Article Text

Download PDFPDF
Original research
Risk of psychosis in illicit amphetamine users: a 10 year retrospective cohort study
  1. Chieh-Liang Huang1,2,
  2. I-Ju Tsai3,
  3. Cynthia Wei-Sheng Lee4,5
  1. 1 Tsaotun Psychiatric Centre Ministry of Health and Welfare, Nan-Tou County, Taiwan
  2. 2 School of Medicine, China Medical University, Taichung, Taiwan
  3. 3 Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
  4. 4 Centre for Drug Abuse and Addiction, China Medical University Hospital, Taichung, Taiwan
  5. 5 Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
  1. Correspondence to Dr Cynthia Wei-Sheng Lee, Centre for Drug Abuse and Addiction, China Medical University Hospital, 2 Yude Road, Taichung 40447, Taiwan; cindywslee{at}gmail.com

Abstract

Question Amphetamine use is a risk factor for psychosis, which imposes a substantial burden on society. We aimed to investigate the incidence of psychosis associated with illicit amphetamine use and whether rehabilitation treatments could influence the psychosis risk.

Study selection and analysis A retrospective cohort study was conducted using the population based Taiwan Illicit Drug Issue Database (TIDID) and the National Health Insurance Research Database (NHIRD), from 2007 to 2016. We identified 74 601 illicit amphetamine users as the amphetamine cohort and 2 98 404 subjects as the non-amphetamine cohort. The incidence rate of newly diagnosed psychosis was the main outcome. Cox proportional hazards models were applied to assess the effects of amphetamine, and the Kaplan–Meier method was used to estimate the cumulative psychosis incidence curves.

Findings Illicit amphetamine users were 5.28 times more likely to experience psychosis than those without illicit drug use records. The risk was higher for subjects with multiple arrests for amphetamine use. A greater hazard ratio (HR) magnitude was observed in female patients. We also observed a significant decrease in the risk of psychosis in patients receiving rehabilitation treatments during deferred prosecution (adjusted HR 0.74, 95% CI 0.61 to 0.89).

Conclusions Illicit amphetamine use was associated with an increased incidence of psychosis. The risk was identified across all age groups, particularly in women and in those arrested multiple times, and was inversely correlated with rehabilitation treatments for amphetamine misuse.

  • illicit amphetamine use
  • psychosis
  • rehabilitation treatments
  • cohort study

Data availability statement

Data may be obtained from a third party and are not publicly available. Due to constraints on data sharing permissions from the Health and Welfare Data Science Centre, Taiwan, we are not allowed to share the data for public use.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data may be obtained from a third party and are not publicly available. Due to constraints on data sharing permissions from the Health and Welfare Data Science Centre, Taiwan, we are not allowed to share the data for public use.

View Full Text

Footnotes

  • Contributors C-LH conceived the study, acquired the funding, and interpreted the data. I-JT performed the data analysis. CW-SL designed the investigation, and was a major contributor in writing the manuscript and responsible for the overall content as the guarantor. All authors approved the final manuscript.

  • Funding This study was supported in part by the Ministry of Science and Technology (MOST 104-3011-F-039-001), Ministry of Health and Welfare (M05B4352), National Health Research Institutes (NP-108-GP-05), Ministry of Health and Welfare Clinical Trial Centre (MOHW109-TDU-B-212-114004), China Medical University Hospital and China Medical University, under the Higher Education Sprout Project of the Ministry of Education, Taiwan. The funders had no role in the study design, decision to publish or preparation of the manuscript.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.