DOCSLIB.ORG

STIMULANT USE DISORDERS and PSYCHOSIS Prevalence, Correlates

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
STIMULANT USE DISORDERS and PSYCHOSIS Prevalence, Correlates STIMULANT USE DISORDERS AND PSYCHOSIS Prevalence, correlates and impacts Grant Evan Sara MB BS, MM, MM (Psychotherapy), FRANZCP A thesis submitted for the degree of Doctor of Philosophy at The University of Queensland in 2014 School of Population Health Abstract BACKGROUND Stimulants such as amphetamine, methamphetamine, cocaine and ecstasy are the most widely used illicit drugs after cannabis, and may influence the onset and course of psychosis. However, evidence about stimulant misuse in people with psychotic disorders is limited, because stimulant use is usually preceded by cannabis use, and both are associated with other personal and social risk factors. Therefore even large clinical studies of people with psychosis have often not examined the impacts of stimulants separately from those of cannabis. Epidemiological approaches, using population surveys and administrative health datasets, provide an additional method for studying the associations and impacts of stimulant drug misuse in people with psychosis. AIMS This research addresses three questions. First, what is the prevalence of stimulant use disorders in people with psychosis? Second, what are the correlates of stimulant use disorders in people with psychosis, and how do they compare with people with psychosis who do not use stimulants? Third do stimulant use disorders influence the course of illness for people with psychosis? METHODS The research examines three overlapping groups. Part 1 examines the rate and correlates of stimulant disorders in the Australian population, using data from the 2007 Australian National Survey of Mental Health and Wellbeing. Part 2 focuses on early psychosis, examining people admitted with psychosis to hospitals in New South Wales (NSW, population 7.2 million) over a 13 year period. It comprises three studies, examining (i) whether admission to hospital with psychoses is influenced by variations in stimulant availability in the NSW community, (ii) the prevalence and correlates of stimulant use disorders in people with a first admission for psychosis and (iii) the relationship between stimulant misuse and hospital readmission over two years. Part 3 examines enduring psychosis, using data from NSW hospital and community mental health services. It investigates the impact of stimulant use disorders on (i) diagnostic stability and progression to a diagnosis of schizophrenia and (ii) service use and social outcomes in ii people with schizophrenia. All studies measured and controlled for comorbid cannabis use disorders and potential personal and social confounders. RESULTS In the Australian population, the lifetime prevalence of stimulant disorders was 3.3%, and 12-month prevalence was 0.6%, equating to more than 97,000 Australians. Stimulant use disorders were most common in people with other risk factors for developing psychosis, including younger age, male gender, a family history of psychosis, earlier and more frequent use of cannabis, anxiety and depressive symptoms, and subclinical psychotic symptoms. Quarterly variations in amphetamine availability accounted for 50% of variation in the rate of admission for stimulant induced psychosis. People with first admission psychoses had stimulant use disorders at a rate more than ten times that of the age-matched Australian population. Stimulant use disorders were associated with diagnoses of brief and drug induced psychoses. Cannabis and stimulant disorders at first admission did not predict readmission, whereas prior admissions with stimulant disorders did. The associations of stimulant use disorders differed from those of cannabis use disorders. In the five years following admission for psychosis, comorbid stimulant use disorders were associated with diagnostic instability, reduced likelihood of diagnostic progression to schizophrenia and increased likelihood of revision of an initial diagnosis of schizophrenia to other conditions. By contrast, comorbid cannabis use disorders increased the likelihood of progression to schizophrenia. Fourteen percent (14%) of people admitted to hospital with diagnoses of schizophrenia had comorbid stimulant use disorders, and these were associated with physical health comorbidities, social dislocation and frequent use of mental health and emergency services. More than 80% of those with stimulant use disorders also had cannabis disorders: the risks of cannabis and stimulants appeared additive in this group. CONCLUSIONS In the Australian population and in Australians with psychosis, the rate of stimulant disorders is consistent with that reported from the US but higher than for many other developed countries. Around one in seven Australians with psychosis also has a stimulant use disorder, a rate at least ten times that of the general population. Because stimulants iii may precipitate or worsen acute psychotic symptoms, this suggests that they contribute to the overall burden of psychosis in Australia. The associations of stimulant use disorders are distinct from those of cannabis use disorders. For people with early psychosis, stimulant disorders are associated with initial diagnoses of brief and drug-induced psychosis, lower rates of ongoing contact with specialist mental health services and lower rates of transition to a final diagnosis of schizophrenia. These findings are consistent with developmental and dimensional models of psychosis: stimulants are potent precipitants of acute psychotic symptoms and may therefore trigger psychotic symptoms in people with less personal vulnerability to the development of schizophrenia. An implication for clinical services is that stimulant- associated psychoses mark an important window of opportunity. Young people with stimulant-associated psychoses may have positive outcomes if they are supported in managing their substance use early in their illness. However, ongoing substance use is associated with high rates of relapse and readmission. For those people with schizophrenia, ongoing stimulant use disorders are associated with significant harms and frequent service use. More research is needed to identify effective interventions for this group. iv Declaration by author This thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis. I have clearly stated the contribution of others to my thesis as a whole, including statistical assistance, survey design, data analysis, significant technical procedures, professional editorial advice, and any other original research work used or reported in my thesis. The content of my thesis is the result of work I have carried out since the commencement of my research higher degree candidature and does not include a substantial part of work that has been submitted to qualify for the award of any other degree or diploma in any university or other tertiary institution. I have clearly stated which parts of my thesis, if any, have been submitted to qualify for another award. I acknowledge that an electronic copy of my thesis must be lodged with the University Library and, subject to the General Award Rules of The University of Queensland, immediately made available for research and study in accordance with the Copyright Act 1968. I acknowledge that copyright of all material contained in my thesis resides with the copyright holder(s) of that material. Where appropriate I have obtained copyright permission from the copyright holder to reproduce material in this thesis. v Publications during candidature Peer reviewed publications Sara, G., P. Burgess, M. G. Harris, G. Malhi and H. Whiteford (2011). Stimulant Use And Stimulant Disorders In Australia: Findings From The National Survey Of Mental Health And Wellbeing. Medical Journal of Australia 195: 607-610. Sara, G., P. Burgess, G. Malhi and H. Whiteford (2011). Amphetamine availability and admissions for psychosis in New South Wales, 2001-2009. Australian and New Zealand Journal of Psychiatry 45(4): 317-324. Sara, G., P. Burgess, M. G. Harris, G. Malhi, H. Whiteford and W. Hall (2012). Stimulant disorders: characteristics and correlates in an Australian population sample. Australian and New Zealand Journal of Psychiatry 46: 1165-1172. Large M, Smith G, Sara G, et al. (2012) Meta-analysis of self-reported substance use compared with laboratory substance assay in general adult mental health settings. International Journal of Methods in Psychiatric Research 21: 134-148. Sara, G., P. Burgess, G. Malhi, H. Whiteford and W. Hall (2013). Differences in associations between cannabis and stimulant disorders in first admission psychosis. Schizophrenia Research 147: 216-222 Sara, G., P. Burgess, G. Malhi, H. Whiteford and W. Hall (2014). Cannabis and stimulant disorders and readmissions 2 years after first episode psychosis. British Journal of Psychiatry 204: 448-453. Sara, G., P. Burgess, G. Malhi, H. Whiteford and W. Hall (2014). The impact of cannabis and stimulant disorders on diagnostic stability in psychosis. Journal of Clinical Psychiatry. 75(4): 349-356. Degenhardt, L., A. J. Baxter, Y. Y. Lee, W. Hall, G. Sara, N. Johns, A. Flaxman, H. Whiteford and T. Vos (2014). The global epidemiology and burden of psychostimulant dependence: findings from the Global Burden of Disease Study 2010. Drug and Alcohol Dependence 137: 36-47. Sara, G., P. Burgess, M. G. Harris, G. Malhi, H. Whiteford and W. Hall (2014). Stimulant and other substance
Load more

Recommended publications
  • Neurotoxicity and Neuropathology Associated with Cocaine Abuse
    Neurotoxicity and Neuropathology Associated with Cocaine Abuse Editor: Maria Dorota Majewska, Ph.D. NIDA Research Monograph 163 1996 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute on Drug Abuse Medications Development Division 5600 Fishers Lane Rockville, MD 20857 i ACKNOWLEDGMENT This monograph is based on the papers from a technical review on "Neurotoxicity and Neuropathology Associated with Cocaine Abuse" heldon July 7-8, 1994. The review meeting was sponsored by the National Institute on Drug Abuse. COPYRIGHT STATUS The National Institute on Drug Abuse has obtained permission from the copyright holders to reproduce certain previously published material as noted in the text. Further reproduction of this copyrighted material is permitted only as part of a reprinting of the entire publication or chapter. For any other use, the copyright holder's permission is required. All other material in this volume except quoted passages from copyrighted sources is in the public domain and may be used or reproduced without permission from the Institute or the authors. Citation of the source is appreciated. Opinions expressed in this volume are those of the authors and do not necessarily reflect the opinions or official policy of the National Institute on Drug Abuse or any other part of the U.S. Department of Health and Human Services. The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this publication are used only because they are considered essential in the context of the studies reported herein. National Institute on Drug Abuse NIH Publication No.
    [Show full text]
  • Group-Based Outpatient Treatment for Adolescent Substance Abuse
    Group-Based Outpatient Treatment for Adolescent Substance Abuse Elizabeth C. Katz, Ph.D.1 Emily A. Sears, M.S.1,2 Cynthia A. Adams, M.A.1,2 Robert J. Battjes, D.S.W.1 and The Epoch Counseling Center Adolescent Treatment Team2 The Social Research Center1 Friends Research Institute, Inc. 1040 Park Avenue, Suite 103 Baltimore, MD 21201 and Epoch Counseling Center2 800 Ingleside Avenue Catonsville, MD 21228 This manual was prepared under funding provided by grant no. KD1TI11874 from the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Administration (SAMHSA). The treatment model and approaches described in this manual are those of the authors and do not necessarily reflect views or policies of CSAT or SAMHSA. 1 Group-Based Outpatient Treatment for Adolescent Substance Abuse Elizabeth C. Katz, Ph.D., Emily A. Sears, M.S., Cynthia A. Adams, M.A., Robert J. Battjes, D.S.W., and The Epoch Counseling Center Adolescent Treatment Team This manual describes a moderate-intensity group-based approach to adolescent outpatient substance abuse treatment, implemented by the Epoch Counseling Center, Baltimore County, Maryland. The Group-Based Outpatient Treatment for Adolescent Substance Abuse (GBT) program combines a 20-week group counseling intervention with individual and family therapy and is designed to address the issues and problems commonly facing adolescent substance abusers ages 14 to 18 years old. This manual provides an overview of the theoretical basis for the intervention, a brief description of the outpatient drug-free treatment program within which the adolescent intervention was implemented, and a curriculum guide for implementing the treatment protocol.
    [Show full text]
  • Methamphetamine Psychosis: Epidemiology and Management
    HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author CNS Drugs Manuscript Author . Author manuscript; Manuscript Author available in PMC 2016 September 19. Published in final edited form as: CNS Drugs. 2014 December ; 28(12): 1115–1126. doi:10.1007/s40263-014-0209-8. Methamphetamine Psychosis: Epidemiology and Management Suzette Glasner-Edwards, Ph.D. and Larissa J. Mooney, M.D. UCLA Integrated Substance Abuse Programs Abstract Psychotic symptoms and syndromes are frequently experienced among individuals who use methamphetamine, with recent estimates of up to approximately 40% of users affected. Though transient in a large proportion of users, acute symptoms can include agitation, violence, and delusions, and may require management in an inpatient psychiatric or other crisis intervention setting. In a subset of individuals, psychosis can recur and persist and may be difficult to distinguish from a primary psychotic disorder such as schizophrenia. Differential diagnosis of primary versus substance-induced psychotic disorders among methamphetamine users is challenging; nevertheless, with careful assessment of the temporal relationship of symptoms to methamphetamine use, aided by state-of-the art psychodiagnostic assessment instruments and use of objective indicators of recent substance use (i.e., urine toxicology assays), coupled with collateral clinical data gathered from the family or others close to the individual, diagnostic accuracy can be optimized and the individual can be appropriately matched to a plan of treatment. The pharmacological treatment of acute methamphetamine-induced psychosis may include the use of antipsychotic medications as well as benzodiazepines, although symptoms may resolve without pharmacological treatment if the user is able to achieve a period of abstinence from methamphetamine.
    [Show full text]
  • The Relationship Between Psychoactive Drugs, the Brain and Psychosis Sutapa Basu1*And Deeptanshu Basu2
    Basu and Basu. Int Arch Addict Res Med 2015, 1:1 ISSN: 2474-3631 International Archives of Addiction Research and Medicine Review Article: Open Access The Relationship between Psychoactive Drugs, the Brain and Psychosis Sutapa Basu1*and Deeptanshu Basu2 1Institute of Mental Health, Singapore 2University at Buffalo, State University of New York, USA *Corresponding author: Sutapa Basu, Consultant, Institute of Mental Health, Singapore, Tel: +6597112015, E-mail: [email protected] grey of the midbrain [7] whereas some alter neurotransmission Abstract by interacting with molecular components of the sending and This paper explores the interaction between four psychoactive drugs, receiving process, an example being cocaine. Some drugs alter namely MDMA (Ecstasy), Cocaine, Methamphetamine and LSD, neurotransmission in different fashion. Benzodiazepines enhance the with neurotransmitters in the brain with the aim of understanding response of receiving cells mediated by serotonin, possibly with the what links exist between these drugs and Psychosis. The paper is restricted to three neurotransmitters – dopamine, serotonin, and involvement of GABA [8]. One of the unwanted effects of many of the norepinephrine (noradrenaline) and explores in some detail how psychoactive drugs is psychotic symptoms. However, most research they are affected by the aforementioned drugs. The paper aims has been centered on cannabis (Marijuana) use and Psychosis. This to go beyond existing research on drugs and psychosis which has paper therefore explores to what extent other psychoactive drugs been primarily limited to cannabis (Marijuana) and psychosis. The affect psychotic symptoms and illnesses. findings and conclusions drawn show that all the drugs explored have the potential to induce psychosis in abusers to some degree; In order to delve into the above topic, secondary research from the effects vary from drug to drug.
    [Show full text]
  • Differences in the Symptom Profile of Methamphetamine-Related Psychosis and Primary Psychotic Disorders
    Author’s Accepted Manuscript Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders Rebecca McKetin, Amanda L. Baker, Sharon Dawe, Alexandra Voce, Dan I. Lubman www.elsevier.com/locate/psychres PII: S0165-1781(16)31641-9 DOI: http://dx.doi.org/10.1016/j.psychres.2017.02.028 Reference: PSY10322 To appear in: Psychiatry Research Received date: 27 September 2016 Revised date: 13 January 2017 Accepted date: 12 February 2017 Cite this article as: Rebecca McKetin, Amanda L. Baker, Sharon Dawe, Alexandra Voce and Dan I. Lubman, Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders, Psychiatry Research, http://dx.doi.org/10.1016/j.psychres.2017.02.028 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders Rebecca McKetina,b,c*, Amanda L. Bakerd, Sharon Dawee, Alexandra Voceb and Dan I. Lubmanf a National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia bCentre for Research on Ageing, Health
    [Show full text]
  • Induced Psychosis: a Rising Problems in Malaysia
    EDITORIAL AMPHETAMINE TYPE STIMULANT (ATS) INDUCED PSYCHOSIS: A RISING PROBLEMS IN MALAYSIA Ahmad Hatim S Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur The past decade has seen a marked increase in the popularity of ATS use, particularly methamphetamine, within East Asia, and the Pacific region (1) In Malaysia, the National Anti Drug Agency has identified 8,870 addicts (from January till August 2008) out of which 1,126 was ATS dependence. During the same period, the police have arrested 46,388 people under the Dangerous Drug Act 1952. They also has seize 283kg of syabu, 545kg of ecstacy powder, 66194 tablets of esctacy pills and 222,376 tablets of yaba pills from Jan till August this year.(2) The occurrence of psychosis arising from the use of ATS was first reported in the late 1930’s. With growing ATS use, particularly methamphetamine, ATS-induced psychosis has become a major impact on public health. Symptoms of ATS-induced psychosis Methamphetamine use produces a variety of effects, ranging from irritability, to physical aggression, hyperawareness, hypervigilance, and psychomotor agitation. Repeated or high-dose use of the stimulant can cause drug-induced psychosis resembling paranoid schizophrenia, characterized by hallucinations, delusions and thought disorders. When used in long term, methamphetamine may lead to development of psychiatric symptoms due to dopamine depletion in the striatum. The most common lifetime psychotic symptoms among methamphetamine psychotic patients – as reported in a cross-country study (3) involving Australia, Japan, the Philippines and Thailand – are persecutory delusion, auditory hallucinations, strange or unusual beliefs and thought reading.
    [Show full text]
  • Smoking and Stimulant Abuse in Schizophrenia
    STIMULANTS AND SCHIZOPHRENIA 1 Smoking and Stimulant Abuse in Schizophrenia: An Examination of the Causes and Effects Brian Waterman Copyright 2003, Brian Waterman, www.bedrugfree.net. This paper may not be reprinted or reposted without the author's express written consent. STIMULANTS AND SCHIZOPHRENIA 2 ABSTRACT: Examines the causes and effects of stimulant and nicotine usage in schizophrenics. Compares three schools of thought on the smoking-schizophrenia connection: smoking causes schizophrenia; smoking out of boredom; smoking to ameliorate side effects of medications. Considers the shortcomings of current treatment modalities in drug abuse and smoking cessation where psychotic clients are concerned. Discusses possible solutions for problems related to smoking and stimulant abuse in schizophrenics for the future, including medication advances. Copyright 2003, Brian Waterman, www.bedrugfree.net. This paper may not be reprinted or reposted without the author's express written consent. STIMULANTS AND SCHIZOPHRENIA 3 INTRODUCTION: It has been well established that tobacco smoking is the most preventable cause of death in the United States (Watkins, et al, 2000). Lung cancer is the most common type of fatal cancer, and cigarette smoking is the primary cause of that. Changes in societal norms, taxes and laws aimed at reducing smoking, and media and school messages aimed at smoking prevention have helped to reduce the prevalence of smoking down to about 25% of people today (Watkins, et al, 2000; Eden Evins, et al, 2001). Yet, among the schizophrenic, the rate of smoking approaches 90% (Eden Evins, et al, 2001; Tidey, et al, 1999; Tracy, et al, 2000). In addition, most schizophrenics smoke high-tar, high-nicotine cigarettes, smoke a far higher number of cigarettes than non- smokers, and tend to smoke in a fashion that extracts greater nicotine from cigarettes (McChargue, et al, 2002).
    [Show full text]
  • Methamphetamine-Associated Psychosis
    University of Nebraska - Lincoln DigitalCommons@University of Nebraska - Lincoln Faculty Publications, Department of Psychology Psychology, Department of April 2012 Methamphetamine-Associated Psychosis Kathleen M. Grant VA Nebraska-Western Iowa Health Care System, [email protected] Tricia D. Le Van VA Nebraska-Western Iowa Health Care System, [email protected] Sandra M. Wells University of Nebraska Medical Center, [email protected] Ming Li University of Nebraska-Lincoln, [email protected] Scott F. Stoltenberg University of Nebraska-Lincoln, [email protected] See next page for additional authors Follow this and additional works at: https://digitalcommons.unl.edu/psychfacpub Part of the Psychiatry and Psychology Commons Grant, Kathleen M.; Le Van, Tricia D.; Wells, Sandra M.; Li, Ming; Stoltenberg, Scott F.; Gendelman, Howard E.; Carlo, Gustavo; and Bevins, Rick A., "Methamphetamine-Associated Psychosis" (2012). Faculty Publications, Department of Psychology. 562. https://digitalcommons.unl.edu/psychfacpub/562 This Article is brought to you for free and open access by the Psychology, Department of at DigitalCommons@University of Nebraska - Lincoln. It has been accepted for inclusion in Faculty Publications, Department of Psychology by an authorized administrator of DigitalCommons@University of Nebraska - Lincoln. Authors Kathleen M. Grant, Tricia D. Le Van, Sandra M. Wells, Ming Li, Scott F. Stoltenberg, Howard E. Gendelman, Gustavo Carlo, and Rick A. Bevins This article is available at DigitalCommons@University of Nebraska - Lincoln: https://digitalcommons.unl.edu/ psychfacpub/562 J Neuroimmune Pharmacol (2012) 7:113–139 DOI 10.1007/s11481-011-9288-1 INVITED REVIEW Methamphetamine-Associated Psychosis Kathleen M. Grant & Tricia D. LeVan & Sandra M. Wells & Ming Li & Scott F.
    [Show full text]
  • Treatment for Stimulant Use Disorders Treatment Improvement Protocol (TIP) Series 33
    Treatment for Stimulant Use Disorders Treatment Improvement Protocol (TIP) Series 33 Richard A. Rawson, Ph.D. Consensus Panel Chair U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fishers Lane Rockville, MD 20857 DHHS Publication No. (SMA) 99-3296 Printed 1999 Table of Contents • [Front Matter] • Executive Summary and Recommendations • Chapter 1 -- Introduction • Chapter 2 -- How Stimulants Affect the Brain and Behavior • Chapter 3 -- Approaches to Treatment • Chapter 4 -- Practical Application of Treatment Strategies • Chapter 5 -- Medical Aspects of Stimulant Use Disorders • Chapter 6 -- Treatment Issues for Special Groups and Settings • Appendix A -- Bibliography • Appendix B -- Client Worksheets • Appendix C -- Screening Tests for Cognitive Impairments • Appendix D -- Glossary • Appendix E -- Resource Panel • Appendix F -- Field Reviewers • [Exhibits] Treatment for Stimulant Use Disorders Treatment Improvement Protocol (TIP) Series 33 Treatment for Stimulant Use Disorders [Front Matter] [Title Page] Treatment for Stimulant Use Disorders Treatment Improvement Protocol (TIP) Series 33 Richard A. Rawson, Ph.D. Consensus Panel Chair U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Rockwall II, 5600 Fishers Lane Rockville, MD 20857 DHHS Publication No. (SMA) 99‐3296 Printed 1999 [Disclaimer] This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. All material appearing in this volume except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) or the authors.
    [Show full text]
  • Epidemilogy and Diagnosis of Substance Induced Psychosis
    EPIDEMILOGY AND DIAGNOSIS OF SUBSTANCE INDUCED PSYCHOSIS Jassin M. Jouria, MD Dr. Jassin M. Jouria is a practicing Emergency Medicine physician, professor of academic medicine, and medical author. He graduated from Ross University School of Medicine and has completed his clinical clerkship training in various teaching hospitals throughout New York, including King’s County Hospital Center and Brookdale Medical Center, among others. Dr. Jouria has passed all USMLE medical board exams, and has served as a test prep tutor and instructor for Kaplan. He has developed several medical courses and curricula for a variety of educational institutions. Dr. Jouria has also served on multiple levels in the academic field including faculty member and Department Chair. Dr. Jouria continues to serve as a Subject Matter Expert for several continuing education organizations covering multiple basic medical sciences. He has also developed several continuing medical education courses covering various topics in clinical medicine. Recently, Dr. Jouria has been contracted by the University of Miami/Jackson Memorial Hospital’s Department of Surgery to develop an e- module training series for trauma patient management. Dr. Jouria is currently authoring an academic textbook on Human Anatomy & Physiology. ABSTRACT When patients present with signs of psychosis, it is critical that health clinicians are able to properly assess and determine root cause. A diagnosis of substance-induced psychosis is an opportunity to work with the patient to determine and resolve underlying mental illnesses and to discourage a reliance on drugs or alcohol. Because individuals with a history of psychosis have a higher than average suicide rate, early recognition and intervention by a qualified health clinician is extremely important.
    [Show full text]
  • Major Physical and Psychological Harms of Methamphetamine Use
    SCII.001.001.0060 Drug and Alcohol Review (May 2008), 27, 253 – 262 Major physical and psychological harms of methamphetamine use 1 1 1 1,2 SHANE DARKE , SHARLENE KAYE , REBECCA MCKETIN , & JOHAN DUFLOU 1National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia, and 2Department of Forensic Medicine, Sydney South West Area Health Service, Sydney, New South Wales, Australia Abstract Issues. The major physical and psychological health effects of methamphetamine use, and the factors associated with such harms. Approach. Comprehensive review. Key Findings. Physical harms reviewed included toxicity and mortality, cardiovascular/cerebrovascular pathology, dependence and blood-borne virus transmission. Psychological harms include methamphetamine psychosis, depression, suicide, anxiety and violent behaviours. Implications. While high-profile health consequences, such as psychosis, are given prominence in the public debate, the negative sequelae extend far beyond this. This is a drug class that causes serious heart disease, has serious dependence liability and high rates of suicidal behaviours. Conclusion. The current public image of methamphetamine does not portray adequately the extensive, and in many cases insidious, harms caused. [Darke S, Kaye S, McKetin R, Duflou J. Major physical and psychological harms of methamphetamine use. Drug Alcohol Rev 2008;27:253–262] Key words: cardiovascular, methamphetamine, psychostimulants, psychopathology. methamphetamine to include both methamphetamine Introduction and its less potent analogue amphetamine, which are In recent years, there has been mounting concern about sold under the street names of ‘speed’, ‘base’, ‘ice’, the increasing prevalence of methamphetamine use. ‘crystal meth’ and ‘amphetamines’. Where appropriate, The extent of the problem suggests the need for a a distinction between methamphetamine and amphe- comprehensive review of the major harms that are tamine will be made.
    [Show full text]
  • H-MRS and Neurocognitive Analysis of Psychotic Symptoms in Stimulant Dependence
    University of Alberta A 1H-MRS and Neurocognitive Analysis of Psychotic Symptoms in Stimulant Dependence by Bonnie June Lakusta A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Psychiatry ©Bonnie June Lakusta Spring 2012 Edmonton, Alberta Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission. DEDICATION This thesis is dedicated to my husband, Sean, for his patience, for always being understanding and for providing the voice of reason; and to my family, my parents Wendy and Evan and brother Stephen, for their never-ending support and encouragement, and for fostering a love of learning. ABSTRACT The association between stimulant drug use and the presence of a psychotic disorder raises questions about causation. Substance-induced psychosis may differ etiologically from schizophrenia despite similar phenotypic presentation. It is possible that stimulant drug users who develop symptoms of psychosis have a pre-existing vulnerability to schizophrenia. A recent theory building on the neurodevelopmental hypothesis of schizophrenia proposes that a second insult in conjunction with a pre-existing vulnerability may be necessary to trigger the onset of psychosis.
    [Show full text]