Relationship between gender and psychotic symptoms in cocaine-dependent and methamphetamine-dependent participants

• Published in: Gender medicine 2010-10, Vol.7 (5), p.414-421
• Main Authors: Mahoney, James J., MA, Hawkins, Rollin Y., MD, De La Garza, Richard, PhD, Kalechstein, Ari D., PhD, Newton, Thomas F., MD
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Amphetamine-Related Disorders - psychology; Biological and medical sciences; Body Dysmorphic Disorders - epidemiology; Body Dysmorphic Disorders - etiology; Chi-Square Distribution; cocaine; Cocaine-Related Disorders - psychology; Delusions - epidemiology; Delusions - etiology; Drug addiction; Female; gender; Hallucinations - epidemiology; Hallucinations - etiology; Humans; Internal Medicine; Linear Models; Male; Medical sciences; methamphetamine; Methamphetamine - adverse effects; Middle Aged; Miscellaneous; Paranoid Disorders - epidemiology; Paranoid Disorders - etiology; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses, Substance-Induced - epidemiology; psychosis; Public health. Hygiene; Public health. Hygiene-occupational medicine; Sex Factors; stimulant; Surveys and Questionnaires
• ISSN: 1550-8579; 1878-7398
• DOI: 10.1016/j.genm.2010.09.003

Abstract Background: It has been well documented that cocaine and methamphetamine use can lead to the onset of psychotic symptoms similar to schizophrenia. However, the research and literature on gender differences and stimulant-induced psychosis have been mixed. Objective: The primary aim of this study was to investigate gender differences in the reporting of psychotic symptoms in cocaine- versus methamphetamine-dependent individuals. Methods: Participants were recruited from the Los Angeles, California, community via radio and newspaper advertisements. All met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , criteria for cocaine or methamphetamine dependence, and all reported either methamphetamine or cocaine as their primary drug of abuse. During a screening interview, participants answered questions from the Psychotic Symptom Assessment Scale, which characterizes various types of psychotic symptoms during drug use (“while high”) or during periods of nonuse (“while abstinent”). Results: Participants included 42 cocaine-dependent individuals (27 men, 15 women) and 43 methamphetamine-dependent individuals (25 men, 18 women). Among cocaine users, there were no significant differences between men and women with regard to ethnicity, years of use, route of administration, and amount used in the past week, though they differed significantly with regard to age ( P = 0.029). In the “while abstinent” condition, women were significantly more likely than men to report experiencing auditory hallucinations (13% vs 0%, respectively; P = 0.050) and tactile hallucinations (20% vs 0%; P = 0.016), whereas men were more likely to report delusions of grandeur (48% vs 6%; P = 0.006). During the “while high” condition, women were significantly more likely than men to report delusions of grandeur (13% vs 0%, respectively; P = 0.050), tactile hallucinations (33% vs 0%; P = 0.001), and olfactory hallucinations (13% vs 0%; P = 0.050). Among methamphetamine users, there were no significant differences between men and women with regard to age, ethnicity, years of use, route of administration, or amount used in the past week. In the “while abstinent” condition, women were significantly more likely than men to report feeling that something was wrong with the way a part of their body looked (72% vs 32%, respectively; P = 0.009), olfactory hallucinations (39% vs 8%; P = 0.010) and dressing inappropriately (22% vs 0%; P = 0.010). During the “while high” condition,