Psychiatric Symptom Characteristics in Methamphetamine-Induced Psychosis With and Without Lifetime Cannabis Use

Official title

Investigation of Factors Associated With Psychiatric Symptoms in Participants Diagnosed With Methamphetamine-Induced Psychotic Disorder With and Without Lifetime Cannabis Use

Overview

This prospective cohort study aims to investigate factors associated with psychiatric symptom severity in participants diagnosed with methamphetamine-induced psychotic disorder (MP) with and without lifetime cannabis use (LCU). Participants hospitalized at Elazığ Mental Health and Diseases Hospital who meet Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria for MP will be included. Participants will be divided into two groups based on the presence or absence of LCU. Psychiatric symptoms and clinical characteristics will be assessed weekly during an eight-week inpatient follow-up period using standardized psychometric instruments. The study aims to determine whether LCU influences the course and severity of psychiatric symptoms in MP and to identify environmental, individual, and familial factors associated with symptom progression.

Detailed description

Methamphetamine is a synthetic central nervous system stimulant with strong addictive potential and significant neurotoxic effects. Chronic methamphetamine exposure causes dopaminergic dysregulation and may lead to the development of psychotic symptoms, including hallucinations, delusions, and behavioral disturbances. Methamphetamine-induced psychotic disorder (MP) occurs in a substantial proportion of individuals who use methamphetamine.

Cannabis use is frequently observed among individuals who use methamphetamine. Lifetime cannabis use (LCU) has been associated with a variety of psychiatric symptoms including anxiety, irritability, sleep disturbances, cognitive impairment, and psychotic symptoms. However, the effect of LCU on the course of MP has not been clearly established.

Most existing studies examining psychotic symptoms in MP have been cross-sectional or retrospective in design. Prospective cohort studies investigating symptom progression and associated risk factors remain limited.

This study is designed as a prospective cohort study and will conduct in participants hospitalized at Elazığ Mental Health and Diseases Hospital psychiatry inpatient clinic. Participants diagnosed with MP according to (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision) DSM-5-TR criteria will be included and divided into two groups: Group 1=Participants with MP plus LCU (MP+LCU), Group 2=Participants with MP (no current and lifetime cannabis use).

LCU will be defined as using cannabis three or more times within the past 30 days and/or using cannabis more than forty times during the past year.

Participants will be followed weekly for eight weeks during hospitalization. Psychiatric symptoms, substance/drug use characteristics, and psychosocial variables will be assessed using standardized psychometric instruments.

The scales used/will be used in this study are as follows: Insight Assessment Scale, Addiction Profile Index Clinical-Practitioner Form, Positive and Negative Syndrome Scale, Global Assessment Scale, Pittsburgh Sleep Quality Index.

The primary aim of this study is to identify environmental, familial, and individual factors associated with psychiatric symptom severity in participants with MP and to determine whether LCU affects symptom progression.

After completion of the follow-up period, the data will be analyzed using a statistical software and the results will be prepared for publication in scientific journals.

Primary outcome measures

• Insight Assessment Scale (IAS) [Time frame: It will be administered once a week for eight weeks.]
• Addiction Profile Index Clinical-Practitioner Form (API-C) [Time frame: It will be administered once a week for eight weeks.]
• Positive and Negative Syndrome Scale (PANSS) [Time frame: It will be administered once a week for eight weeks.]
• Global Assessment Scale (GAS) [Time frame: It will be administered once a week for eight weeks.]
• Pittsburgh Sleep Quality Index (PSQI) [Time frame: It will be administered once a week for eight weeks.]

Eligibility criteria

• For Methamphetamine-Induced Psychotic Disorder plus Lifetime Cannabis Use (MP + LCU) Group:

\*Inclusion Criteria:

• Diagnosis of MP according to DSM-5-TR
• Diagnosis of Cannabis Use Disorder according to DSM-5-TR
• Medication-free for at least one month prior to admission
• Age ≥ 18 years and <65 years
• Provided informed consent

For Methamphetamine-Induced Psychotic Disorder plus Lifetime Cannabis Use (MP + LCU) Group:

\*Exclusion Criteria:

• Hypertension

• Diabetes mellitus

• Chronic kidney disease

• Rheumatoid arthritis

• Systemic lupus erythematosus

• Cardiac illness
• Severe neurological disorders
• Immunological or systemic illness
• Primary psychiatric disorders other than MP
• Alcohol use disorder
• For Methamphetamine-Induced Psychotic Disorder (MP without LCU) Group:

\*Inclusion Criteria:

• Diagnosis of MP according to DSM-5-TR

• Medication-free for at least one month prior to admission

• Age ≥ 18 years and <65 years

• Provided informed consent

For Methamphetamine-Induced Psychotic Disorder (MP without LCU) Group:

\*Exclusion Criteria:

• Hypertension

• Diabetes mellitus

• Chronic kidney disease
• Rheumatoid arthritis
• Systemic lupus erythematosus
• Cardiac illness
• Severe neurological disorders
• Immunological or systemic illness
• Primary psychiatric disorders other than MP
• Alcohol use disorder

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Observational model

Cohort

Study locations

Turkey (Türkiye) · 1 center

• Elazığ Mental Health and Diseases Hospital — Elâzığ

Publications

• McKetin R, Baker AL, Dawe S, Voce A, Lubman DI. Differences in the symptom profile of methamphetamine-related psychosis and primary psychotic disorders. Psychiatry Res. 2017 May;251:349-354. doi: 10.1016/j.psychres.2017.02.028. Epub 2017 Feb 13. PMID 28282630
• Wearne TA, Cornish JL. A Comparison of Methamphetamine-Induced Psychosis and Schizophrenia: A Review of Positive, Negative, and Cognitive Symptomatology. Front Psychiatry. 2018 Oct 10;9:491. doi: 10.3389/fpsyt.2018.00491. eCollection 2018. PMID 30364176
• Rogers JM, Iudicello JE, Marcondes MCG, Morgan EE, Cherner M, Ellis RJ, Letendre SL, Heaton RK, Grant I. The Combined Effects of Cannabis, Methamphetamine, and HIV on Neurocognition. Viruses. 2023 Mar 3;15(3):674. doi: 10.3390/v15030674. PMID 36992383
• Orum D, Orum MH, Kapici Y, Abus S. Ten-year cardiovascular disease risk and related factors in lifetime marijuana use with comorbid methamphetamine-associated psychotic disorder: a QRISK(R)3 study. BMC Psychiatry. 2024 Aug 19;24(1):563. doi: 10.1186/s12888-024-06018-1. PMID 39160490
• Glasner-Edwards S, Mooney LJ. Methamphetamine psychosis: epidemiology and management. CNS Drugs. 2014 Dec;28(12):1115-26. doi: 10.1007/s40263-014-0209-8. PMID 25373627
• Courtney KE, Ray LA. Methamphetamine: an update on epidemiology, pharmacology, clinical phenomenology, and treatment literature. Drug Alcohol Depend. 2014 Oct 1;143:11-21. doi: 10.1016/j.drugalcdep.2014.08.003. Epub 2014 Aug 17. PMID 25176528
• Schulenberg JE, Merline AC, Johnston LD, O'Malley PM, Bachman JG, Laetz VB. Trajectories of Marijuana Use During the Transition to Adulthood: The Big Picture Based on National Panel Data. J Drug Issues. 2005;35(2):255-279. doi: 10.1177/002204260503500203. PMID 16534532

Identifiers

NCT: NCT07459270 · EMHDH-2026-METH-CANNABIS-01

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗