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Psychotic disorders among inpatients with abuse of cannabis, amphetamine and opiates. Do dopaminergic stimulants facilitate psychiatric illness?

Published online by Cambridge University Press:  16 April 2020

A. Dalmau
Affiliation:
Department of Clinical Neuroscience, Psychiatry Section, Huddinge Hospital, Huddinge
B. Bergman*
Affiliation:
Department of Clinical Neuroscience, Psychiatry Section, Huddinge Hospital, Huddinge
B. Brismar
Affiliation:
A-division, Huddinge Hospital, Huddinge, Sweden
*
*Correspondence: Dr Bo Bergman, Department of Psychiatry, M56, Karolinska Institute, Huddinge Hospital, SE-141 86 Huddinge, Sweden.
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Summary

We have studied the occurrence of dual diagnoses (psychoses as well as abuse of either amphetamine, cannabis or opiates) during a 15-year period, among patients treated at Huddinge Hospital, Stockholm, Sweden. The purpose of the study is to evaluate if the different drugs were coupled to different rates of psychiatric co-morbidity. During the period in question, 461, 425 and 371 different patients respectively had been admitted at least once due to dependency on amphetamine, cannabis and opiates. Approximately 30% of the patients with a pure abuse of amphetamine or cannabis and less than 6% of the opiate abusers had been diagnosed at least once with any of the psychoses studied. Comparing the frequency of psychoses among mixed and pure abusers of illegal drugs, with and without a concomitant abuse of alcohol, we found that the co-morbidity rate for mixed opiate abusers increased significantly from 7.2 to 20.2% when alcohol abuse was also present. For abusers of amphetamine and cannabis (both pure and mixed), no differences in co-morbidity rates were seen when an abuse of alcohol was added to that of the drugs. It is difficult to find an explanation for the significant difference between the co-morbidity of pure abuse of amphetamine or cannabis on the one hand and opiates on the other. In conclusion, our findings show that the distribution of psychotic illness is high among abusers of amphetamine and cannabis, in contrast to the generally lower co-morbidity among abusers of opiates. Although these findings are consistent with earlier studies that have shown a propensity for developing psychoses among abusers of amphetamine and cannabis, one should bear in mind that this study is based on inpatients, and is not necessarily representative for all abusers of the drugs in question.

Type
Original article
Copyright
Copyright © European Psychiatric Association 1999

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References

Abbott, PJWeller, SBWalker, SR. Psychiatric disorders of opioid addicts entering treatment: preliminary data. In: Magura, SRosenblum, A, eds. Experimental Therapeutics in Addiction Medicine. The Haworth Press; 1994. p. 111.Google Scholar
Allebeck, PAdamsson, CEngström, ARydberg, U. Cannabis and schizophrenia - A longitudinal study of cases treated in Stockholm County Acta Psychiatr Scand 1993 ; 88 : 21-4.CrossRefGoogle ScholarPubMed
Andréasson, SAllebeck, PEngström, ARydberg, U. Cannabis and schizophrenia- A longitudinal study of Swedish conscripts Lancet 1987 ; 26 : 1483-6.CrossRefGoogle Scholar
Andréasson, SAllebeck, PRydberg, U. Schizophrenia in users and non-users of cannabis Acta Psychiatr Scand 1989 ; 79 : 505-10.CrossRefGoogle Scholar
Angrist, BMGershon, S. The phenomenology of experimentally induced amphetamine psychosis-preliminary observations Biol Psychiatry 1970 ; 2 : 95107.Google ScholarPubMed
Baberg, HTNelesen, RADimsdale, JE. Amphetamine use: return of an old scourge in a consultation psychiatry setting Am J Psychiatry 1996 ; 153 : 789-93.Google Scholar
Brooner, RKKing, VLKidorf, MSchmidt, CWBigelow, GE. Psychiatric and substance use comorbidity among treatmentseeking opioid abusers Arch Gen Psychiatry 1997 ; 54 : 7180.CrossRefGoogle Scholar
CAN (Central Unit for Information concerning Alcohol and Narcotic drugs). Alcohol and narkotikaanvändandet i Sverige (The use of alcohol and drugs in Sweden). Report No. 6. Stockholm: 1998.Google Scholar
Cohen, MKlein, DFOaks, G. Age of onset of drug abuse in psychiatric inpatients Arch Gen Psychiatry 1972 ; 26 : 266-9.CrossRefGoogle ScholarPubMed
Dixon, LHaas, GWeiden, PJSweeney, JFrances, AJ. Drug abuse in schizophrenic patients: clinical correlates and reasons for use Am J Psychiatry 1991 ; 148 : 224-30.Google ScholarPubMed
Griffith, JDFann, WEOates, JA. The amphetamine psychosis: experimental manifestations In: Ellinwood, EHCohen, S, eds. Current concepts on amphetamine abuse Rockville Maryland National Institute of Mental Health: DHEW Publication; 1972. p 185-91.Google Scholar
Hechtman, L. Adolescent outcome of hyperactive children treated with stimulants in childhood: A review Psychopharmacol Bull 1985 ; 21 : 178-91.Google ScholarPubMed
Helling, S. Droger utan gräns (Drugs without border). Stockholm: P A Norstedt & Söners förlag; 1985. p. 92102.Google Scholar
Helling, S. Världens droger, Världens fakta nr 13, Utrikespolitiska Institutet (The drugs of the world, The fact of the world No 13, The Institute of Foreign Affairs). Stockholm: Tierps Tryckeri AB; 1993. p. 13.Google Scholar
Jansson, B. Ungdomsnarkomanin i Sverige (Narcotic addiction among youngsters in Sweden). Nordisk psykiatrisk tidskrift 1970 ; 24 : 4456.CrossRefGoogle Scholar
Kessler, RCNelson, CBMcGonagle, KAEdlund, MJFrank, RGLeaf, PJ. The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization Am J Orthopsychiatry 1996 ; 66 : 1731.CrossRefGoogle ScholarPubMed
Khantzian, EJTreece, C. DSM-III psychiatric diagnosis of narcotic addicts Arch Gen Psychiatry 1985 ; 42 : 1067-71.CrossRefGoogle ScholarPubMed
Kokkevi, AStefanis, C. Drug abuse and psychiatric comorbidity Compr Psychiatry 1995 ; 36 : 329-37.CrossRefGoogle ScholarPubMed
Konuma, K. Use and abuse of amphetamines in Japan In: Cho, AKSegal, DS, eds. Amphetamine and Its Analogs San Diego: Academic Press Inc. ; 1994. p. 415-35.Google Scholar
Kuczenski, RSegal, DS. Neurochemistry of amphetamine In: Cho, AKSegal, DS, eds. Amphetamine and Its Analogs San Diego: Academic Press Inc. ; 1994. p. 81104.Google Scholar
McLelland, ATWoody, GEO’Brian, CP. Development of psychiatric illness in drug abusers The N Engl J Med 1979 ; 301 : 1310-4.CrossRefGoogle Scholar
Miller, MAHughes, AL. Epidemiology of amphetamine use in the United States In: Cho, AKSegal, DS, eds. Amphetamine and Its Analogs San Diego: Academic Press Inc.; 1994. p. 439-57.Google Scholar
Negrete, JCKnapp, WPDouglas, DESmith, WB. Cannabis affects the severity of schizophrenic symptoms: results of a clinical survey Psychol Med 1986 ; 16 : 515-20.CrossRefGoogle ScholarPubMed
Regier, DAFarmer, MERae, DSLocke, BZKeith, SJJudd, LL, et al. Comorbidity of mental disorders with alcohol and other drug abuse JAMA 1990 ; 264 : 2511-8.CrossRefGoogle ScholarPubMed
Rounsaville, BJWeissman, MMKleber, HWilber, C. Heterogeneity of psychiatric diagnosis in treated opiate addicts Arch Gen Psychiatry 1982 ; 39, 161-6.CrossRefGoogle ScholarPubMed
Ross, HEGlaser, FBGermanson, T. The prevalence of psychiatric disorders in patients with alcohol and other drug problems Arch Gen Psychiatry 1988 ; 45 : 1023-31.CrossRefGoogle ScholarPubMed
Russell, JMNewman, SCBland, RC. Drug abuse and dependence Acta Psychiatr Scand 1994 ; Suppl 376 : 5462.CrossRefGoogle ScholarPubMed
Swedish version of International Classification of Diseases Eighth Rev. Stockholm: Liber Distribution; 1968.Google Scholar
Swedish version of International Classification of Diseases Ninth Rev. Stockholm: Nordstedts Tryckeri; 1987.Google Scholar
Schneier, FRSiris, SG. A review of psychoactive substance use and abuse in schizophrenia J Nerv Ment Dis 1987 ; 175 : 641-52.CrossRefGoogle Scholar
Shaffer, D. Attention deficit hyperactivity disorder in adults Am J Psychiatry 1994 ; 151 : 633-8.Google ScholarPubMed
Treffert, DA. Marijuana use in schizophrenia: a clear hazard Am J Psychiatry 1978 ; 135 : 1213-5.Google ScholarPubMed
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