Background: Methamphetamine psychosis (MAP) symptomatology has been described as indistinguishable from that of schizophrenia (SZ), yet research comparing these two disorders on specific psychotic symptoms such as schneiderian first-rank symptoms (FRS) is lacking. We aimed to determine and compare the occurrence and associations of FRS in patients diagnosed with MAP and with SZ. Sampling and Method: Data from SCID-I interviews performed on patients with either a diagnosis of SZ or MAP were compared. We calculated the prevalence of different FRS between MAP and SZ patients and used logistic regression to assess the association between FRS and diagnosis. Results: 102 patients were included in the study (MAP = 33, SZ = 69). Thought broadcasting occurred significantly more often in SZ (42%) than in MAP (24.2%) patients (adjusted OR = 3.02; 95% CI: 1.12-8.15; p = 0.028), while auditory hallucinations (voices conversing) were significantly higher in MAP (48.5%) than in SZ (20.3%) patients (adjusted OR = 0.27; 95% CI: 0.10-0.66; p = 0.004). However, there was no significant difference in the occurrence of one or more FRS in MAP and SZ, with most FRS showing overlap. Conclusions: We found that first-rank auditory hallucinations were more prevalent in MAP, whereas first-rank delusions of thought broadcasting were more prevalent in SZ. However, there was a substantial overlap in MAP and SZ for most FRS. This is consistent with the finding that FRS may have limited diagnostic specificity and that there is significant overlap in the symptoms of MAP and SZ. Future research into the neurobiology of delusions and hallucinations needs to take FRS into account.

1.
Ali R, Baigent M, Marsden J, Montiero M, Srisurapanont M, Sunga A, Vial R, Wada K: WHO Multi-Site Project on Methamphetamine-Induced Psychosis: A Descriptive Report of Findings from Participating Countries. Adelaide, Drug & Alcohol Services South Australia, 2006, vol 20.
2.
Dada S, Burnhams NH, Johnson K, Parry C, Bhana A, Timol F, Fourie D: Alcohol and Drug Abuse Trends: January-June 2014 (Phase 36). Cape Town, South African Medical Research Council, 2014.
3.
UNODC: World Drug Report 2011. Vienna, United Nations Publications, 2011.
4.
Pluddemann A, Dada S, Parry CD, Kader R, Parker JS, Temmingh H, et al: Monitoring the prevalence of methamphetamine-related presentations at psychiatric hospitals in Cape Town, South Africa. Afr J Psychiatry (Johannesbg) 2013;16:45-49.
5.
McKetin R, McLaren J, Lubman DI, Hides L: The prevalence of psychotic symptoms among methamphetamine users. Addiction 2006;101:1473-1478.
6.
Norman R, Bradshaw D, Schneider M, Pieterse D, Groenewald P: Revised Burden of Disease Estimates for the Comparative Risk Factor Assessment, South Africa 2000. Methodological Note. Cape Town, South African Medical Research Council, 2006.
7.
Baker A, Dawe S: Amphetamine use and co-occurring psychological problems: review of the literature and implications for treatment. Aust Psychol 2005;40:88-95.
8.
Bell DS: Comparison of amphetamine psychosis and schizophrenia. Br J Psychiatry 1965;111:701-707.
9.
Davis JM, Schlemmer RF: The amphetamine psychosis; in Caldwell J, Mulé SJ (eds): Amphetamines and Related Stimulants: Chemical, Biological, Clinical and Sociological Aspects. Boca Raton, CRC Press, 1980, pp 161-173.
10.
Connell PH: Amphetamine Psychosis. Maudsley Monograph No. 5. London, Chapman & Hall, 1958.
11.
Medhus S, Mordal J, Holm B, Morland J, Bramness JG: A comparison of symptoms and drug use between patients with methamphetamine-associated psychoses and patients diagnosed with schizophrenia in two acute psychiatric wards. Psychiatry Res 2013;206:17-21.
12.
Srisurapanont M, Arunpongpaisal S, Wada K, Marsden J, Ali R, Kongsakon R: Comparisons of methamphetamine psychotic and schizophrenic symptoms: a differential item functioning analysis. Prog Neuropsychopharmacol Biol Psychiatry 2011;35:959-964.
13.
Oyebode F: Sims' Symptoms in the Mind: An Introduction to Descriptive Psychopathology, ed 4. Philadelphia, Saunders, Elsevier, 2008.
14.
Crichton P: First-rank symptoms or rank-and-file symptoms? Br J Psychiatry 1996;169:537-540; discussion 541-550.
15.
Srisurapanont M, Ali R, Marsden J, Sunga A, Wada K, Monteiro M: Psychotic symptoms in methamphetamine psychotic in-patients. Int J Neuropsychopharmacol 2003;6:347-352.
16.
Bousman CA, McKetin R, Burns R, Woods SP, Morgan EE, Atkinson JH, et al: Typologies of positive psychotic symptoms in methamphetamine dependence. Am J Addict 2015;24:94-97.
17.
Nordgaard J, Arnfred SM, Handest P, Parnas J: The diagnostic status of first-rank symptoms. Schizophr Bull 2008;34:137-154.
18.
Soares-Weiser K, Maayan N, Bergman H, Davenport C, Kirkham AJ, Grabowski S, et al: First rank symptoms for schizophrenia. Cochrane Database Syst Rev 2015;1:CD010653.
19.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 5. Arlington, American Psychiatric Association, 2013.
20.
Gaebel W: Status of psychotic disorders in ICD-11. Schizophr Bull 2012;38:895-898.
21.
Ihara K, Morgan C, Fearon P, Dazzan P, Demjaha A, Lloyd T, et al: The prevalence, diagnostic significance and demographic characteristics of Schneiderian first-rank symptoms in an epidemiological sample of first-episode psychoses. Psychopathology 2009;42:81-91.
22.
Ramperti N, Anwar M, Renwick L, Jackson D, Foley S, McWilliams S, et al: First rank symptoms in first episode psychosis and their relationship to the duration of untreated illness. J Nerv Ment Dis 2010;198:820-823.
23.
Salleh MR: Specificity of Schneider's first rank symptoms for schizophrenia in Malay patients. Psychopathology 1992;25:199-203.
24.
Tandon R, Greden JF: Schneiderian first rank symptoms: reconfirmation of high specificity for schizophrenia. Acta Psychiatr Scand 1987;75:392-396.
25.
Rosse RB, Collins JP Jr, Fay-McCarthy M, Alim TN, Wyatt RJ, Deutsch SI: Phenomenologic comparison of the idiopathic psychosis of schizophrenia and drug-induced cocaine and phencyclidine psychoses: a retrospective study. Clin Neuropharmacol 1994;17:359-369.
26.
Schanzer BM, First MB, Dominguez B, Hasin DS, Caton CL: Diagnosing psychotic disorders in the emergency department in the context of substance use. Psychiatr Serv 2006;57:1468-1473.
27.
Bramness JG, Gundersen OH, Guterstam J, Rognli EB, Konstenius M, Loberg EM, et al: Amphetamine-induced psychosis - a separate diagnostic entity or primary psychosis triggered in the vulnerable? BMC Psychiatry 2012;12:221.
28.
Barnes TR: Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2011;25:567-620.
29.
Howells FM, Uhlmann A, Temmingh H, Sinclair H, Meintjes E, Wilson D, et al: 1H-magnetic resonance spectroscopy (1H-MRS) in methamphetamine dependence and methamphetamine induced psychosis. Schizophr Res 2014;153:122-128.
30.
First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition. (SCID-I/P). New York, Biometrics Research, New York State Psychiatric Institute, 2002.
31.
Bursac Z, Gauss CH, Williams DK, Hosmer DW: Purposeful selection of variables in logistic regression. Source Code Biol Med 2008;3:17.
32.
StataCorp: Stata Statistical Software: Release 13. College Station, StataCorp, 2013.
33.
Sato M, Numachi Y, Hamamura T: Relapse of paranoid psychotic state in methamphetamine model of schizophrenia. Schizophr Bull 1992;18:115-122.
34.
Hsieh JH, Stein DJ, Howells FM: The neurobiology of methamphetamine induced psychosis. Front Hum Neurosci 2014;8:537.
35.
Caton CL, Hasin DS, Shrout PE, Drake RE, Dominguez B, First MB, et al: Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis. Br J Psychiatry 2007;190:105-111.
36.
Niemi-Pynttari JA, Sund R, Putkonen H, Vorma H, Wahlbeck K, Pirkola SP: Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. J Clin Psychiatry 2013;74:e94-e99.
37.
Upthegrove R, Broome MR, Caldwell K, Ives J, Oyebode F, Wood SJ: Understanding auditory verbal hallucinations: a systematic review of current evidence. Acta Psychiatr Scand 2016;133:352-367.
38.
Kalmady SV, Venkatasubramanian G, Shivakumar V, Jose D, Ravi V, Gangadhar BN: Relationship between brain-derived neurotrophic factor and Schneiderian first rank symptoms in antipsychotic-naive schizophrenia. Front Psychiatry 2013;4:64.
39.
Venkatasubramanian G, Jayakumar PN, Keshavan MS, Gangadhar BN: Schneiderian first rank symptoms and inferior parietal lobule cortical thickness in antipsychotic-naïve schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2011;35:40-46.
40.
Ford JM: Studying auditory verbal hallucinations using the RDoC framework. Psychophysiology 2016;53:298-304.
41.
Jardri R, Pins D, Lafargue G, Very E, Ameller A, Delmaire C, et al: Increased overlap between the brain areas involved in self-other distinction in schizophrenia. PLoS One 2011;6:e17500.
42.
Liang X, He Y, Salmeron BJ, Gu H, Stein EA, Yang Y: Interactions between the salience and default-mode networks are disrupted in cocaine addiction. J Neurosci 2015;35:8081-8090.
43.
Uhlmann A, Fouche JP, Koen N, Meintjes EM, Wilson D, Stein DJ: Fronto-temporal alterations and affect regulation in methamphetamine dependence with and without a history of psychosis. Psychiatry Res 2016;248:30-38.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.