Objectives Methamphetamine (MA) use among young people is of significant social, economic and public health concern to affected communities and policy makers. While responses have focused upon various perceived severe harms of MA use, effective public health interventions require a strong scientific evidence base. Methods We conducted a systematic review to identify scientific studies investigating health outcomes associated with MA use among young people aged 10-24 years. The International Classification of Diseases (ICD-10) was used to categorize outcomes and determine the level of evidence for each series of harms. Results We identified 47 eligible studies for review. Consistent associations were observed between MA use and several mental health outcomes, including depression, suicidal ideation and psychosis. Suicide and overdose appear to be significant sources of morbidity and mortality among young MA users. Evidence for a strong association between MA use and increased risk of human immunodeficiency virus (HIV) and other sexually transmitted infections is equivocal. Finally, we identified only weak evidence of an association between MA use and dental diseases among young people. Conclusions Available evidence indicates a consistent relationship between MA use and mental health outcomes (e.g. depression, psychosis) and an increased risk of mortality due to suicide and overdose. We found insufficient evidence of an association between MA use and other previously cited harms, including infectious diseases and dental outcomes. As such, future research of higher methodological quality is required to further investigate possible associations. Current interventions should focus attention upon MA-related health outcomes for which sound scientific evidence is available. Language: en

Health outcomes associated with methamphetamine use among young people: a systematic review.

eveloped as an amphetamine derivative, methamphetamine quickly ecame a popular medication during the 1940s and 1950s, prescribed for variety of indications Extensive diversion of methamphetamine during he 1960s and an increasing awareness of the adverse health effects ssociated with methamphetamine led to the withdrawal of most of the ndications for licit methamphetamine use and declines in legal producion of the drug However, the illicit manufacture of methamphetamine ncreased to meet the demand for methamphetamine, and methamphetmine abuse has increased with variable geographic penetrance over the ast 30 years Methamphetamine is an indirect sympathomimetic agent that is distinuished from amphetamine by a more rapid distribution into the central ervous system (CNS), resulting in the rapid onset of euphoria that is the esired effect for those abusing the drug Increases in monoamine eurotransmission are responsible for the desired effects—wakefulness, nergy, sense of well-being, and euphoria—as well as the excess ympathetic tone that mediates many its adverse health effects Methamphetamine is associated with adverse effects to every organ ystem Although the most significant morbidity and mortality occur ecause of cardiovascular effects, such as myocardial infarction and ypertensive crisis, no organ system remains unscathed by methamphet-

Methamphetamine: History, Pathophysiology, Adverse Health Effects, Current Trends, and Hazards Associated with the Clandestine Manufacture of Methamphetamine

Objective To describe mental health services utilization for adolescents after attempted suicide, explore factors related to treatment compliance, and determine the relation between compliance and suicidality. Method Eighty-five adolescents (ages 13-18) who had attempted suicide and their families were recruited from four psychiatric hospitals and were evaluated for symptoms of psychopathology. Subsequent assessments were conducted every 6 months for 2 years to determine treatment utilization, treatment compliance (nonadherence to medication regimens or nonattendance of psychosocial treatments against provider advice), attitudes toward treatments used, and further suicide attempts and ideation. Results Adolescents with a disruptive behavior disorder diagnosis were less compliant with individual psychotherapy, as were those with a substance dependence other than alcohol or marijuana. Those with an affective/anxiety disorder diagnosis were less compliant with psychopharmacological interventions (6 months postattempt). Parental perception of treatment as helpful was predictive of greater compliance, whereas adolescents' attitudes toward treatment were not predictive of compliance. Finally, compliance with treatment was not generally predictive of future suicidality. Conclusions Interventions focused on increasing compliance with mental health treatment for adolescent suicide attempters should focus on specific child psychopathology, as well as parental attitudes toward treatment. J. Am. Acad. Child Adolesc. Psychiatry , 2008;47(8):948-957.

/pdf/treatment-compliance-in-adolescents-after-attempted-suicide-4yyc4r1ebr.pdf

Treatment compliance in adolescents after attempted suicide: a 2-year follow-up study.

Over the past few years, methamphetamine-induced psychosis (MIP) has increased in Iran, accounting for a significant percentage of psychiatry hospital admissions. The present study was conducted with an aim to investigate clinical symptoms, and course and treatment methods of MIP inpatients in Shafa Psychiatry Hospital in northern Iran. Participants were 152 MIP inpatients. Brief Psychiatric Rating Scale (BPRS) subscales of suspiciousness, unusual thought content; hallucinations and hostility were used to measure psychiatric symptoms. Data regarding suicide and homicide and violence were also obtained through interviews with the inpatients and their family. Based on their lengths of recovery time, the inpatients were categorized into 3 clinical groups. These inpatients received their usual treatments and were monitored for their psychiatric symptoms and clinical course of illness. The data were analyzed by descriptive statistics. The most frequent psychiatric symptoms were violence (75.6 %), intimate partner violence (61.2 %), delusions of persecution (85.5 %), delusions of reference (38.5 %), delusions of grandiosity (32.9 %), delusions of infidelity (30.2 %), auditory hallucinations (51.3 %), visual hallucinations (18.4 %), suicidal thoughts (14.5 %), homicidal thoughts (3.9 %), suicide attempts (10.5 %) and homicide attempts (0.7 %). Recovery from psychotic symptoms in 31.6 % of the inpatients took more than one month. 46.1% of the inpatients were treated with Risperidone and 37.5 % with Olanzapine. Persecutory delusion and auditory hallucination were the most frequent persistent psychotic symptoms. 20.8 % of the inpatients with duration of psychosis more than one month were treated with electroconvulsive therapy (ECT) along with antipsychotics. All forms of violence are highly frequent in MIP inpatients. Our finding agrees with many other studies suggesting that recovery from MIP can take more than a month. Initial promising findings were found regarding the efficacy of Electroconvulsive therapy in MIP patients.

/pdf/clinical-features-course-and-treatment-of-methamphetamine-5frqy7fdbt.pdf

Clinical features, course and treatment of methamphetamine-induced psychosis in psychiatric inpatients.

Crystal methamphetamine: A source of added sexual risk for Hispanic men who have sex with men?

. Objective: A study of medical examiner records from suicide completers was designed to identify potential precipitating factors in the decision to commit suicide. Methods: Forensic data has been collected for a subset of suicide victims in Utah who completed suicide between 1996 and 2002. Results: Youth suicide completers appear to be undiagnosed for mental illness, or to be noncompliant with psychotropic medications. Along with treatment issues, alcohol and methamphetamine were the most common substances found in the blood and/or urine of suicide completers. Conclusions: Accurate diagnosis of mental illness, and improved compliance with psychotropic medications may play a critical role in suicide prevention. The prevalence of methamphetamine in suicide completers is unexpectedly high and requires further investigation.

Preliminary Findings of Noncompliance with Psychotropic Medication and Prevalence of Methamphetamine Intoxication Associated with Suicide Completion

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Preliminary Findings of Noncompliance with Psychotropic Medication and Prevalence of Methamphetamine Intoxication Associated with Suicide Completion