Tags

Type your tag names separated by a space and hit enter

Stimulant use disorders in people with psychosis: a meta-analysis of rate and factors affecting variation.
Aust N Z J Psychiatry. 2015 Feb; 49(2):106-17.AN

Abstract

OBJECTIVE

Stimulant abuse and dependence often complicate the care of people with psychotic disorders. This study systematically reviews the prevalence estimates reported for stimulant abuse and dependence in people with psychotic disorders, and examines personal, clinical, regional and methodological factors which explain variation in these rates.

METHODS

PsychINFO, EMBASE and MEDLINE (1946-2013) were searched systematically for studies reporting on stimulant drug use disorders in representative samples of people with psychotic disorders. Random effects models estimated the pooled rate of a stimulant use disorder, defined to include stimulant abuse and stimulant dependence. Study characteristics associated with heterogeneity in rates of stimulant use disorder were examined by subgroup analyses for categorical variables, by meta-regression for continuous independent variables and by multiple meta-regression.

RESULTS

Sixty-four studies provided 68 estimates of lifetime or recent stimulant use disorders in 22,500 people with psychosis. The pooled rate of stimulant use disorder was 8.9% (95% CI 7.4%, 10.5%). Higher rates of stimulant use disorders were reported in studies of affective psychosis, studies from inpatient settings, studies from the USA and Australia, and studies with higher rates of cannabis disorder; in multiple meta-regression analysis these factors explained 68% of between-study variance. Rates of stimulant use disorder were stable over time, and unrelated to age, sex, stage of psychosis, type of stimulant drug or study methodology factors.

CONCLUSIONS

Reported rates of stimulant use disorder in people with psychosis are much higher than in the general population but vary widely and are associated with regional, service setting and clinical differences between studies. It is likely that stimulants contribute to the overall burden of psychosis, and that social and environmental factors combine with drug and illness-related factors to influence stimulant use in psychosis.

Authors+Show Affiliations

InforMH, Mental Health and Drug and Alcohol Office, NSW Health, North Sydney, Australia School of Population Health, University of Queensland, Brisbane, Australia Grant.Sara@health.nsw.gov.au.Mental Health Service, Prince of Wales Hospital, Randwick, Australia School of Psychiatry, University of New South Wales, Randwick, Australia.Schizophrenia Research Institute, Darlinghurst, Australia.School of Population Health, University of Queensland, Brisbane, Australia.Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, Australia CADE Clinic, Department of Academic Psychiatry, Royal North Shore Hospital, Sydney, Australia.School of Population Health, University of Queensland, Brisbane, Australia Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Australia.Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Australia.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

25518844

Citation

Sara, Grant E., et al. "Stimulant Use Disorders in People With Psychosis: a Meta-analysis of Rate and Factors Affecting Variation." The Australian and New Zealand Journal of Psychiatry, vol. 49, no. 2, 2015, pp. 106-17.
Sara GE, Large MM, Matheson SL, et al. Stimulant use disorders in people with psychosis: a meta-analysis of rate and factors affecting variation. Aust N Z J Psychiatry. 2015;49(2):106-17.
Sara, G. E., Large, M. M., Matheson, S. L., Burgess, P. M., Malhi, G. S., Whiteford, H. A., & Hall, W. D. (2015). Stimulant use disorders in people with psychosis: a meta-analysis of rate and factors affecting variation. The Australian and New Zealand Journal of Psychiatry, 49(2), 106-17. https://doi.org/10.1177/0004867414561526
Sara GE, et al. Stimulant Use Disorders in People With Psychosis: a Meta-analysis of Rate and Factors Affecting Variation. Aust N Z J Psychiatry. 2015;49(2):106-17. PubMed PMID: 25518844.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stimulant use disorders in people with psychosis: a meta-analysis of rate and factors affecting variation. AU - Sara,Grant E, AU - Large,Matthew M, AU - Matheson,Sandra L, AU - Burgess,Philip M, AU - Malhi,Gin S, AU - Whiteford,Harvey A, AU - Hall,Wayne D, Y1 - 2014/12/17/ PY - 2014/12/19/entrez PY - 2014/12/19/pubmed PY - 2015/9/29/medline KW - affective psychosis KW - amphetamine KW - cocaine KW - ecstasy KW - schizophrenia KW - systematic review SP - 106 EP - 17 JF - The Australian and New Zealand journal of psychiatry JO - Aust N Z J Psychiatry VL - 49 IS - 2 N2 - OBJECTIVE: Stimulant abuse and dependence often complicate the care of people with psychotic disorders. This study systematically reviews the prevalence estimates reported for stimulant abuse and dependence in people with psychotic disorders, and examines personal, clinical, regional and methodological factors which explain variation in these rates. METHODS: PsychINFO, EMBASE and MEDLINE (1946-2013) were searched systematically for studies reporting on stimulant drug use disorders in representative samples of people with psychotic disorders. Random effects models estimated the pooled rate of a stimulant use disorder, defined to include stimulant abuse and stimulant dependence. Study characteristics associated with heterogeneity in rates of stimulant use disorder were examined by subgroup analyses for categorical variables, by meta-regression for continuous independent variables and by multiple meta-regression. RESULTS: Sixty-four studies provided 68 estimates of lifetime or recent stimulant use disorders in 22,500 people with psychosis. The pooled rate of stimulant use disorder was 8.9% (95% CI 7.4%, 10.5%). Higher rates of stimulant use disorders were reported in studies of affective psychosis, studies from inpatient settings, studies from the USA and Australia, and studies with higher rates of cannabis disorder; in multiple meta-regression analysis these factors explained 68% of between-study variance. Rates of stimulant use disorder were stable over time, and unrelated to age, sex, stage of psychosis, type of stimulant drug or study methodology factors. CONCLUSIONS: Reported rates of stimulant use disorder in people with psychosis are much higher than in the general population but vary widely and are associated with regional, service setting and clinical differences between studies. It is likely that stimulants contribute to the overall burden of psychosis, and that social and environmental factors combine with drug and illness-related factors to influence stimulant use in psychosis. SN - 1440-1614 UR - https://www.unboundmedicine.com/medline/citation/25518844/Stimulant_use_disorders_in_people_with_psychosis:_a_meta_analysis_of_rate_and_factors_affecting_variation_ L2 - https://journals.sagepub.com/doi/10.1177/0004867414561526?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -