Methamphetamine-Related Psychiatric Emergencies in Türkiye: Clinical Features, Risk Factors, and Follow-Up Results from a Tertiary Mental Health Centre

Mine Ergelen Yalçın^*Salih Cihat Paltun

• Istanbul Erenkoy Training and Research Hospital For Psychiatric and Neurological Diseases, Istanbul, Türkiye

Objectives: Methamphetamine (MA) use is a growing public health issue in Türkiye, leading to an increasing number of psychiatric emergencies. There is limited information on the clinical features and outcomes of MA users in non-Western countries. Methods: This retrospective cohort study included 423 patients with confirmed MA use among 12,501 psychiatric emergency department (PED) admissions at a tertiary mental health center in Istanbul, Türkiye, between January and June 2022. Data on demographics, clinical presentation, comorbidities, and follow-up outcomes were collected from electronic medical records. Results: Most patients were young adult males (84.2%). Psychotic symptoms (65.5%), agitation (65.7%), and insomnia (60.8%) were common. Depression (OR=18.0, 95% CI: 3.7– 88.1) and self-harm (OR=26.5, 95% CI: 7.1–98.9) were the strongest predictors of suicide attempts. Psychotic symptoms (OR=2.6, 95% CI: 1.5–4.7), agitation (OR=2.2, 95% CI: 1.3– 3.7), and self-harm (OR=3.5, 95% CI: 1.9–6.6) were linked to aggression. Prior psychiatric hospitalization (OR=7.4, 95% CI: 4.4–12.3) and comorbid psychiatric disorders (OR=2.2, 95% CI: 1.3–3.6) predicted frequent PED visits. Within one year, 33.3% of patients were hospitalized. Conclusions: MA users admitted to psychiatric emergency services in Türkiye often present with severe symptoms, high rates of comorbidity, and polysubstance use. Recognizing key risk factors may help guide early intervention and integrated care for this vulnerable group. These findings add new knowledge from a non-Western context and may inform clinical practice and policy in similar settings worldwide.