Details

Autor(en) / Beteiligte

• Voce, Alexandra
• Burns, Richard
• Castle, David
• Calabria, Bianca
• McKetin, Rebecca

Titel

Is there a discrete negative symptom syndrome in people who use methamphetamine?

Ist Teil von

• Comprehensive psychiatry, 2019-08, Vol.93, p.27-32

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Quelle

MEDLINE

Beschreibungen/Notizen

• Positive psychotic symptoms have consistently been associated with methamphetamine use but the presence of a negative symptom cluster remains unclear. We used exploratory factor analysis to examine whether a discrete negative syndrome could be delineated among methamphetamine users, and to examine the clinical correlates of this syndrome. Participants (N = 154) were people who used methamphetamine at least monthly and did not meet DSM-IV diagnostic criteria for lifetime schizophrenia. Scores on the Brief Psychiatric Rating Scale for the past month were subject to exploratory factor analysis. Latent class analysis was applied to resultant factor scores to determine whether negative and positive factors were experienced by the same participants. Past-month substance use measures were days of use for each drug type and methamphetamine dependence assessed using the Severity of Dependence Scale. We articulated a three-factor model including ‘positive/activation symptoms’ (e.g. suspiciousness, hallucinations, conceptual disorganisation, tension), ‘affective symptoms’ (e.g. depression, anxiety) and ‘negative symptoms’ (e.g. blunted affect, motor retardation). Positive-activation and affective symptoms (but not negative symptoms) were positively correlated with past month days of methamphetamine use (r = 0.16; r = 0.25) and severity of dependence (r = 0.24; r = 0.41). Negative symptoms were correlated with heroin (r = 0.24) and benzodiazepine use (r = 0.21). Latent class analysis revealed a three-class model comprising a positive-symptom class (44%, high positive-activation, low negative symptoms), a negative-symptom class (31%, low positive-activation, high negative symptoms), and a low-symptom class (38%, low on all factors). A negative symptom syndrome exists among people who use methamphetamine, but this appears related to polysubstance use rather than forming a part of the psychotic syndrome associated with methamphetamine use. Overlooking the role of polysubstance use on negative symptoms may conflate the profiles of methamphetamine-associated psychosis and schizophrenia. •A negative syndrome exists in methamphetamine users without schizophrenia (SZ).•This negative syndrome was not correlated with methamphetamine use.•This negative syndrome may be an artefact of depressant use.•Depressant use may obfuscate differences between SZ and methamphetamine psychosis.•Differential diagnosis may be more accurate with complete drug history assessment.