This case report describes a 31-year-old male patient with psychosis presumably related to methamphetamine-associated psychosis (MAP). Our patient was experiencing persistent symptoms of visual, tactile, and auditory hallucinations after cessation of methamphetamine. He has a medical history of a substance use disorder, post-traumatic stress disorder, attention-deficit hyperactivity disorder, nicotine dependence and major depressive disorder. Previously, he received a wide range of antipsychotic drug treatment regimens at other psychiatric facilities, all with some degree of effect, but never with complete symptom relief. At the time of admission to our inpatient clinic, he was started on cariprazine and reported a significant decrease in visual, auditory, and tactile hallucinations with complete cessation for a period of two weeks. There appears to be a unique ability of cariprazine\'s mechanism of action to reverse symptoms of the presumable diagnosis of MAP that is unable to be achieved with other antipsychotic medications.

UNASSIGNED: Attentional bias plays an important role in sustaining various types of drug addiction. No prior studies examined methamphetamine (MA)-associated psychosis (MAP) relationships between ERP time course and performance on an addiction Stroop task in MA abusers. The aim of the present study was to determine whether MA abusers with (MAP+) or without (MAP-) psychosis exhibit alterations of the ERP during the addiction Stroop task.
UNASSIGNED: Thirty-one healthy controls (CTRL), 14 MAP-, and 24 MAP+ participants were recruited and completed the addiction Stroop task during EEG recording using 32 electrodes. Group variations were compared on measures of behavioral task performance and event-related potentials (ERP) of performance monitoring (N200, P300, N450). The Barratt impulsiveness scores were analyzed to investigate correlations with ERP changes.
UNASSIGNED: MA-related word stimulus elicited a more negative N200 amplitude over left-anterior electrodes in MAP- abusers; furthermore, a positive association between the N200 amplitude and Barratt attentional scores and non-planning scores was observed, while no such differences were found in MAP+ abusers. There were no significant differences in reaction time (RT) and error rate between each group.
UNASSIGNED: This is the first study to examine psychosis relationships between ERP time course and performance on an addiction Stroop task in MA abusers with or without psychosis. These findings support the association between attentional bias measured by the MA addiction Stroop task and N200 component as well as indicate the possibility of using this cognitive task in combination with ERP technology to detect psychosis factors among abstinent MA abusers.

The clinical symptoms and signs of methamphetamine-associated psychosis (MAP) and schizophrenia are highly similar, but the situation is completely different when MAP and schizophrenia patients need to be assessed for criminal responsibility after they comitted a harmful behavior. Therefore, the distinction between the two psychoses is very important in forensic psychiatry. At present, the identification of these two psychoses is mainly dependent on the corresponding criteria such as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and the Chinese Classification of Mental Disorders Version 3 (CCMD-3). It\'s challenging to diagnose and distinguish between the two in practical cases due to their similar clinical symptoms and the lack of effective objective indexes. Different from the limitations of single omics, integrative omics intergrates data from multiple dimensions and has been extensively studied in the field of schizophrenia and has achieved some preliminary results. In view of the correlation between MAP and schizophrenia and the potential application value of integrative omics, this paper proposes an integrative omics strategy for MAP pathogenesis and forensic identification, aiming to improve the further understanding of the relationship between the two psychoses and the corresponding pathogenesis. It also provides references for the future exploration of integrative omics in forensic precise identification and effective monitoring and early warning methods.
甲基苯丙胺所致精神障碍（methamphetamine-associated psychosis，MAP）和精神分裂症的临床症状及体征十分相似，但MAP和精神分裂症患者在发生危害行为后需评定刑事责任时的情况却完全不同，因而两者的甄别在法医精神病学鉴定中十分重要。目前对于两者的鉴别主要依据《精神障碍诊断与统计手册（第五版）》《中国精神障碍分类与诊断标准（第三版）》等诊断标准，但由于两者高度相似的临床表现和客观指标的缺乏，给法医学鉴识实践工作带来了很大的困难和挑战。不同于单一组学的局限性，整合组学将多个维度的数据整合起来，已在精神分裂症领域开展了广泛研究并初步取得一些应用成果。鉴于MAP和精神分裂症的关联性和整合组学的潜在的应用价值，本文提出以整合组学的策略进行MAP发病机制及法医学鉴识的研究思路，旨在完善对MAP与精神分裂症之间的关系及相应发病机制的进一步理解，也为未来整合组学在法医学精准鉴识及有效监测预警方法的探索提供借鉴与参考。.

Methamphetamine (MA)-associated psychosis has become a public concern. However, its mechanism is not clear. Investigating similarities and differences between MA-associated psychosis and schizophrenia in brain alterations would be informative for neuropathology.
This study compared gray matter volumes of the brain across four participant groups: healthy controls (HC, n = 53), MA users without psychosis (MA, n = 22), patients with MA-associated psychosis (MAP, n = 34) and patients with schizophrenia (SCZ, n = 33). Clinical predictors of brain alterations, as well as association of brain alterations with psychotic symptoms and attention impairment were further investigated.
Compared with the HC, the MAP and the SCZ showed similar gray matter reductions in the frontal cortex, particularly in prefrontal areas. Moreover, a stepwise extension of gray matter reductions was exhibited across the MA - MAP - SCZ. Duration of abstinence was associated with regional volumetric recovery in the MAP, while this amendment in brain morphometry was not accompanied with symptom\'s remission. Illness duration of psychosis was among the predictive factors of regional gray matter reductions in both psychotic groups. Volume reductions were found to be associated with attention impairment in the SCZ, while this association was reversed in the MAP in frontal cortex.
This study suggested MA-associated psychosis and schizophrenia had common neuropathology in cognitive-related frontal cortices. A continuum of neuropathology between MA use and schizophrenia was tentatively implicated. Illness progressions and glial repairments could both play roles in neuropathological changes in MA-associated psychosis.

UNASSIGNED: Both patients with methamphetamine-associated psychosis (MAP) and patients with schizophrenia suffer from obvious cognitive deficits in working memory, and this affects the functional prognosis of patients.
UNASSIGNED: This study is to investigate the difference of working memory deficits between patients with MAP and patients with schizophrenia, especially the difference of central executive system function, and the relevance of working memory deficits and clinical characteristics.
UNASSIGNED: Twenty-eight male patients with MAP and twenty-eight patients with schizophrenia were recruited. The working memory of subjects was evaluated with the n-back task edited and adapted from English language materials. The positive syndrome scale of PANSS and CGI were employed to assess psychotic symptoms and the severity of patients.
UNASSIGNED: According to the results of repeated measure variance analysis, it was found that both the between-group variable (group) and within-group variable (n) had significant main effects, and the interaction between the between-group variable and the within-group variable was also significant. After Z-transformation, mean (sd) working memory scores of patients with MAP and schizophrenia were 0.91 (0.77) and -0.91 (2.11) respectively, and the difference between these two groups were statistically significant (F=19.253, p<0.001). The relevance between working memory deficits and clinical characteristics was low in both the patients with MAP and patients with schizophrenia.
UNASSIGNED: Patients with MAP were better at regulating, updating, executing and controlling active information than patients with schizophrenia.
UNASSIGNED: 甲基苯丙胺所致精神病性障碍 （methamphetamine-associated psychosis，MAP） 患者 和精神分裂症患者均存在明显的工作记忆等认知功能 缺陷，并且均影响患者的功能预后。.
UNASSIGNED: 探讨MAP 患者和精神分裂症患者工作记忆缺陷， 尤其中央执行系统功能的差异，以及工作记忆缺损与 临床特征的相关性。.
UNASSIGNED: 共入组了28 例男性MAP 患者及28 例男性精神 分裂症患者。应用基于语言材料编制的n-back 任务评 估被试的工作记忆。应用阳性与阴性症状量表（PANSS） 的阳性量表及临床总体印象量表（CGI）评估患者的精 神症状及其严重程度。.
UNASSIGNED: 对n-back 数据进行重复测验方差分析，结果发 现组间变量（组别）及组内变量（n）的主效应均显著， 组间变量与组内变量的交互作用亦显著。经Z 转换后， MAP 患者及精神分裂症患者的工作记忆成绩分别为 0.91（0.77）和-0.91（2.11），组间差异有统计学意义 （F=19.253，p<0.001）。无论MAP 患者或精神分裂症 患者，其工作记忆缺陷与临床特征均缺乏相关性。.
UNASSIGNED: MAP 患者对激活信息的管理、更新及执行控制 能力优于精神分裂症患者。.

Chronic methamphetamine use is associated with executive functioning deficits that suggest dysfunctional cognitive control networks (CCNs) in the brain. Likewise, abnormal connectivity between intrinsic CCNs and default mode networks (DMNs) has also been associated with poor cognitive function in clinical populations. Accordingly, we tested the extent to which methamphetamine use predicts abnormal connectivity between these networks, and whether, as predicted, these abnormalities are compounded in patients with a history of methamphetamine-associated psychosis (MAP). Resting-state fMRI data were acquired from 46 methamphetamine-dependent patients [19 with MAP, 27 without (MD)], as well as 26 healthy controls (CTRL). Multivariate network modelling and whole-brain voxel-wise connectivity analyses were conducted to identify group differences in intrinsic connectivity across four cognitive control and three DMN networks identified using an independent components analysis approach (meta-ICA). The relationship of network connectivity and psychotic symptom severity, as well as antipsychotic treatment and methamphetamine use variables, was also investigated. Robust evidence of hyper-connectivity was observed between the right frontoparietal and anterior DMN networks in MAP patients, and \'normalized\' with increased duration of treatment with antipsychotics. Attenuation of anticorrelated anterior DMN-dorsal attention network activity was also restricted to this group. Elevated coupling detected in MD participants between anterior and posterior DMN networks became less apparent with increasing duration of abstinence from methamphetamine. In summary, we observed both alterations of RSN connectivity between DMN networks with chronic methamphetamine exposure, as well as DMN-CCN coupling abnormalities consistent with possible MAP-specific frontoparietal deficits in the biasing of task-appropriate network activity.

We evaluated tolerability and efficacy of aripiprazole and risperidone for treatment of methamphetamine (METH) associated psychotic symptoms in China. Patients with acute METH-associated psychotic symptoms (N=42) and with Positive and Negative Syndrome Scale (PANSS) total score between 60 and 120 were randomized to aripiprazole (initial dose 5-10mg per day followed by flexible doses 5-15 mg per day) or risperidone (initial dose 2-4 mg per day followed by flexible doses 4-6 mg per day) from day 3 to 25 of inpatient hospital stay. Outcome measures included PANSS and Clinical Global Impressions-Severity of Illness scale (CGI-S), METH craving Visual Analogue Scale (VAS), Simpson Angus Scale (SAS), Barnes Assessments Akathasia Rating Scale (BARS), and self-reported adverse effects evaluated during treatment. Retention was evaluated using Kaplan-Meier survival analysis and the MIXED models procedure was used to compare the groups on measures of psychotic and extra-pyramidal symptoms. Patients in both aripiprazole and risperidone groups showed statistically significant reductions in psychotic symptomatology from baseline during treatment (p<0.001) with no statistically significant differences between the treatment groups (p=0.73 and p=0.15, respectively). Risperidone-treated patients reported significantly greater METH craving reductions (p<0.001). Overall, 71% of patients completed the entire study, but the aripiprazole group had a significantly lower retention than the risperidone group (p=0.007), primarily due to medication related adverse effects. Aripiprazole-treated patients also had significantly more akathisia (p=0.03) and agitation (p=0.02) than risperidone-treated patients. Patients in both groups who tolerated their medications and completed the entire study achieved comparable reductions of psychotic symptoms.

Methamphetamine abuse and dependence, frequently accompanied by schizophrenia-like psychotic symptoms [methamphetamine-associated psychosis (MAP)], is a serious public health problem worldwide. Few studies, however, have characterized brain dysfunction associated with MAP, nor investigated similarities and differences in brain dysfunction between MAP and schizophrenia. We compared prefrontal cortical activity associated with stop-signal inhibitory task in 21 patients with MAP, 14 patients with schizophrenia and 21 age- and gender-matched healthy controls using a 52-channel near-infrared spectroscopy (NIRS) system. Both the MAP and the schizophrenia groups showed significantly reduced activation in the bilateral ventrolateral prefrontal cortex compared with controls; however, only the MAP group showed reduced activation in the frontopolar prefrontal cortex. The MAP group demonstrated significant positive correlations between task performance and hemodynamic responses in the bilateral ventrolateral, polar and left dorsolateral regions of the prefrontal cortex. The MAP and schizophrenia groups demonstrated a significant difference in the relationship of impulsivity to hemodynamic changes in the bilateral premotor cortex. These findings characterize similarities and differences in prefrontal cortical dysfunction between psychosis associated with methamphetamine and schizophrenia. The reduced hemodynamic changes in the bilateral ventrolateral prefrontal cortex suggest a common underlying pathophysiology of MAP and schizophrenia, whereas those in the frontopolar prefrontal cortex point to an impaired state that is either inherent or caused specifically by methamphetamine use.