Abstract：
BACKGROUND: Synthetic cathinones are the most used novel psychoactive substances in Taiwan because they exhibit psychoactive effects similar to those of methamphetamine, inducing acute psychosis, violence, and self-harm. However, the differences in the clinical characteristics of patients with synthetic cathinone and methamphetamine intoxication admitted to psychiatric emergency departments (EDs) remain unclear.
METHODS: This study recruited patients with stimulant intoxication who were admitted to a psychiatric ED from April 2019 to May 2020. Sociodemographic, lifestyle, and psychopathological data were collected through face-to-face interviews and evaluated. Immunoassay tests and liquid chromatography-quadrupole time-of-flight mass spectrometry were performed to detect substances in urine specimens. The patients were matched by sex and age (in 5-year intervals). The associations between the 2 groups and physical complications were analyzed through logistic regression.
RESULTS: Twenty-four patients with synthetic cathinone intoxication were identified and matched with 48 patients with methamphetamine intoxication. The 2 groups exhibited similar clinical severity of psychotic symptoms and high risks of violence and self-harm. Both groups were predominated by unmarried patients, unemployed patients, and habitual smokers and drinkers. However, family histories of substance use and criminal records were less prevalent among the patients with synthetic cathinone intoxication, but they had a higher rate of physical complications (odds ratio, 8.55; 95% confidence interval, 2.15-34.03), compared with patients with methamphetamine intoxication.
CONCLUSIONS: Compared with patients intoxicated with methamphetamine, those intoxicated with synthetic cathinones may have similar tendencies toward psychosis, violence, and self-harm but higher risks of physical complications, which are prioritized in psychiatric EDs.
METHODS: This study recruited patients with stimulant intoxication who were admitted to a psychiatric ED from April 2019 to May 2020. Sociodemographic, lifestyle, and psychopathological data were collected through face-to-face interviews and evaluated. Immunoassay tests and liquid chromatography-quadrupole time-of-flight mass spectrometry were performed to detect substances in urine specimens. The patients were matched by sex and age (in 5-year intervals). The associations between the 2 groups and physical complications were analyzed through logistic regression.
RESULTS: Twenty-four patients with synthetic cathinone intoxication were identified and matched with 48 patients with methamphetamine intoxication. The 2 groups exhibited similar clinical severity of psychotic symptoms and high risks of violence and self-harm. Both groups were predominated by unmarried patients, unemployed patients, and habitual smokers and drinkers. However, family histories of substance use and criminal records were less prevalent among the patients with synthetic cathinone intoxication, but they had a higher rate of physical complications (odds ratio, 8.55; 95% confidence interval, 2.15-34.03), compared with patients with methamphetamine intoxication.
CONCLUSIONS: Compared with patients intoxicated with methamphetamine, those intoxicated with synthetic cathinones may have similar tendencies toward psychosis, violence, and self-harm but higher risks of physical complications, which are prioritized in psychiatric EDs.
摘要：
背景：合成卡西酮是台湾使用最多的新型精神活性物质，因为它们表现出与甲基苯丙胺相似的精神活性作用，诱发急性精神病，暴力,和自我伤害。然而,精神科急诊科(ED)收治的合成卡西酮和甲基苯丙胺中毒患者的临床特征差异尚不清楚.
方法：这项研究招募了从2019年4月至2020年5月收治的精神病性ED的兴奋剂中毒患者。社会人口统计学，生活方式,和精神病理学数据通过面对面访谈收集和评估.进行免疫分析和液相色谱-四极杆飞行时间质谱检测尿液标本中的物质。患者按性别和年龄匹配（间隔5年）。采用logistic回归分析两组患者与身体并发症的关系。
结果：确定了24例合成卡西酮中毒患者，并与48例甲基苯丙胺中毒患者相匹配。两组表现出相似的精神病症状临床严重程度以及暴力和自我伤害的高风险。两组均以未婚患者为主，失业的病人,习惯性吸烟者和饮酒者。然而,在合成卡西酮中毒的患者中，药物使用和犯罪记录的家族史较少，但他们的身体并发症发生率较高(赔率比，8.55；95%置信区间，2.15-34.03),与甲基苯丙胺中毒患者相比。
结论：与甲基苯丙胺中毒患者相比，那些用合成卡西诺中毒的人可能对精神病有类似的倾向，暴力,和自我伤害，但身体并发症的风险更高，在精神病ED中优先考虑。
方法：这项研究招募了从2019年4月至2020年5月收治的精神病性ED的兴奋剂中毒患者。社会人口统计学，生活方式,和精神病理学数据通过面对面访谈收集和评估.进行免疫分析和液相色谱-四极杆飞行时间质谱检测尿液标本中的物质。患者按性别和年龄匹配（间隔5年）。采用logistic回归分析两组患者与身体并发症的关系。
结果：确定了24例合成卡西酮中毒患者，并与48例甲基苯丙胺中毒患者相匹配。两组表现出相似的精神病症状临床严重程度以及暴力和自我伤害的高风险。两组均以未婚患者为主，失业的病人,习惯性吸烟者和饮酒者。然而,在合成卡西酮中毒的患者中，药物使用和犯罪记录的家族史较少，但他们的身体并发症发生率较高(赔率比，8.55；95%置信区间，2.15-34.03),与甲基苯丙胺中毒患者相比。
结论：与甲基苯丙胺中毒患者相比，那些用合成卡西诺中毒的人可能对精神病有类似的倾向，暴力,和自我伤害，但身体并发症的风险更高，在精神病ED中优先考虑。
