Psychiatric and Substance Dependence Comorbidities, Sexually Transmitted Diseases, and Risk Behaviors Among Methamphetamine-Dependent Gay and Bisexual Men Seeking Outpatient Drug Abuse Treatment

Friends Research Institute, Inc., Los Angeles, California, USA.
Journal of psychoactive drugs (Impact Factor: 1.1). 06/2003; 35 Suppl 1(sup1):161-8. DOI: 10.1080/02791072.2003.10400511
Source: PubMed


This article describes psychiatric and substance dependence comorbidities, lifetime rates of infectious disease, and reported high-risk sexual behaviors for methamphetamine-dependent, gay and bisexual men at entry to outpatient drug abuse treatment in Los Angeles. Participants' self-reports of high-risk sexual and drug use behaviors and of history of infectious disease status were correlated with diagnostic information from 155 Structured Clinical Interviews for the DSM-IV (SCID). A total of 82 participants met criteria for lifetime depressive disorders; 44 participants met criteria for lifetime anxiety disorders. Compared to those without psychiatric diagnoses, significant differences were observed in lifetime prevalence of sexually transmitted infections among those who have generalized anxiety disorder (higher rates of genital gonorrhea), specific phobia and major depressive disorder (higher rates of oral gonorrhea), social phobia (higher rates of syphilis) and bipolar disorder, type I (higher rates of HIV). Differences in infectious disease prevalence did not correspond to significantly different rates of high-risk sexual behaviors. Findings indicate that gay and bisexual men seeking outpatient treatment for methamphetamine dependence are likely to experience psychiatric comorbidity and to have high rates of infectious disease, including HIV, syphilis and gonorrhea.

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    • "The available studies are from high-income countries with samples that may be unique in certain respects. For example, the samples were made up of only females in one study (Semple et al. 2007), only gay and bisexual men in another (Shoptaw et al. 2003) and arrestees from forensic units in yet another (Kalechstein et al. 2000). This South African study therefore used a structured diagnostic interview to assess co-morbid psychiatric disorders in individuals with methamphetamine dependence; reporting on prevalence, pattern and risk factors for this comorbidity. "
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    ABSTRACT: Methamphetamine dependence may be associated with a range of psychiatric disorders. However, relatively few studies have systematically examined these disorders and possible risk factors. This study used a structured diagnostic interview to assess the prevalence and pattern of co-morbid psychiatric disorders in individuals with methamphetamine dependence; and identified risk factors for this comorbidity. One hundred adult volunteers with a diagnosis of methamphetamine dependence and without co-morbid medical disorders were consecutively recruited from three drug rehabilitation centres. Each volunteer was assessed with a socio-demographic questionnaire and evaluated for psychiatric comorbidity using the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). A regression model was used to determine predictors of psychiatric comorbidity. Co-morbid psychiatric disorders were present in 36.0 % of the sample; these included mood disorders (16.0 %), psychotic disorders (13.0 %) and anxiety disorders (7.0 %). One in four of these disorders were assessed as being substance-induced. Independent predictors of psychiatric comorbidity included being male (OR = 10.04, 95 % C.I = 2.07-48.63, p = 0.004), younger (OR = 0.87, 95 % C.I = 0.77-0.99, p = 0.04), and having a previous psychiatric disorder (OR = 18.45, 95 % C.I = 3.81-89.33, p < 0.001). Mood, psychotic, and anxiety disorders are common in individuals with methamphetamine dependence. Risk factors for such comorbidity can be identified. These findings underscore the need for an integrated model of care addressing both substance use disorders and psychiatric comorbidity.
    Metabolic Brain Disease 02/2014; 29(2):351-357. DOI:10.1007/s11011-014-9496-5 · 2.64 Impact Factor
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    • "Chronic use results in several health complications, including hypertension (e.g., Chin et al., 2006) and stroke (Yen et al, 1994), as well as increased rates of comorbid infections such as HIV and hepatitis C virus (HCV) (Gonzales et al., 2006; Shoptaw et al., 2003). Psychiatric disorders also frequently co-occur with chronic MA abuse during both intoxication and withdrawal phases, including psychosis (McKetin et al., 2006) depression and increased risk for suicidal ideation (Kalechstein et al., 2000; Zweben et al., 2004), and bipolar disorder (Shoptaw et al., 2003). Long-term use often results in considerable disruption in daily functioning, including interpersonal difficulties (Cretzmeyer et al., 2003), impulsivity (Semple et al., 2004, 2005), and unemployment (Baberg et al., 1996). "
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    ABSTRACT: Chronic use of methamphetamine (MA) has moderate effects on neurocognitive functions associated with frontal systems, including the executive aspects of verbal episodic memory. Extending this literature, the current study examined the effects of MA on visual episodic memory with the hypothesis that a profile of deficient strategic encoding and retrieval processes would be revealed for visuospatial information (i.e., simple geometric designs), including possible differential effects on source versus item recall. The sample comprised 114 MA-dependent (MA+) and 110 demographically-matched MA-nondependent comparison participants (MA-) who completed the Brief Visuospatial Memory Test-Revised (BVMT-R), which was scored for standard learning and memory indices, as well as novel item (i.e., figure) and source (i.e., location) memory indices. Results revealed a profile of impaired immediate and delayed free recall (p<0.05) in the context of preserved learning slope, retention, and recognition discriminability in the MA+ group. The MA+ group also performed more poorly than MA- participants on Item visual memory (p<0.05) but not Source visual memory (p>0.05), and no group by task-type interaction was observed (p>0.05). Item visual memory demonstrated significant associations with executive dysfunction, deficits in working memory, and shorter length of abstinence from MA use (p<0.05). These visual memory findings are commensurate with studies reporting deficient strategic verbal encoding and retrieval in MA users that are posited to reflect the vulnerability of frontostriatal circuits to the neurotoxic effects of MA. Potential clinical implications of these visual memory deficits are discussed.
    Australian and New Zealand Journal of Psychiatry 02/2012; 46(2):141-52. DOI:10.1177/0004867411433212 · 3.41 Impact Factor
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    • "The prevalence of OCD among methamphetamine users and the link between patterns of methamphetamine use and OCD have not been studied. Moreover, there is little information on the relationship between OCD and high-risk sexual behaviors, which are common among methamphetamine users [3, 4]. We propose that successful treatment of individuals with OCD and methamphetamine use disorder may require addressing both conditions. "
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    ABSTRACT: Substance use has been identified as a risk factor for elevated levels of obsessive-compulsive disorder (OCD). This study examined methamphetamine use and sexual risk behaviors as correlates of OCD in a sample of 245 HIV-positive men having sex with men (MSM) in San Diego, CA. In a logistic regression analysis, OCD was associated with greater frequency of methamphetamine use, more depressive symptoms, seeking out risky venues and risky sexual partners when "high" on methamphetamine, and reporting fewer sex acts in the past 2 months. These data suggest the need for increased awareness and understanding of the role that OCD may play in the drug use behaviors and risky sexual practices of methamphetamine users.
    AIDS and Behavior 08/2011; 15(6):1153-60. DOI:10.1007/s10461-010-9719-7 · 3.49 Impact Factor
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