Comparison of Psychiatric Disorders in a Sample of Egyptian Patients with Methamphetamine versus Opioid Use Disorder: Rate and Addiction Severity
Authors: Nagy Nahla El Sayed , Mohsen Nesreen Mohamed , Elrassas Hanan Hany , Mohammed Rehab Serag , Abdelhamied Nada Helmy 
Published: November 2024

Abstract

Background
Methamphetamine use is markedly increasing worldwide. That widespread isn’t limited to high income countries, it's also evidently in developing and low-income countries, including Africa. According to a United States study, the prevalence of psychiatric disorders in patients with methamphetamine dependence is (34%-48.1%). Clinical effect of methamphetamine is done by increasing monoamine centrally therefore potentiate sympathetic system, causing both psychiatric and physical manifestations. While opioid effect is done by activation opioid receptors as μ, δ, κ and nociceptin opioid peptide (NOP) receptors.

Objective
the study aims to compare rate of psychiatric disorders between methamphetamine and opioid use disorder. Also, it was used to assess the rate of personality disorders in patients with methamphetamine in comparison to opioid use disorder. Furthermore, this study was conducted to assess clinical correlates in relation to socio-demographics, personality disorders and degree of addiction severity in patient with methamphetamine and/or opioid use disorder.

Patients and Methods
The study was carried out at Okasha Institute of Psychiatry, Ain Shams University, particularly the outpatient clinic. Participants were selected as sample sizes of 45 and 45according to those meeting, the inclusion Criteria for participants: diagnosed with methamphetamine/ opioid dependence according to DSM-IV, both genders, aged between (18 – 45) years old, Egyptian nationality, and Agreement for written informed consent for participation in this study).

Results
In our study, the percentage of psychosis was found to be 42.2% in the methamphetamine group and 13.3% in the opioid group with an evident statistically high significance difference between both groups and a P-value of 0.002. Regarding bipolar affective disorder, it was found to be 15.56% of the methamphetamine group and 2.22% of the opioid group with statistical significance between both groups and a P-value of 0.026. Moreover, regarding depression, the percentage was 2.22% in the methamphetamine group and 40 % in the opioid group with high significance between both groups and a P-value of &lt; 0.001. Finally, the anxiety rate was 26.6% in the methamphetamine group versus 0% in the opioid group. There was a high significance between both groups with a P-value of &lt; 0.001. the current study showed that the borderline personality disorder in methamphetamine use disorder patients’ percentage was found to be 66.6% in the methamphetamine group and 26.6% in the opioid group with evident statistical high significance difference between both groups and a P-value of &lt; 0.001.

Conclusion
The current study showed that the substance use disorders were associated with higher incidence of mental disorders and poor physical health. The patients with MUD have higher rates of Psychosis, BAD and Anxiety and lower rate of Depression compared to patients with OUD. The patients with MUD have higher rates of borderline personality disorders and lower rate of Avoidant compared to patients with OUD. The patients with OUD have higher addiction severity index compared to patients with MUD. Opioid use disorder patents have poorer physical health, more severe alcohol use, and more severe family and psychiatric problems than MUD.