Differences in clinical features of methamphetamine users with persistent psychosis and patients with schizophrenia

Liang Jen Wang, Shih Ku Lin, Yi Chih Chen, Ming Chyi Huang, Tzu Ting Chen, Shao Chun Ree, Chih Ken Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

19 Scopus citations


Background: Methamphetamine exerts neurotoxic effects and elicits psychotic symptoms. This study attempted to compare clinical differences between methamphetamine users with persistent psychosis (MAP) and patients with schizophrenia. In addition, we examined the discrimination validity by using symptom clusters to differentiate between MAP and schizophrenia. Methods: We enrolled 53 MAP patients and 53 patients with schizophrenia. The psychopathology of participants was assessed using the Chinese version of the Diagnostic Interview for Genetic Studies and the 18-item Brief Psychiatric Rating Scale. Logistic regression was used to examine the predicted probability scores of different symptom combinations on discriminating between MAP and schizophrenia. The receiver operating characteristic (ROC) analyses and area under the curve (AUC) were further applied to examine the discrimination validity of the predicted probability scores on differentiating between MAP and schizophrenia. Results: We found that MAP and schizophrenia demonstrated similar patterns of delusions. Compared to patients with schizophrenia, MAP experienced significantly higher proportions of visual hallucinations and of somatic or tactile hallucinations. However, MAP exhibited significantly lower severity in conceptual disorganization, mannerism/posturing, blunted affect, emotional withdrawal, and motor retardation compared to patients with schizophrenia. The ROC analysis showed that a predicted probability score combining the aforementioned 7 items of symptoms could significantly differentiate between MAP and schizophrenia (AUC = 0.77). Conclusion: Findings in the current study suggest that nuanced differences might exist in the clinical presentation of secondary psychosis (MAP) and primary psychosis (schizophrenia). Combining the symptoms as a whole may help with differential diagnosis for MAP and schizophrenia.

Original languageEnglish
Pages (from-to)108-115
Number of pages8
Issue number2
StatePublished - 01 06 2016

Bibliographical note

Publisher Copyright:
© 2016 S. Karger AG, Basel.


  • Drug-induced psychosis
  • Methamphetamine
  • Psychopathology
  • Schizophrenia


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