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3 results

  • Direction of the relationship between methamphetamine use and positive psychotic symptoms in regular methamphetamine users: evidence from a prospective cohort study

  • Leanne Hides, Gary Chan, Sharon Dawe, Rebecca McKetin, David J. Kavanagh, Ross McD Young, Maree Teesson, John B. Saunders
  • Journal:
    The British Journal of Psychiatry / Volume 219 / Issue 1 / July 2021
    Published online by Cambridge University Press:
    17 January 2020, pp. 361-367
    Print publication:
    July 2021
    • Article
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  • Background

    Methamphetamine has been consistently associated with positive psychotic symptoms, but little is known about whether the reverse also occurs.

    Aims

    This study determined whether the relationship between methamphetamine use and positive psychotic symptoms is bidirectional over 12 months. The impact of lifetime psychotic disorders and methamphetamine dependence on these relationships was also examined.

    Method

    A total of 201 regular (at least monthly) primary methamphetamine users were recruited from free needle and syringe programmes in three Australian cities. Data on the frequency of methamphetamine and other drug use (from Timeline Followback inteviews) and the severity of positive psychotic symptoms (using the Brief Psychiatric Rating Scale) in the past 2 weeks were collected in 12 contiguous monthly face-to-face interviews (mean of 9.14/11 (s.d. = 3.16) follow-ups completed). Diagnoses were derived using the Psychiatric Research Interview for DSM-IV Substance and Mental Disorders.

    Results

    The mean age of participants was 31.71 years (s.d. = 8.19) and 39% (n = 77) were women. At baseline 55% (n = 110) were dependent on methamphetamine and 51% (n = 102) had a lifetime psychotic disorder. Cross-lagged dynamic panel models found a significant bidirectional relationship between psychotic symptoms and methamphetamine use (Comparative Fit Index (CFI) = 0.94, standardised root mean square residual (SRMR) = 0.05, root mean square error of approximation (RMSEA) = 0.05, 95% CI 0.04–0.06). The magnitude of the relationship in each direction was similar, and the presence of methamphetamine dependence or a lifetime psychotic disorder did not have an impact on results.

    Conclusions

    A dynamic, bidirectional relationship between methamphetamine and psychotic symptoms of similar magnitude in each direction was found over 1 year. This suggests integrated treatments that target methamphetamine, psychotic symptoms and their interrelationship may be of most benefit.

  • Relationship between heart rate variability and the severity of psychotic symptoms in schizophrenia

  • Jong-Hoon Kim, Jun-Hyung Ann, Jinyoung Lee
  • Journal:
    Acta Neuropsychiatrica / Volume 23 / Issue 4 / August 2011
    Published online by Cambridge University Press:
    24 June 2014, pp. 161-166

  • Kim J-H, Ann J-H, Lee J. Relationship between heart rate variability and the severity of psychotic symptoms in schizophrenia.

    Objective: The relationship between autonomic neurocardiac function and schizophrenia remains elusive. This study investigated the relationship between the heart rate variability (HRV) parameters and the severity of psychotic symptoms in schizophrenic patients.

    Methods: Twenty-one patients receiving risperidone monotherapy and 21 matched normal control subjects were evaluated for HRV analysis. The severity of schizophrenic symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS) and a five-factor model of the PANSS was used.

    Results: The value of the ratio of low-to-high frequency spectral power was significantly higher in the patient group. The patient group also showed a significantly lower value of approximate entropy. After controlling the dosage of risperidone, the PANSS total score had significant negative correlations with the standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal sinus intervals (RMSSD). With respect to the PANSS factors, the score of the PANSS cognitive/disorganisation factor had significant negative correlations with SDNN and RMSSD.

    Conclusion: These results provide some evidence that the severity of psychotic symptoms, especially cognitive/disorganisation symptom dimensions, may be associated with reduced HRV, suggesting a potential involvement of neuroautonomic dysfunction in the pathophysiology of specific symptoms of schizophrenia.

  • 14 - The early course of schizophrenia: new concepts for early intervention

  • from Part III - Unmet need: people with specific disorders
  • Edited by Gavin Andrews, University of New South Wales, Sydney, Scott Henderson, Australian National University, Canberra
  • Book:
    Unmet Need in Psychiatry
    Published online:
    21 August 2009
    Print publication:
    06 January 2000, pp 218-232

  • Summary

    In schizophrenia, the first contact with mental health services is frequently preceded by a lengthy, mostly untreated prephase. The few studies assessing the duration of the early period of illness from the first sign of the disorder until the first contact with mental health services give estimates ranging from two to almost nine years. This chapter focuses on when and with what symptoms does schizophrenia start, and explores how the disorder develops before the first episode. It analyses when and how does schizophrenia lead to social consequences and what are the implications for early intervention. The early course of schizophrenia, from the first prodromal sign until the climax of the first psychotic episode, seems to be a decisive period in the total course of the illness. Early detection and early intervention are therefore necessary and meaningful.