Comparisons of methamphetamine psychotic and schizophrenic symptoms: A differential item functioning analysis

Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand.
Progress in Neuro-Psychopharmacology and Biological Psychiatry (Impact Factor: 3.69). 02/2011; 35(4):959-64. DOI: 10.1016/j.pnpbp.2011.01.014
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The concept of negative symptoms in methamphetamine (MA) psychosis (e.g., poverty of speech, flatten affect, and loss of drive) is still uncertain. This study aimed to use differential item functioning (DIF) statistical techniques to differentiate the severity of psychotic symptoms between MA psychotic and schizophrenic patients. Data of MA psychotic and schizophrenic patients were those of the participants in the WHO Multi-Site Project on Methamphetamine-Induced Psychosis (or WHO-MAIP study) and the Risperidone Long-Acting Injection in Thai Schizophrenic Patients (or RLAI-Thai study), respectively. To confirm the unidimensionality of psychotic syndromes, we applied the exploratory and confirmatory factor analyses (EFA and CFA) on the eight items of Manchester scale. We conducted the DIF analysis of psychotic symptoms observed in both groups by using nonparametric kernel-smoothing techniques of item response theory. A DIF composite index of 0.30 or greater indicated the difference of symptom severity. The analyses included the data of 168 MA psychotic participants and the baseline data of 169 schizophrenic patients. For both data sets, the EFA and CFA suggested a three-factor model of the psychotic symptoms, including negative syndrome (poverty of speech, psychomotor retardation and flatten/incongruous affect), positive syndrome (delusions, hallucinations and incoherent speech) and anxiety/depression syndrome (anxiety and depression). The DIF composite indexes comparing the severity differences of all eight psychotic symptoms were lower than 0.3. The results suggest that, at the same level of syndrome severity (i.e., negative, positive, and anxiety/depression syndromes), the severity of psychotic symptoms, including the negative ones, observed in MA psychotic and schizophrenic patients are almost the same.

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Available from: Robert Leonard Ali, Jan 15, 2014
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    • "Conversely, dopaminomimetic drugs (receptor agonists or amphetamine-like drugs) induce positive symptoms similar to those observed in acute paranoid crisis (Sayed & Garrison, 1983). The chronic use of dopaminomimetic drugs leads to severe states of hallucinations (Srisurapanont et al., 2011) and cognitive deficits (Nordahl, Salo, & Leamon, 2003; Rund et al., 2004). Likewise, the administration of amphetamine to rodents induces responses such as stereotyped behavior (Kurokawa, Mizuno, Shibasaki, & Ohkuma, 2010), and decreases the prepulse inhibition (PPI) of the acoustic startle response (Arai et al., 2008), a sensory gating response that is characteristically blunted in schizophrenics (Powell, Weber, & Geyer, 2012). "
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    • "Whether there are fewer presentations of negative symptoms (lack of affect, social withdrawal) in MAP than schizophrenia (Tomiyama, 1990; Panenka et al., 2013), or whether both positive and negative symptom presentations are similar in MAP and schizophrenia (Srisurapanont et al., 2003, 2011), is still under debate. However, there is broad consensus that the positive symptoms of psychosis induced by methamphetamine use are difficult to distinguish from the positive symptoms of schizophrenia (Connell, 1958; Janowsky and Risch, 1979; Bramness et al., 2012; Medhus et al., 2013). "
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    • "Schizophrenia and methamphetamine (METH)-induced psychosis can be difficult to differentiate on the basis of acute symptoms (Srisurapanont et al., 2011) and as a result of this similarity in presenting symptoms, METH-induced psychosis was proposed as a model for studying schizophrenia (Hermens et al., 2009). The two conditions may be linked on a cellular level given that over 55% of people with a first episode of METH-induced psychosis experience relapse and up to 38% of the relapsing methamphetamine addicted individuals are eventually diagnosed with schizophrenia (Kittirattanapaiboon et al., 2010; Bramness et al., 2012). "
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