported from studies done in the West. Local criteria and instruments should be developed for use in our own population.

Management of Medication-Induced Psychiatric Disorders.

Management of Medication-Induced Psychiatric Disorders.

Revisiting Tulsa: Understanding Amphetamine Addiction in the Early Photography of Larry Clark

Revisiting <i>Tulsa</i>: Understanding Amphetamine Addiction in the Early Photography of Larry Clark

Psychotic disorders in the diagnostic stability of a Portuguese ward - Diagnostic retrospective analysis

ObjectivesPsychiatric diagnosis is based on clinical manifestations, resulting from patients’ internal state, their life situation, the evolution of their condition and the response to our interventions. There are currently few objective data which help to establish the diagnosis which is why this is based on diagnostic criteria such as the Diagnostic and Statistical Manual of Mental Disorders (DSM).The DSM defines entities by their diagnostic stability, however there are several causes of variability as categorised by Spritzer et al. (1987): subjects variance (changing in patients), occasions variance (different episodes), information variance (new information) and observation variance (different interpretations).This paper aims to determine the diagnostic stability of patients with Psychotic Disorders among patients readmitted to our Psychiatric Unit. MethodsRetrospective analysis of the diagnoses of patients with Psychotic Disorders who had been readmitted to our unit. We analysed data from the last 12 years – 5422 admission episodes with 507 patients with a relevant diagnosis in this period. ResultsPsychiatric diagnosis does evolve over time, nevertheless some diagnostic groups show a relatively significant stability over time – Bipolar Disorder and Schizophrenia with 69% and 77% stability, respectively. Diagnosis such as Depressive Psychosis and Drug-induced psychosis show a significantly lower stability (8% and 21%, respectively). ConclusionsKnowing our own reality can make us aware that a cross-sectional view of patients can be insufficient and only time can determine a clear diagnosis. This study may help us to understand how psychotic disorders evolve.

Impact of comorbid substance use and infectious and non-communicable diseases in a cross-sectional study, Thailand

ABSTRACT Background Substance use has been recognized as increasing risk for concomitant infectious and non-communicable diseases (NCDs), which has contributed to poor treatment outcomes and a social burden, particularly in low-middle income countries. This study aimed at investigating effects of comorbid substance use and infectious and NCDs on psychological, suicidal behaviors and cognitive assessments. Methods In a cross-sectional study, 141 participants were recruited from six wards in one rehabilitation center and data consisting of demographic and personal characteristics and three self-administered instruments were obtained. Descriptive statistics, Mann–Whitney U test and binary logistic regression were used for data analysis. Results Findings showed that participants’ age and reasons for hospitalization were significantly related to comorbid substance use, χ2(48) = 97.348, p < .05, and χ2(60) = 84.790, p < .05, respectively. Compared with methamphetamine dependence, participants with concomitant methamphetamine psychosis were five times more likely to develop severe anxiety disorders (OR = 5.00, 95% CI = 1.16–21.45) but there were no significant differences for suicidal behaviors and cognitive impairment. Conclusions Because of severe anxiety symptoms, treatment for users with comorbid methamphetamine and psychosis should be closely monitored to increase therapeutic effects.

Treatment Response Distinguishes Persistent Type of Methamphetamine Psychosis From Schizophrenia Spectrum Disorder Among Inmates at Japanese Medical Prison.

Introduction: Persistent methamphetamine-associated psychosis (pMAP) is a disorder similar to schizophrenia, so much so that the differences in clinical symptoms and treatment response between the two remain unknown. In this study, we compared the features of pMAP with those of schizophrenia spectrum disorders (SSD).Materials and Methods: This was a retrospective quasi-experimental case-control study of inmates in a medical prison. The behavioral problems, clinical symptoms, and chlorpromazine (CP)-equivalent doses of 24 patients with pMAP and 27 with SSD were compared.Results: Patients in the pMAP group were hospitalized for fewer days than those in the SSD group (281.5 vs. 509.5; p = 0.012), but there were no other significant group differences in behavioral problems or clinical symptoms. The pMAP group received fewer antipsychotics in CP-equivalent doses than the SSD group at 4, 8, and 12 weeks after admission and at the time of discharge (p = 0.018, 0.001, 0.007, and 0.023, respectively). The number of CP-equivalent doses in the SSD group tended to increase after admission, but not in the pMAP group.Discussion: These findings suggest that differentiation between pMAP and SSD based on behavior and symptoms alone may be difficult, and that patients with pMAP may respond better to treatment with a lower dose of antipsychotic medication than those with SSD. Further confirmatory studies are warranted.

Methylphenidate-induced psychosis in a young antipsychotic-naïve female patient

Methylphenidate (MPD) is commonly prescribed for patients with Attention Deficit/Hyperactivity Disorder (ADHD). Although used off-label, MPD forms part of complex and multifactorial treatment regimen for narcolepsy and hypersomnia, together with including behavioural interventions. The drug is sometimes also prescribed off-label to subjects with other mental illness or somatic condition to improve intellectual outcome, ease fatigue or enhance the ability to concentrate. Common side effects include headache, insomnia, decreased appetite and hypertension. Concurrently, clinicians should be aware of relatively rare but potentially threatening adverse effects including agitation and psychotic symptoms. Several case reports regarding MPD-induced psychosis have been published, but most of them regard children or teenagers (1) and much less is known about drug-induced psychosis in adults (2). In this article, we present a case report of MPD-induced psychosis in a 31-year-old, antipsychotic-naïve patient. Careful evaluation including clinical examination, medical and family history and possible early signs of psychosis is recommended each time before MPD treatment will be initiated.

Identifying a probable suicide cluster in an acute care psychiatric hospital in the Eastern Cape, South Africa.

BackgroundTwo young male patients who were diagnosed with drug-induced psychosis committed suicide in a psychiatric hospital in South Africa within a month of each other. The psychiatric nurses working in the hospital had never before had to deal with a similar trauma of suicide cluster.AimTo assess the psychiatric nurses’ experiences of suicide cluster in an inpatient psychiatric setting.SettingA psychiatric hospital in the Eastern Cape, South Africa.MethodA qualitative design was used. The research population consisted of psychiatric nurses who were purposively selected. Data were gathered using in-depth interviews where the participants narrated their experiences of the incidents. The interviews were transcribed verbatim and the data was coded using descriptive and explanatory codes. Trustworthiness was ensured. Ethical principles of justice, autonomy, beneficence and non-maleficence were ensured.ResultsAn attempt was made to compare the suicides of two patients with the characteristics of cluster suicide to determine if clustering took place. Two young males committed suicide in an institutional setting within a month of each other. Other characteristics present included using the same method, in the same venue and in the same unit. They had similar educational and social backgrounds. The second victim knew the first victim and was aware of what happened.ConclusionWhen the two events are analysed together it would seem as if clustering did occur. The suicide victims knew each other and victim number 2 was aware of the facts of the first suicide. They were in their early 20’s, were mentally ill and committed suicide in the same site, using the same method and were both institutionalised at the time. Members of the mental healthcare team should be made aware of the characteristics of clustering so that when a suicide attempt occurs in a place where mentally-ill individuals are cared for, measures can be put in place to prevent another patient from copying such an event.

The role of social acuity assessment in differentiating primary psychoses from drug-induced psychoses

IntroductionThe dual diagnosis among patients with primary psychotic disorders is frequent and causes diagnostic and treatment challenges. In clinical practice, differentiating between substance-induced psychoses and independent (primary) psychoses when the patient is actively using drugs of addiction, is difficult, especially in the acute phase of the psychosis.ObjectivesThe aim of the study is to identify clinical data relevant for differentiating between primary psychoses triggered by addictive drug misuse and substance-induced psychoses, using psychometric scales.MethodsThe study was conducted on 111 patients divided in four samples: 28 dual diagnosis psychotic patients (DD), 27 bipolar patients (BD), 25 schizoaffective patients (SCA) and 31 patients with schizophrenia (SCZ). The subjects were assessed using scales for the severity of psychiatric symptoms, cognitive functions and social acuity (theory of mind): BPRS-E (Brief Psychiatric Rating Scale – Expanded), MoCA (Montreal Cognitive Assessment), CBS (Cambridge Behavioral Scale), and RMET (Reading the Mind in the Eyes Test). The tests were performed when patients were in the remission phase of the psychosis.ResultsBPRS-E scores showed significant differences between DD subjects and patients from the other three samples (primary psychoses). CBS revealed significant differences between the DD subjects and patients with schizophrenia spectrum psychoses (SCA and SCZ). RMET identified significant differences between DD and BD patients.ConclusionsAlthough differentiating between substance-induced and primary psychoses remains a difficult task, social acuity assessment performed in remitted patients may be helpful in guiding the clinician to establish a more accurate diagnosis.

Herbal High: Substance-Induced Psychosis after Consumption of Seeds of the Hawaiian Baby Woodrose.

Seeds of the Hawaiian Baby Woodrose (HBWR, Argyreia nervosa) are known as "legal or herbal highs" and can be easily purchased online in Germany. They contain various ergot alkaloids, including lysergic acid amide (LSA), which is chemically related to lysergic acid diethylamide (LSD). Pharmacological data are limited but suggest that LSA-concentration in HBWR seeds is highly variable, and that adverse psychiatric and somatic effects are not related to LSA-dosage. Anecdotal, mostly cross-sectional clinical case reports describe spontaneous remission of intoxication-related somatic and psychiatric symptoms as well as intoxication-related death. Treatment recommendations for LSA-induced psychiatric syndromes are not available. We report here on the clinical course and treatment of a drug-induced psychosis after consumption of HBWR seeds. The adolescent had consumed HBWR seeds once before without suffering any negative effects.

Efficacy and dropout rates of antipsychotic medications for methamphetamine psychosis: A systematic review and network meta-analysis

BackgroundThis study aimed to compare the treatment effects of different antipsychotics for methamphetamine psychosis (MAP). MethodsClinical Trials, Cochrane Library, Pubmed, Scopus, and Web of Science were searched for short-term, randomized controlled trials (RCTs) from the inception to June 15, 2020. Standardized mean differences (SMDs) and odds ratios (ORs) were aggregated using random-effects pairwise comparisons and frequentist network meta-analyses (NMAs). Primary outcomes of interest were the main psychotic symptoms and dropout rates. We also rated the quality of NMA estimates. ResultsThis NMA included six RCTs of 395 patients with MAP. Six studied antipsychotics were aripiprazole, haloperidol, olanzapine, paliperidone extended-release, quetiapine, and risperidone. Risperidone is the most frequently studied antipsychotic, being investigated in four trials. Low quality of evidence was available to determine the efficacy of those antipsychotics for main psychotic symptoms. Aripiprazole was significantly inferior to olanzapine (SMD = 1.36, 95 % CI = 0.46–2.26), quetiapine (SMD = 1.13, 95 % CI = 0.28–1.98), haloperidol (SMD = 0.87, 95 % CI = 0.14–1.60), and paliperidone extended-release (SMD = 0.60, 95 % CI = 0.06–1.14). Olanzapine and quetiapine were superior to risperidone (SMD = -1.09, 95 % CI = -1.89 to -0.28 and SMD = -0.86, 95 % CI = -1.61 to -0.11, respectively). The dropout rates were not significantly different among the studied antipsychotics. ConclusionsThis analysis suggests that olanzapine or quetiapine may be a preferred antipsychotic for MAP, although the evidence for this was rated low-quality due to the high risk of bias or indirectness/intransitivity.

Cannabis use and mental health among young sexual and gender minority men: A qualitative study

Despite a growing body of evidence demonstrating that cannabis use is associated with mental illness among sexual and gender minority (SGM) men, little is known about the motivations, patterns and contexts that influence this relationship. Our study aimed to characterize how cannabis use features within the mental health-related experiences of young SGM men in Vancouver, Canada. From January to December 2018, semi-structured interviews were conducted with 50 SGM men ages 15 to 30 years to explore their experiences using cannabis. We draw on thematic analysis to reveal three themes regarding participants' experiences with cannabis use and mental health. First, participants experiences emphasized the interconnectedness of cannabis use, sexual, and mental health, including using cannabis to: (i) cope with mental health symptoms during sexual encounters (e.g., anxiety, sexual trauma-related stress); and (ii) substitute or replace other substances (e.g., crystal methamphetamine, MDMA) to reduce drug-related harms in Chemsex practices (e.g., decreased ability to consent, drug-induced psychosis). Second, participants discussed the instrumental use of cannabis to alleviate and address symptoms of mental health (e.g., depression, post-traumatic experiences). Third, participants described adverse effects of cannabis use on their mental health, including feelings of paranoia that they associated with cannabis use, as well as concerns around developing cannabis dependence. Our findings reveal important implications for public health policy on how cannabis can be used to manage experiences of mental health among young SGM men, while also highlighting the need to develop harm reduction services for those who may experience mental health-related harms.

Evaluation of COMT (rs4680), CNR2 (rs2501432), CNR2 (rs2229579), UCP2 (rs659366), and IL-17 (rs763780) gene variants in synthetic cannabinoid use disorder patients

Synthetic cannabinoids (SC) are psychoactive drugs that generally produce more severe clinical outcomes compared to Δ9-tetrahydrocannabinol. This study aimed to evaluate the relationship between clinical features of synthetic cannabinoid use disorder (SCUD) and COMT (rs4680), CNR2 (rs2501432), CNR2 (rs2229579), UCP2 (rs659366), and IL-17 (rs763780) gene variants in SCUD patients by comparing the genotype distributions of gene variants between patients and healthy controls. Based on the DSM-5 criteria, 94 patients with SCUD, confirmed with a positive urine test, and 95 healthy volunteers were included in the study. Self-mutilation, suicidal behavior, psychotic symptoms, drug-induced psychosis, tobacco use disorder (TUD) or alcohol use disorder (AUD) comorbidity, and family history of TUD or AUD were evaluated in all patients. PCR-RFLP was used to identify gene variants from DNA material. The distributions of CNR2 (rs2229579) and UCP2 (rs659366) variants were significantly different in patients diagnosed with SCUD compared to the control group. SC-related psychotic symptoms were associated with the IL-17 (rs763780) variant in SCUD patients who had an onset of SC usage under 18 years of age. While the COMT Val108Met gene variant was related to self-mutilation, the COMT Val158Met variant was associated with attempted suicide. In addition, in SCUD patients, the UCP2 (rs659366) variant was associated with a family history of AUD or TUD. In summary, CNR2 (rs2229579) and UCP2 (rs659366) variants were associated with SCUD. While SC-related psychotic symptoms were related to the IL-17 (rs763780) variant, the COMT variants were associated with self-mutilation or attempted suicide in SCUD patients.

Psychotic disorders in the diagnostic stability of a Portuguese ward - Diagnostic retrospective analysis

ObjectivesPsychiatric diagnosis is based on clinical manifestations, resulting from patients’ internal state, their life situation, the evolution of their condition and the response to our interventions. There are currently few objective data which help to establish the diagnosis which is why this is based on diagnostic criteria such as the Diagnostic and Statistical Manual of Mental Disorders (DSM).The DSM defines entities by their diagnostic stability, however there are several causes of variability as categorised by Spritzer et al. (1987): subjects variance (changing in patients), occasions variance (different episodes), information variance (new information) and observation variance (different interpretations).This paper aims to determine the diagnostic stability of patients with Psychotic Disorders among patients readmitted to our Psychiatric Unit. MethodsRetrospective analysis of the diagnoses of patients with Psychotic Disorders who had been readmitted to our unit. We analysed data from the last 12 years – 5422 admission episodes with 507 patients with a relevant diagnosis in this period. ResultsPsychiatric diagnosis does evolve over time, nevertheless some diagnostic groups show a relatively significant stability over time – Bipolar Disorder and Schizophrenia with 69% and 77% stability, respectively. Diagnosis such as Depressive Psychosis and Drug-induced psychosis show a significantly lower stability (8% and 21%, respectively). ConclusionsKnowing our own reality can make us aware that a cross-sectional view of patients can be insufficient and only time can determine a clear diagnosis. This study may help us to understand how psychotic disorders evolve.

Implementing a Psychiatric Behaviours of Concern emergency team in an acute inpatient psychiatry unit: Staff perspectives.

Behaviours of concern including aggression are widespread in mental health inpatient settings. Restrictive interventions such as restraint and seclusion can cause additional trauma to already traumatized patients. To decrease use of these interventions in an acute psychiatric unit in Melbourne, Australia, a Psychiatric Behaviours of Concern (Psy-BOC) response team was introduced. In a Psy-BOC call, senior medical, nursing, and allied health staff respond to escalating behavioural situations to work with the primary treating team to implement clinical interventions of least restrictive practice. Here, we present qualitative findings reporting staff response to Psy-BOC. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Twenty-four staff participated in five focus groups. Four themes were identified: Identifying behavioural deterioration, responding to behaviours of concern, staff reactions, and barriers. Although staff were skilled in recognizing and de-escalating behaviours of concern, patients were secluded when heightened risk was perceived. The adoption of Psy-BOC was met with some resistance to the cultural change required to adopt this new model. Increased awareness, early identification of behaviours of concern, and pressure from management resulted in reductions in restrictive interventions. Management of patients with drug-induced psychosis without restraint presented specific difficulties. The ward setting was challenging, offering no break-out spaces for patients, and few comfortable areas. Some staff appreciated the advice and expertise of the Psy-Boc team, others felt disempowered and undermined. Improving leadership, staff education, support and collaboration, and including frontline staff in refining the process could enhance the Psy-BOC response and increase safety for all.

Methamphetamine use, health and criminal justice system outcomes: A systematic review.

Methamphetamine use is a problem for health and criminal justice systems (CJS) worldwide. Methamphetamine is used at higher rates in CJS-involved populations than the general community. This systematic review synthesises the evidence for health and CJS outcomes post-CJS contact for people reporting pre-CJS methamphetamine use. Academic databases were searched to identify peer-reviewed original studies using a longitudinal design that investigated associations between pre-CJS methamphetamine use and health and criminal justice outcomes after CJS contact. Identified studies were screened in two stages: title and abstract, then full-text. Data from the included studies were extracted and analysed. Results are reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Nine studies met the inclusion criteria: five investigated health and four investigated CJS outcomes. Pre-CJS methamphetamine use was associated with subsequent hospitalisation for drug-induced psychosis, increased risk of recidivism and higher crime costs after CJS contact. Pre-CJS methamphetamine use was not associated with subsequent hospitalisation for non-drug induced psychosis or post-release mortality. Current evidence suggests that pre-CJS contact methamphetamine use increases the risk of subsequent drug-induced psychosis and recidivism. There is a need for more longitudinal research that measures mediators and moderators of health and criminal justice outcomes after CJS contact, to inform targeted prevention. Methamphetamine use is a major problem that is contributing to serious mental illness and recidivism among CJS-involved populations. Prioritising treatment during CJS contact is recommended. Further research to identify key opportunities during health service and CJS contact for intervention is needed.

Cognitive impairment in methamphetamine users with recent psychosis: A cross-sectional study in Thailand

BackgroundCognitive impairment in methamphetamine (MA) users with psychosis may be more severe than that in MA users without psychosis. This study aimed to compare the overall cognitive function and specific cognitive domains between MA users with and without psychosis. MethodsParticipants in this cross-sectional study were adult inpatients who used MA within the month prior to admission. The recent use of MA was confirmed using quantitative analysis of hair. We used the Mini International Neuropsychiatric Interview (MINI) - Plus, Psychotic Module to confirm the presence of recent psychosis in the participants who fulfilled the inclusion criteria, excluding the individuals with a lifetime history of schizophrenia. We assessed the severity of depression and MA withdrawal using the Patient Health Questionnaire (PHQ-9) and the Amphetamine Withdrawal Questionnaire. The severity of cognitive impairment was assessed using the Montreal Cognitive Assessment (MoCA). The MoCA total and subtest scores were used to compare participants with and without psychosis. ResultsParticipants included 113 MA users with psychosis and 120 MA users without psychosis. Those with psychosis had significantly lower MoCA total, visuaospatial/executive subtest, and abstract subtest scores than those without psychosis (mean differences=−0.8, −0.3, and −0.2, respectively). The association between MA psychosis and the MoCA total scores was still statistically significant after the adjustment for years in education in an ordinal logistic regression analysis. ConclusionsMA users with psychosis had poorer overall cognitive function than MA users without psychosis. The cognitive impairment is prominent in the domains of visuospatial/executive function and abstraction.

Psychotic Episodes After Vigabatrine Treatment: A Case Report

Vigabatrin is an antiepileptic that functions by increasing ɣ-aminobutyric acid (GABA) levels in the brain. Like other antiepileptics, it also causes neuropsychiatric side effects. Among these side effects, psychosis draws particular attention. Drug-induced psychosis has been reported in previous publications at the beginning of the drug, while psychosis reports during the cessation period are limited. We discussed the possible mechanisms of psychosis that can be seen in the use of vigabatrin in the light of the assumptions that GABA, glutamate and dopamine are involved in the formation of positive symptoms in psychosis.