Predictors of methamphetamine psychosis: history of ADHD-relevant childhood behaviors and drug exposure

Abstract

The goal of this study was to extend our previous research that reported a significant association between Attention Deficit Hyperactivity Disorder (ADHD)-relevant childhood behaviors and the frequency of methamphetamine (MA)-induced psychotic symptoms in an expanded sample. 190 participants who met DSM-IV criteria for MA dependence were administered the Methamphetamine Experience Questionnaire that assessed MA-induced psychosis. Data related to MA exposure, comorbid drug use, education, familial psychiatric history and assessments of ADHD-relevant childhood behaviors as measured by the Wender Utah Rating Scale (WURS) were collected. Although WURS scores did not differ between 145 MAP+ and 45 MAP- subjects, MAP+ subjects with higher WURS scores were significantly more likely to report more frequent psychosis. Although mean daily MA dosage did not differ between the MAP+ and MAP- subjects, MAP+ subjects who consumed larger doses of MA were significantly more likely to experience frequent psychosis. These data suggest that ADHD-relevant childhood behaviors may interact with MA exposure to reflect a neurobiological vulnerability related to the emergence of frequent MA-induced psychotic symptoms. These results may elucidate factors that contribute to the psychiatric sequelae of MA abuse.

Keywords: ADHD; Attention; Methamphetamine; Predictors; Prefrontal cortex; Psychosis; Substance abuse.

Figure 1

Association between Wender Utah Rating Scale of childhood attention and methamphetamine daily dose with frequency of psychosis measured on a Likert scale. Box plots define the values for median, range, 25th and 75th percentiles. Means are represented by filled circles. The proportional odds model was used to calculate the odds (OR) of developing more frequent psychosis for higher Wender Utah scores (OR = 1.04, p < 0.0001) and larger methamphetamine daily dose (OR = 1.61, p = 0.003), respectively.