背景:甲基苯丙胺诱发的精神病(MIP)和精神分裂症的临床特征在很大程度上重叠,这使得分化具有挑战性。在这篇系统综述和荟萃分析中,我们旨在比较MIP和精神分裂症的阳性和阴性症状,以更好地了解它们之间的差异。
方法:根据我们的预注册协议(CRD42021286619),直到12月16日,我们对英语语言研究进行了搜索,2022年,在PubMed,EMBASE,和PsycINFO,包括患有MIP和精神分裂症的稳定门诊患者。我们使用纽卡斯尔-渥太华量表来测量横截面的质量,病例控制,和队列研究。
结果:在检索到的2052篇文章中,我们纳入了12项研究(6项横断面研究,3病例控制,和2项队列研究)在我们的荟萃分析中,涉及624名MIP患者和524名精神分裂症患者。我们的分析发现两组之间的阳性症状没有显着差异(SMD,-0.01;95CI,-0.13至+0.11;p=1)。然而,与精神分裂症患者相比,MIP患者的阴性症状明显减少(SMD,-0.35;95CI%,-0.54至-0.16;p=0.01;I2=54%)。我们的敏感性分析,其中仅包括低偏倚风险的研究,没有改变结果。然而,我们的荟萃分析受到其横截面方法的限制,这限制了对因果关联的解释。此外,人口差异,纳入标准,方法论,和药物暴露影响我们的发现。
结论:MIP患者的阴性症状较不明显。虽然两组在阳性症状方面没有差异,增加了与MIP和精神分裂症相关的共享和部分不同的潜在神经生物学机制的可能性。
BACKGROUND: The clinical profiles of methamphetamine-induced psychosis (MIP) and schizophrenia are largely overlapping making differentiation challenging. In this systematic review and meta-analysis, we aim to compare the positive and negative symptoms of MIP and schizophrenia to better understand the differences between them.
METHODS: In accordance with our pre-registered protocol (CRD42021286619), we conducted a search of English-language studies up to December 16th, 2022, in PubMed, EMBASE, and PsycINFO, including stable outpatients with MIP and schizophrenia. We used the Newcastle-Ottawa Scale to measure the quality of cross-sectional, case-control, and cohort studies.
RESULTS: Of the 2052 articles retrieved, we included 12 studies (6 cross-sectional, 3 case-control, and 2 cohort studies) in our meta-analysis, involving 624 individuals with MIP and 524 individuals with schizophrenia. Our analysis found no significant difference in positive symptoms between the two groups (SMD, -0.01; 95%CI, -0.13 to +0.11; p = 1). However, individuals with MIP showed significantly less negative symptoms compared to those with schizophrenia (SMD, -0.35; 95CI%, -0.54 to -0.16; p = 0.01; I2 = 54 %). Our sensitivity analysis, which included only studies with a low risk of bias, did not change the results. However, our meta-analysis is limited by its cross-sectional approach, which limits the interpretation of causal associations. Furthermore, differences in population, inclusion criteria, methodology, and drug exposure impact our findings.
CONCLUSIONS: Negative symptoms are less prominent in individuals with MIP. While both groups do not differ regarding positive symptoms, raises the possibility of shared and partly different underlying neurobiological mechanisms related to MIP and schizophrenia.