Symptomatological structure of volatile solvent-induced psychosis: is "solvent psychosis" a discernible syndrome?

Solvent-induced psychosis has been clinically identified among patients suffering from dependence on volatile solvents and those in psychotic state due to chronic solvent use. To clarify the symptomatological difference between solvent-induced psychosis and schizophrenia, the principal component analysis with VARIMAX rotation was applied to the point and duration estimates of symptoms observed among the solvent group and among the schizophrenic group. There were no significant group differences in age and family history of any psychosis. The study findings are as follows: (1) It is difficult to distinguish two groups based on the prevalence rates of symptoms alone. (2) However, the principal component VARIMAX rotation analysis of the prevalence and duration observing among the solvent group revealed seven factors consisting of "amotivation", "intoxication", "emotional instability", "delusion", "hallucination", "disinhibition" and "memory". The seven factors explained 75.4% of the variance of the symptoms in this group. (3) The same analysis applied to the data from the schizophrenic group showed six factors consisting of "thought progression", "emotional instability", "amotivation (or negative symptoms)", "delusion", "hallucination" and "anxiety". These factors explained 62.9% of the variance in the data of the schizophrenic group. These results support clinical observations the "amotivational syndrome" may be a characteristic feature of patients suffering from solvent-induced psychosis. The results also suggest "solvent psychosis" is a discernible syndrome, and is distinctive from psychotic symptoms of typical schizophrenia.

Methamphetamine in Japan: the consequences of methamphetamine abuse as a function of route of administration.

AIMS: To determine differences in life backgrounds and clinical features between methamphetamine (MAP) smokers and injectors in Japan. SETTING: Out-patient clinic at a psychiatric centre. PARTICIPANTS: Among 451 MAP abusers undergoing initial assessments, 116 subjects whom the first author had directly interviewed and treated were studied. DESIGN AND PROCEDURES: In this study, life backgrounds, clinical features and psychiatric symptoms were compared between three subgroups: 42 (36.2%) in group S (smoking only); 57 (49.1%) in group I (injection only); and 17 (14.7%) in group SI (initially smoking, later injecting). FINDINGS: Group I more often had parental absence (P < 0.001), a family history of alcoholism (P < 0.05), limited education (P < 0.001), or a criminal record (P < 0.001) than patients in the other two groups. Group S had the most cannabis use (P < 0.01), while group I had the most volatile solvents use (P < 0.01). Group S experienced their first psychotic episode sooner after first MAP use (P < 0.01), but showed fewer auditory hallucinations at initial assessment than patients in other groups (P < 0.001). Group SI was intermediate between groups S and I in life background, clinical features and psychotic symptoms, while they had lost control of their drug use most frequently (P < 0.02). CONCLUSIONS: In Japan, MAP smokers have different life backgrounds from injectors. Smoking MAP does not appear to be a safer route as regards losing control of MAP use and inducing psychosis than injection.