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Journal of Substance Abuse Treatment Feb 2020Regular methamphetamine use is associated with increased rates of psychiatric symptoms. Although there has been a substantial body of research reporting on the...
BACKGROUND
Regular methamphetamine use is associated with increased rates of psychiatric symptoms. Although there has been a substantial body of research reporting on the effectiveness of psychological treatments for reducing methamphetamine use, there is a paucity of research examining the effects of these treatments on co-occurring psychiatric symptoms. We addressed this gap by undertaking a systematic review of the evidence of the effectiveness of psychological treatments for methamphetamine use on psychiatric symptom outcomes in randomized controlled trials.
METHODS
A narrative synthesis of studies was conducted following the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement to inform methodology. Eight electronic peer-reviewed databases were searched. Ten eligible studies were assessed.
RESULTS
Most studies found an overall reduction in levels of methamphetamine use and psychiatric symptoms among samples as a whole. Although brief interventions were effective, there is evidence that more intensive interventions have greater impact on methamphetamine use and/or psychiatric symptomatology. Intervention attendance was variable.
CONCLUSIONS
The evidence suggests that a variety of psychological treatments are effective in reducing levels of methamphetamine use and improving psychiatric symptoms. Future research should consider how psychological treatments could maximize outcomes in the co-occurring domains of methamphetamine use and psychiatric symptoms, with increasing treatment attendance as a focus. PROSPERO registration number: CRD42016043657.
Topics: Humans; Methamphetamine; Randomized Controlled Trials as Topic; Substance-Related Disorders; Symptom Assessment
PubMed: 31856953
DOI: 10.1016/j.jsat.2019.09.005 -
Substance Abuse 2022Methamphetamine is a highly addictive central nervous stimulant associated with numerous adverse health, psychological, and social impacts. Family and friends of people... (Review)
Review
Methamphetamine is a highly addictive central nervous stimulant associated with numerous adverse health, psychological, and social impacts. Family and friends of people who use methamphetamine often take on a crucial caregiving role in supporting their loved one. Consequently, they can experience a range of psychosocial challenges themselves. This review aimed to identify and assess the effectiveness of interventions designed to support caregivers of people who use methamphetamine. A systematic search of relevant literature published in the English language was conducted. Of 2257 records identified, only 2 evaluation studies examined interventions specifically designed for caregivers of people who use methamphetamine. Additionally, four qualitative accounts described experiences of caring for people who use methamphetamine. These accounts were summarized narratively to provide a more complete picture of family and caregiver experiences and coping strategies. Effective treatment components included tending to caregiver concerns and providing training to enhance informational support and problem-solving skills. Qualitative accounts uncovered a range of challenges experienced by caregivers, such as emotional distress, concern for the person using methamphetamine, disrupted family structures, and financial difficulties. Coping strategies included attempts at managing and supporting the person using methamphetamine while protecting the overall cohesion and wellbeing of the family unit. This review highlighted a lack of evidence-based interventions for caregivers of people who use methamphetamine. More research is needed to clarify concerns that may be particularly relevant for those in a caregiving role.
Topics: Adaptation, Psychological; Caregivers; Family; Friends; Humans; Methamphetamine
PubMed: 35617624
DOI: 10.1080/08897077.2022.2074600 -
Neuroscience and Biobehavioral Reviews Jul 2022This paper examines developmental outcomes for children prenatally exposed to methamphetamine through maternal use. PSYCHINFO, Scopus, PubMed and ERIC databases were... (Meta-Analysis)
Meta-Analysis Review
This paper examines developmental outcomes for children prenatally exposed to methamphetamine through maternal use. PSYCHINFO, Scopus, PubMed and ERIC databases were systematically searched for studies up to December 2020. The search identified 38 articles examining cognitive, language, motor and neuroanatomical outcomes in children from birth to 16 years. Study quality was appraised using the Newcastle Ottawa Quality Assessment Scale. Findings from neuroanatomical studies suggested that prenatal methamphetamine exposure may alter whole brain microstructure and reduce subcortical volumes across multiple brain regions. Meta-analysis of 14 studies using a random-effects model revealed associations between exposure and poorer intellectual functioning (Cohen's d = 0.89, 95 % CI: 0.47-1.30), problem solving skills (Cohen's d = 0.82, 95 % CI: 0.07 -1.56), short-term memory (Cohen's d = 0.91, 95 % CI: 0.38-1.43), and language development (Cohen's d = 0.74, 95 % CI: 0.30-1.18). These results emphasise the significant impact of intrauterine methamphetamine exposure across multiple areas of child development, noting that limited total sample size, heterogeneity between studies and control for confounds suggested further studies are required. There is a need for further intervention studies to identify effective prevention and harm minimisation approaches.
Topics: Brain; Child; Child Development; Cognition; Female; Humans; Methamphetamine; Pregnancy; Prenatal Exposure Delayed Effects
PubMed: 35661684
DOI: 10.1016/j.neubiorev.2022.104714 -
Psychiatry Research. Neuroimaging Oct 2019Methamphetamine is a highly addictive psychostimulant. A subset of methamphetamine users develops methamphetamine-associated psychosis (MAP), which causes poorer...
Methamphetamine is a highly addictive psychostimulant. A subset of methamphetamine users develops methamphetamine-associated psychosis (MAP), which causes poorer prognoses and cognitive function than those with no psychosis (MNP). Comprehensive and integrative summaries of studies utilizing various neuroimaging modalities (structural, functional, and neurochemical) are limited. We conducted a systematic review of literature regarding clinical neuroimaging research published between January 1988 and July 2018 using the PubMed, Web of Science, Scopus, and ScienceDirect databases. Studies comparing the neuroimaging of patients with MAP with healthy controls or patients with MNP or schizophrenia were included to understand the distinct profiles associated with MAP. A total of six structural, three functional, and three neurochemical studies were reviewed. A general trend was identified that showed MAP-related brain alterations were mainly in the frontal lobe (especially the orbitofrontal cortex), striatum, and limbic systems (amygdala and hippocampus). Furthermore, some clinical manifestations, such as the severity of psychotic symptoms and cognitive performance, were correlated with neuroimaging abnormalities. In summary, distinct structural, functional, and neurochemical changes, especially in the frontostriatal circuit and network dynamic systems, play critical roles in the pathophysiology of MAP. Future studies using longitudinal study designs and including individuals with MNP and schizophrenia as controls are warranted.
Topics: Adult; Brain; Central Nervous System Stimulants; Cognition; Cross-Sectional Studies; Female; Humans; Longitudinal Studies; Magnetic Resonance Imaging; Male; Methamphetamine; Middle Aged; Nerve Net; Neuroimaging; Psychoses, Substance-Induced
PubMed: 31476712
DOI: 10.1016/j.pscychresns.2019.06.002 -
Substance Abuse Treatment, Prevention,... Sep 2018Substance use and depression co-occurrence is a frequent phenomenon and an important public health concern. Given the clinical implications and the high prevalence of... (Review)
Review
INTRODUCTION
Substance use and depression co-occurrence is a frequent phenomenon and an important public health concern. Given the clinical implications and the high prevalence of both disorders, effective interventions are needed.
METHODS
The aim of this study is to review Behavioural Activation (BA) intervention effects to improve substance use behaviour and depression. A systematic review was conducted using MEDLINE, EMBASE, and PsycINFO. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of included studies. Two authors independently screened titles and abstracts, reviewed selected studies, and extracted data.
RESULTS
Of the 7286 studies identified, eight met inclusion criteria. Designs of the studies included six randomized controlled trials (RCTs), and two pre-post design studies. One trial received weak methodological quality, six moderate, and one strong. Three studies addressed smoking behaviour; two targeted opiate dependence; two focused on alcohol/drug dependence; and, one on crystal methamphetamine abuse. Results showed that BA had a positive effect on substance use outcomes in seven of the eight reviewed studies, and improved depression over time in six studies.
CONCLUSIONS
Although studies conducted so far are limited by their heterogeneity and sample sizes, results are promising. There is a need of well controlled and powered studies to establish and to confirm the effectiveness of BA for the treatment of substance use and depression. Future studies should include stronger methodological designs, larger sample sizes, and long-term follow-ups.
TRIAL REGISTRATION
PROSPERO registration number: CRD42016039412 .
Topics: Cognitive Behavioral Therapy; Comorbidity; Depression; Humans; Substance-Related Disorders; Treatment Outcome
PubMed: 30268136
DOI: 10.1186/s13011-018-0173-2 -
Neuroscience and Biobehavioral Reviews Jan 2021Genetic susceptibility to methamphetamine use disorder is poorly understood. No twin or adequately powered genome-wide association studies (GWASs) have been conducted.... (Meta-Analysis)
Meta-Analysis Review
Genetic susceptibility to methamphetamine use disorder is poorly understood. No twin or adequately powered genome-wide association studies (GWASs) have been conducted. However, there are a large number of hypothesis-driven candidate gene association studies, which were systematically reviewed herein. Seventy-six studies were identified, investigating markers of 75 different genes. Allele frequencies, odds ratios, 95 % confidence intervals and power were calculated. Risk of bias was also assessed as a quality measure. Meta-analyses were conducted for gene markers if three or more studies were available. Eleven markers from adequately powered studies were significantly associated with methamphetamine use disorder, with Fatty Acid Amide Hydrolase (FAAH) and Brain Derived Neurotrophic Factor (BDNF) representing promising targets. Limitations of these studies include unclear rationale for candidate gene selection, low power and high risk of bias. Future research should include replications to enable more meta-analyses, well-powered GWASs or whole exome or genome sequencing, as well as twin and family studies to further complement the findings of this review to uncover genetic contributions toward methamphetamine use disorder.
Topics: Amphetamine-Related Disorders; Brain-Derived Neurotrophic Factor; Genetic Association Studies; Genetic Predisposition to Disease; Genome-Wide Association Study; Genotype; Humans; Methamphetamine; Polymorphism, Single Nucleotide
PubMed: 33217458
DOI: 10.1016/j.neubiorev.2020.11.001 -
Child Maltreatment May 2022State and federal policies regarding substance use in pregnancy, specifically whether a notification to child protective services is required, continue to evolve. To...
State and federal policies regarding substance use in pregnancy, specifically whether a notification to child protective services is required, continue to evolve. To inform practice, policy, and future research, we sought to synthesize and critically evaluate the existing literature regarding the association of prenatal substance exposure with child maltreatment. We conducted a comprehensive electronic search of PubMed, Web of Science, PsycInfo, CHINAL, Social Work Abstracts, Sociological Abstracts, and Social Services Abstracts. We identified 30 studies that examined the association of exposure to any/multiple substances, cocaine, alcohol, opioids, marijuana, and amphetamine/methamphetamine with child maltreatment. Overall, results indicated that substance exposed infants have an increased likelihood of child protective services involvement, maternal self-reported risk of maltreatment behaviors, hospitalizations and clinic visits for suspected maltreatment, and adolescent retrospective self-report of maltreatment compared to unexposed infants. While study results suggest an association of prenatal substance exposure with child maltreatment, there are several methodological considerations that have implications for results and interpretation, including definitions of prenatal substance exposure and maltreatment, study populations used, and potential unmeasured confounding. As each may bias study results, careful interpretation and further research are warranted to appropriately inform programs and policy.
Topics: Adolescent; Child; Child Abuse; Child Protective Services; Family; Female; Humans; Infant; Pregnancy; Retrospective Studies; Substance-Related Disorders
PubMed: 33550839
DOI: 10.1177/1077559521990116 -
Schizophrenia Research May 2024The clinical profiles of methamphetamine-induced psychosis (MIP) and schizophrenia are largely overlapping making differentiation challenging. In this systematic review... (Meta-Analysis)
Meta-Analysis Comparative Study Review
BACKGROUND
The clinical profiles of methamphetamine-induced psychosis (MIP) and schizophrenia are largely overlapping making differentiation challenging. In this systematic review and meta-analysis, we aim to compare the positive and negative symptoms of MIP and schizophrenia to better understand the differences between them.
STUDY DESIGN
In accordance with our pre-registered protocol (CRD42021286619), we conducted a search of English-language studies up to December 16th, 2022, in PubMed, EMBASE, and PsycINFO, including stable outpatients with MIP and schizophrenia. We used the Newcastle-Ottawa Scale to measure the quality of cross-sectional, case-control, and cohort studies.
STUDY RESULTS
Of the 2052 articles retrieved, we included 12 studies (6 cross-sectional, 3 case-control, and 2 cohort studies) in our meta-analysis, involving 624 individuals with MIP and 524 individuals with schizophrenia. Our analysis found no significant difference in positive symptoms between the two groups (SMD, -0.01; 95%CI, -0.13 to +0.11; p = 1). However, individuals with MIP showed significantly less negative symptoms compared to those with schizophrenia (SMD, -0.35; 95CI%, -0.54 to -0.16; p = 0.01; I = 54 %). Our sensitivity analysis, which included only studies with a low risk of bias, did not change the results. However, our meta-analysis is limited by its cross-sectional approach, which limits the interpretation of causal associations. Furthermore, differences in population, inclusion criteria, methodology, and drug exposure impact our findings.
CONCLUSIONS
Negative symptoms are less prominent in individuals with MIP. While both groups do not differ regarding positive symptoms, raises the possibility of shared and partly different underlying neurobiological mechanisms related to MIP and schizophrenia.
Topics: Humans; Methamphetamine; Schizophrenia; Psychoses, Substance-Induced; Central Nervous System Stimulants; Amphetamine-Related Disorders
PubMed: 38554698
DOI: 10.1016/j.schres.2024.03.037 -
Effect of Methamphetamine Hydrochloride on Pregnancy Outcome: A Systematic Review and Meta-analysis.Journal of Addiction Medicine 2018Methamphetamine hydrochloride is 1 of the most widespread psycho-stimulants in the world. Nevertheless, its effect on pregnant women and their neonates has not been... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Methamphetamine hydrochloride is 1 of the most widespread psycho-stimulants in the world. Nevertheless, its effect on pregnant women and their neonates has not been investigated extensively.
OBJECTIVE
To systematically review the literature for the effect of methamphetamine exposure during pregnancy to neonatal and pregnancy outcomes.
MATERIALS AND METHODS
A meta-analysis of retrospective, case-control studies was conducted. Inclusion criteria were women who have used methamphetamine during pregnancy, determined by self-report, maternal or neonatal urine test, and/or meconium toxicology, compared with control women not taking methamphetamine. Main study outcomes were gestational age at birth, neonatal characteristics (birth weight, head circumference, body length), and prevalence of gestational hypertensive disorders.
RESULTS
Eight studies involving 626 women taking methamphetamine during pregnancy and 2626 controls were included in the meta-analysis. Pregnancies complicated by the use of methamphetamine resulted in younger gestational age at birth (mean difference [MD] -0.90 weeks, 95% confidence interval [CI] -0.11, -1.69), lower birth weight (MD -245 g, 95% CI -137, -353), head circumference (MD -0.88 cm, 95% CI -0.48, -1.28), body length (MD -0.94 cm, 95% CI -0.55, -1.32), and Apgar score (MD -0.94, 95% CI -0.33, -1.54) compared with control pregnancies. On the contrary, there was no statistical difference on the incidence of pre-eclampsia (risk ratio [RR] 1.77, 95% CI 0.75, 4.14) and hypertensive complications (RR 1.62, 95% CI 0.37, 7.06).
CONCLUSIONS
Use of methamphetamine during pregnancy results in a deterioration of neonatal somatometric characteristics (birth weight, head circumference, body length), but not in excessive pregnancy complications (hypertension).
Topics: Birth Weight; Female; Gestational Age; Humans; Hypertension, Pregnancy-Induced; Infant, Newborn; Methamphetamine; Pregnancy; Pregnancy Complications; Pregnancy Outcome
PubMed: 29509557
DOI: 10.1097/ADM.0000000000000391 -
Psychiatry Research Feb 2022Longitudinal studies of substance-induced psychosis (SIP) suggest that approximately 11-46% of persons will progress to schizophrenia with differential risk of... (Review)
Review
Longitudinal studies of substance-induced psychosis (SIP) suggest that approximately 11-46% of persons will progress to schizophrenia with differential risk of progression depending on the type of substance used. The findings suggest SIP may be a distinct variant of a psychotic disorder, yet SIP is understudied and the disease expression is not well characterized, particularly the cognitive phenotype. There is some evidence for cognitive dysfunction in SIP, but a synthesis of this literature has not been undertaken. We systematically reviewed all empirical research (up to December 31, 2020) that examined cognition in SIP using clinical neuropsychological measures. The cognitive outcomes are summarized by type of SIP (methamphetamine, other stimulants, alcohol, cannabis, undifferentiated). There was evidence for global and domain-specific cognitive dysfunction in SIP compared to controls and non-psychotic persons who use substances. Impairments were of similar magnitude compared to persons with schizophrenia. Delineation of a specific cognitive profile in SIP was precluded by lack of literature with comparable study designs and outcomes. Variation in visual-based cognition may be a distinct feature of SIP, but this requires further investigation. More rigorously controlled studies of cognition in SIP are needed to inform differential diagnosis and identify the unique clinical needs of this population.
Topics: Central Nervous System Stimulants; Cognition; Cognitive Dysfunction; Humans; Neuropsychological Tests; Psychotic Disorders; Schizophrenia
PubMed: 34979380
DOI: 10.1016/j.psychres.2021.114361