Ketamine Psychosis: Clinical Presentations, Neurocognitive Function and Predisposing Factors

In recent years, recreational ketamine use has been remarkably increased in several parts of the world, including Taiwan. New problems including addiction, physical harms and mental harms have emerged. The aims of this investigation are 1) to determine longitudinal changes in neurocognitive function and psychotic/psychomimetic symptoms in ketamine psychisis; 2) to investigate predisposing vulnerability of ketamine associated psychosis (ketamine psychosis) or ketamine associated neurocognitive impairment; 3) to detect genetic variants for ketamine psychosis in a Chinese population with ketamine abuse. We will longitudinally follow up for one year 96 ketamine users with psychosis and 96 ketamine users without psychosis. The main inclusion criteria are: 1) meeting criteria for ketamine abuse or dependence; 2) aged between 18 and 60. The main exclusion criteria are 1) psychosis before first use of ketamine; 2) history of brain injury or medical conditions that influence the central nervous system. Baseline assessments include demographic data, drug use patterns, family psychiatric history, psychiatric diagnoses, psychotic/psychomimetic symptoms and neurocognitive function. The subjects will receive second assessments after one-month abstinence, and follow-up assessments in 6th month and 12th month. Psychiatric diagnosis will be made after interview with the Chinese version of Diagnostic Interview for Genetic Studies. Other assessments include CogState computerized cognitive test, Brief Assessment of Cognition in Schizophrenia, Brief Psychiatric Rating Scale, Psychotomimetic State Inventory, Schizotypal Personality Questionnaire. In addition to psychosis and disease course, the analyses include 1) comparing drug use patterns and predisposing factors; 2) comparing cognitive function; 3) comparing psychotic symptoms and cognitive function of ketamine users with those of 100 methamphetamine users and 50 patients with schizophrenia that we collected in previous studies. After full explanation and signing additional written inform consent, the subjects and their parent will be invited to participate genetic trios study for ketamine psychosis which consisted of COMT val158met candidate gene association and whole exome sequencing. With the experience of studying predisposing factors to methamphetamine psychosis, and the collaboration with the Department of Psychiatry at the Yale School of Medicine, this projects will serve an important role in explore the nature and etiology of ketamine psychosis.

Project ID:PC10207-0421
External Project ID:NSC102-2314-B182-007