Background: The long-term outcome of patients diagnosed with drug-induced psychotic disorders in China is unknown.
Aim: Assess the course of illness and severity of psychiatric symptoms in patients previously admitted to a psychiatric hospital for treatment of psychotic symptoms that were induced by the use of illicit drugs.
Methods: Patients with psychotic symptoms at the time of their first psychiatric admission who had used illicit drugs in the month prior to admission were followed up 13 to 108 months after admission. Patients and coresident family members were interviewed about post-discharge drug use and psychotic symptoms.
Results: The 258 identified patients were primarily young, unemployed males whose most common drug of abuse was methamphetamines and who had been abusing drugs for an average of 7 years at the time of admission. Among these patients 189 (73%) were located and reinterviewed; 168 (89%) had restarted illicit drug use and 25 (13%) had required rehospitalization over the follow-up period. In 114 patients (60%) the psychotic symptoms resolved in less than 1 month after stopping the drugs, in 56 (30%) the symptoms persisted for 1 to 6 months, and in 19 (10%) the symptoms persisted for longer than 6 months (in 8 of these the diagnosis had changed to schizophrenia). Compared to the other two groups, patients whose symptoms persisted more than 6 months were more likely to have a family history of mental illness, an earlier age of onset and a longer duration of drug abuse prior to the index admission; they were also more likely to have been re-hospitalized during the follow-up period and to have psychotic symptoms at the time of follow-up.
Conclusion: Most patients with substance-induced psychotic disorders in our sample had a good long-term prognosis but those who started illegal drug use early, used drugs for prolonged periods, or had a family history of psychiatric illnesses were more likely to develop a chronic psychosis. Further prospective studies are needed to determine the relationship of the neurotoxic effects of illicit drugs and the predisposing characteristics of the individuals in the development of chronic psychosis in persons who use illicit drugs.
背景: 国内关于精神活性物质所致精神病性障碍的长期预后尚不清楚。
目的: 对因吸毒出现精神症状而曾住院治疗的患者，评估其精神症状的严重程度和病程。
方法: 于2012年对2003 年至2010 年期间首次在深圳市康宁医院住院、入院前1个月内曾非法使用过毒品、被诊断为精神活性物质所致精神病性障碍的患者进行随访，随访期为13~108个月。通过对患者及其同住的家庭成员的调查，了解患者出院后复吸情况及精神病性症状演变情况。
结果: 受调查的258例患者主要特点为年轻、男性、无业，主要使用的毒品为冰毒，入院时使用毒品的平均时间为7年。共189例完成随访，其中168例（89%）复吸，25例（13%）在随访期间再次住院。114例（60%）患者的精神症状在停吸1个月内缓解，56例（30%）的精神症状持续1~6个月，19例（10%）的精神症状持续存在超过6个月（其中8例的诊断改为精神分裂症）。与症状持续时间较短的其他两组相比，症状持续6个月以上这组存在精神疾病家族史的比例最高，开始吸毒的年龄最小，首次住院前毒品使用时间最长，随访期间再住院的比例最高，随访时存在精神症状的比例也最高。
结论: 多数精神活性物质所致精神病性障碍患者预后较好，但首次吸毒年龄小、吸毒年限长、存在精神疾病家族史者容易发展为慢性精神病。需要进一步开展前瞻性研究，以明确毒品的神经毒性作用与个体素质之间的相互关系在吸毒者出现慢性精神病中所起的作用。