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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2018.00578

Latent psychotic symptom profiles amongst people who use methamphetamine: what do they tell us about existing diagnostic categories?

 Rebecca McKetin1, 2*, Alexandra Voce2, Richard Burns2, Robert Ali3, Daniel I. Lubman4,  Amanda L. Baker5 and  David J. Castle6
  • 1Curtin University, Australia
  • 2Australian National University, Australia
  • 3University of Adelaide, Australia
  • 4Monash University, Australia
  • 5University of Newcastle, Australia
  • 6The University of Melbourne, Australia

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 < .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.

Keywords: Methamphetamine, Amphetamine-Related Disorders, Psychotic Disorders, Schizophrenia, diagnosis, psychosis

Received: 15 Aug 2018; Accepted: 22 Oct 2018.

Edited by:

Yanping Bao, Peking University, China

Reviewed by:

Giuseppe Carrà, Università degli studi di Milano Bicocca, Italy
Musa B. Sami, King's College London, United Kingdom  

Copyright: © 2018 McKetin, Voce, Burns, Ali, Lubman, Baker and Castle. 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.

* Correspondence: Prof. Rebecca McKetin, Curtin University, Perth, Australia, rebecca.mcketin@curtin.edu.au