Psychiatric Comorbidity Of DSM-IV Axis I Among Male Methamphetamine Dependenct Subjects And Male Heroin Dependenct Subjects

Part Ⅰ. A Comparison Study on Comorbidity of DSM-IV Axis I Disorders among Male Heroin Dependent Subjects and Methamphetamine Dependent SubjectsObjective:To study the demographic characteristics, drug use characteristics, point prevalence and lifetime prevalence of DSM-Ⅳ axis Ⅱ diagnose in male heroin dependent subjects and male methamphetamine dependent subjects.Method:Male heroin dependent subjects and male methamphetamine dependent subjects in four drug rehabilitation centers in Hunan province of China were asked to finish questionnaires on demographics and drug use history. And the Structured Clinical Interview for DSM-IV-TR, Axis I, Patient Version (SCID-I/P) were employed to assess psychiatric diagnoses.Results:1. Age (χ2=28.58, P<0.001), length of education (χ2=9.34, P=0.009), marital status (χ2=7.63, P=0.022), annual income (χ2=238.71, P<0.001), duration of drug use (χ2=101.93, P<0.001), feeling of initial drug use (χ2=25.40, P<0.001), drug abstent experienc (P<0.001), drug use patterens (P<0.001) and positive family history of substance usedisorders (χ2=426.03, P<0.001) were statistically different between male heroin dependent subjects and male methamphetamine dependent subjects.2. Among non-substance use mental disorders in DSM-Ⅳ axis I, mood disorder (point prevalence,9.61%; lifetime prevalence,16.91%) was the most common comorbiding diagnosis, followed by anxiety disorder (point prevalence,7.58%; lifetime prevalence,10.55%) in male heroin dependent subjects, and mood disorder (point prevalence,5.43%; lifetime prevalence,15.58%) was also the most common comorbiding diagnosis, followed by psychotic disorder (point prevalence,7.97%; lifetime prevalence,10.69%) in male methamphetamine dependent subjects. Significant differences were found in point prevalence of mood disorder (χ2=7.63, P=0.006), psychotic disorders (χ2=46.04, P<0.001), anxiety disorder (χ2==4.37, P=0.037) and lifetime prevalence of psychotic disorders (χ2=64.46, P<0.001), anxiety disorder (χ2=11.68, P=0.001) between the two groups.3. Among substance use disorders in DSM-IV axis I, sedative, hypnotic or anxiolytic use disorder (point prevalence,20.84%; lifetime prevalence,33.02%) was the most common comorbiding diagnosis, followed by alcohol use disorder (point prevalence,16.64%; lifetime prevalence,29.09%) in male heroin dependent subjects, and opioid use disorder (point prevalence,3.08%; lifetime prevalence,36.96%) was the most common comorbiding diagnosis, followed by alcohol use disorder (point prevalence,2.54%; lifetime prevalence,32.35%) in male methamphetamine dependent subjects. Significant differences were found in point prevalence of alcohol use disorder (χ2=66.30, P<0.001), sedative, hypnotic or anxiolytic use disorder (P<0.001), hallucinogen use disorder (χ2=55.75, P<0.001), others use disorder (χ2=5.28, P=0.022), polysubstance dependence (χ2=6.98, P=0.009) and lifetime prevalence of sedative, hypnotic or anxiolytic use disorder (χ2=56.45, P<0.001), hallucinogen use disorder (χ2=39.34, P<0.001), polysubstance dependence (χ2=66.34, P<0.001) between the two groups.Conclusions:Differences were found in demographic characteristics, drug using characteristics, point prevalence and lifetime prevalence of mood disorder, psychotic disorders, anxiety disorder and substance use disorders in DSM-Ⅳ axis I diagnose between male heroin dependent subjects and male methamphetamine dependent subjects. More attention should be paid to the high comorbidity rate of heroin dependence or methamphetamine dependence and DSM-IV axis I mental disorders. Part Ⅱ.552Male Methamphetamine Dependent Subjects Comorbiding with Pathological GamblingObjective:To explore the lifetime prevalence rate of pathological gambling in male methamphetamine dependent subjects and the roles of socio-demographic factors, impulsivity and psychotic disorders in this comorbidity.Method:552male methamphetamine dependent subjects from three drug rehabilitation centers in Hunan province of China were asked to finish questionnaires on demographics and the Chinese version of Barratt Impulsiveness Scale-11. The Structured Clinical Interview for DSM-IV-TR, Axis I, Patient Version (SCID-I/P) were employed to assess psychiatric diagnoses.Results:1. The lifetime prevalence of pathological gambling in male methamphetamine dependent subjects was45.29%. Age (χ2=2.44, P=0.002), employment(χ2=9.48, P=0.002), the total BIS-11scores (χ2=0.30,P=0.001), motor impulsiveness (χ2=0.06, P=0.001) and non-planning impulsiveness (χ2=0.00,P=0.001) were statistically different between pathological gamblers and non-pathological gamblers in male methamphetamine dependent subjects.2. Among all the male methamphetamine dependent subjects, lifetime prevalence of psychotic disorder(χ2=15.02, P<0.001) and incidence of delusions (χ2=14.17, P<0.001) were statistically different between pathological gamblers and non-pathological gamblers.3. In binary logistic regression analysis, age (P<0.001, OR=1.060), unemployed (P=0.001, OR=1.853), the total BIS-11scores (P=0.013, OR=1.015) and substance induced psychotic disorder (P<0.001, OR=2.263) were significant risk factors of MA dependence comorbiding with pathological gambling.Conclusions:High lifetime prevalence of pathological gambling in male methamphetamine dependent subjects was found in our study. Differences were discovered in age, employment, impulsivity, psychotic disorders and delusions between pathological gamblers and non-pathological gamblers. Age, unemployment, impulsivity and substance induced psychotic disorder were significant risk factors of MA dependence comorbiding with pathological gambling.