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Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?

The inability to distinguish clearly between methamphetamine-related psychosis and schizophrenia has led to the suggestion that “methamphetamine psychosis” does not represent a distinct diagnostic entity but rather that the drug has triggered a vulnerability to schizophrenia. We tested this possibil...

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Autores principales: McKetin, Rebecca, Voce, Alexandra, Burns, Richard, Ali, Robert, Lubman, Dan I., Baker, Amanda L., Castle, David J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262399/
https://www.ncbi.nlm.nih.gov/pubmed/30524318
http://dx.doi.org/10.3389/fpsyt.2018.00578
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author McKetin, Rebecca
Voce, Alexandra
Burns, Richard
Ali, Robert
Lubman, Dan I.
Baker, Amanda L.
Castle, David J.
author_facet McKetin, Rebecca
Voce, Alexandra
Burns, Richard
Ali, Robert
Lubman, Dan I.
Baker, Amanda L.
Castle, David J.
author_sort McKetin, Rebecca
collection PubMed
description The inability to distinguish clearly between methamphetamine-related psychosis and schizophrenia has led to the suggestion that “methamphetamine psychosis” does not represent a distinct diagnostic entity but rather that the drug has triggered a vulnerability to schizophrenia. We tested this possibility by exploring the latent class structure of psychotic symptoms amongst people who use the drug and examining how these latent symptom profiles correspond to a diagnosis of schizophrenia. Latent class analysis was carried out on the lifetime psychotic symptoms of 554 current methamphetamine users, of whom 40 met the DSM-IV criteria for schizophrenia. Lifetime diagnoses of schizophrenia and individual psychotic symptoms were assessed using the Composite International Diagnostic Interview. The chosen model found 22% of participants had a high propensity to experience a wide range of psychotic symptoms (schizophrenia-like), whereas the majority (56%) more specifically experienced persecutory delusions and hallucinations (paranoid psychosis) and had a lower probability of these symptoms than the schizophrenia-like class. A third class (22%) had a low probability of all symptoms, with the exception of 34% reporting persecutory delusions. Participants in the schizophrenia-like class were more likely to meet diagnostic criteria for schizophrenia (26 vs. 3 and 1% for each of the other classes, p < 0.001) but the diagnosis failed to encompass 74% of this group. These results are consistent with there being a distinction between schizophrenia and methamphetamine-related psychotic symptoms, both in terms of the propensity to experience psychotic symptoms, as well as the symptom profile; however, this distinction may not be captured well by existing diagnostic classifications.
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spelling pubmed-62623992018-12-06 Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories? McKetin, Rebecca Voce, Alexandra Burns, Richard Ali, Robert Lubman, Dan I. Baker, Amanda L. Castle, David J. Front Psychiatry Psychiatry The inability to distinguish clearly between methamphetamine-related psychosis and schizophrenia has led to the suggestion that “methamphetamine psychosis” does not represent a distinct diagnostic entity but rather that the drug has triggered a vulnerability to schizophrenia. We tested this possibility by exploring the latent class structure of psychotic symptoms amongst people who use the drug and examining how these latent symptom profiles correspond to a diagnosis of schizophrenia. Latent class analysis was carried out on the lifetime psychotic symptoms of 554 current methamphetamine users, of whom 40 met the DSM-IV criteria for schizophrenia. Lifetime diagnoses of schizophrenia and individual psychotic symptoms were assessed using the Composite International Diagnostic Interview. The chosen model found 22% of participants had a high propensity to experience a wide range of psychotic symptoms (schizophrenia-like), whereas the majority (56%) more specifically experienced persecutory delusions and hallucinations (paranoid psychosis) and had a lower probability of these symptoms than the schizophrenia-like class. A third class (22%) had a low probability of all symptoms, with the exception of 34% reporting persecutory delusions. Participants in the schizophrenia-like class were more likely to meet diagnostic criteria for schizophrenia (26 vs. 3 and 1% for each of the other classes, p < 0.001) but the diagnosis failed to encompass 74% of this group. These results are consistent with there being a distinction between schizophrenia and methamphetamine-related psychotic symptoms, both in terms of the propensity to experience psychotic symptoms, as well as the symptom profile; however, this distinction may not be captured well by existing diagnostic classifications. Frontiers Media S.A. 2018-11-19 /pmc/articles/PMC6262399/ /pubmed/30524318 http://dx.doi.org/10.3389/fpsyt.2018.00578 Text en Copyright © 2018 McKetin, Voce, Burns, Ali, Lubman, Baker and Castle. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
McKetin, Rebecca
Voce, Alexandra
Burns, Richard
Ali, Robert
Lubman, Dan I.
Baker, Amanda L.
Castle, David J.
Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?
title Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?
title_full Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?
title_fullStr Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?
title_full_unstemmed Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?
title_short Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?
title_sort latent psychotic symptom profiles amongst people who use methamphetamine: what do they tell us about existing diagnostic categories?
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262399/
https://www.ncbi.nlm.nih.gov/pubmed/30524318
http://dx.doi.org/10.3389/fpsyt.2018.00578
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