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    Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?

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    Author
    McKetin, R; Voce, A; Burns, R; Ali, R; Lubman, DI; Baker, AL; Castle, DJ
    Date
    2018-11-19
    Source Title
    Frontiers in Psychiatry
    Publisher
    FRONTIERS MEDIA SA
    University of Melbourne Author/s
    Castle, David
    Affiliation
    Psychiatry
    Metadata
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    Document Type
    Journal Article
    Citations
    McKetin, R., Voce, A., Burns, R., Ali, R., Lubman, D. I., Baker, A. L. & Castle, D. J. (2018). Latent Psychotic Symptom Profiles Amongst People Who Use Methamphetamine: What Do They Tell Us About Existing Diagnostic Categories?. FRONTIERS IN PSYCHIATRY, 9, https://doi.org/10.3389/fpsyt.2018.00578.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253468
    DOI
    10.3389/fpsyt.2018.00578
    Abstract
    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 < 0.001) 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.

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