Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis

Rebecca McKetin, Janni Leung, Emily Stockings, Yan Huo, James Foulds, Julia M. Lappin, Craig Cumming, Shalini Arunogiri, Jesse T. Young, Grant Sara, Michael Farrell, Louisa Degenhardt

Research output: Contribution to journalArticle

Abstract

Background: The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. Methods: A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. Findings: 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95%CI 1.3–3.3), violence (OR = 2.2, 95%CI 1.2–4.1; adjusted OR [AOR] = 1.4, 95%CI 0.8–2.4), suicidality OR = 4.4, 95%CI 2.4–8.2; AOR = 1.7, 95%CI 1.0–2.9) and depression (OR = 1.6, 95%CI 1.1–2.2; AOR = 1.3, 95%CI 1.2–1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95%CI 1.9–4.8; AOR = 2.4, 95%CI 1.6–3.5), violence (OR = 6.2, 95%CI 3.1–12.3), and suicidality (OR = 2.3, 95%CI 1.8–2.9; AOR = 1.5, 95%CI 1.3–1.8). Interpretation: Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.

Original languageEnglish
JournalEClinicalMedicine
DOIs
Publication statusE-pub ahead of print - 17 Oct 2019

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Amphetamines
Meta-Analysis
Mental Health
Odds Ratio
Methamphetamine
Amphetamine
Violence
Psychotic Disorders
Cross-Sectional Studies
Depression
Case-Control Studies
Cohort Studies
Anxiety
Randomized Controlled Trials
Public Health

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McKetin, Rebecca ; Leung, Janni ; Stockings, Emily ; Huo, Yan ; Foulds, James ; Lappin, Julia M. ; Cumming, Craig ; Arunogiri, Shalini ; Young, Jesse T. ; Sara, Grant ; Farrell, Michael ; Degenhardt, Louisa. / Mental health outcomes associated with of the use of amphetamines : A systematic review and meta-analysis. In: EClinicalMedicine. 2019.
@article{553d55b6031141c5a25bddbb1022da14,
title = "Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis",
abstract = "Background: The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. Methods: A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. Findings: 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95{\%}CI 1.3–3.3), violence (OR = 2.2, 95{\%}CI 1.2–4.1; adjusted OR [AOR] = 1.4, 95{\%}CI 0.8–2.4), suicidality OR = 4.4, 95{\%}CI 2.4–8.2; AOR = 1.7, 95{\%}CI 1.0–2.9) and depression (OR = 1.6, 95{\%}CI 1.1–2.2; AOR = 1.3, 95{\%}CI 1.2–1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95{\%}CI 1.9–4.8; AOR = 2.4, 95{\%}CI 1.6–3.5), violence (OR = 6.2, 95{\%}CI 3.1–12.3), and suicidality (OR = 2.3, 95{\%}CI 1.8–2.9; AOR = 1.5, 95{\%}CI 1.3–1.8). Interpretation: Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.",
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author = "Rebecca McKetin and Janni Leung and Emily Stockings and Yan Huo and James Foulds and Lappin, {Julia M.} and Craig Cumming and Shalini Arunogiri and Young, {Jesse T.} and Grant Sara and Michael Farrell and Louisa Degenhardt",
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McKetin, R, Leung, J, Stockings, E, Huo, Y, Foulds, J, Lappin, JM, Cumming, C, Arunogiri, S, Young, JT, Sara, G, Farrell, M & Degenhardt, L 2019, 'Mental health outcomes associated with of the use of amphetamines: A systematic review and meta-analysis' EClinicalMedicine. https://doi.org/10.1016/j.eclinm.2019.09.014

Mental health outcomes associated with of the use of amphetamines : A systematic review and meta-analysis. / McKetin, Rebecca; Leung, Janni; Stockings, Emily; Huo, Yan; Foulds, James; Lappin, Julia M.; Cumming, Craig; Arunogiri, Shalini; Young, Jesse T.; Sara, Grant; Farrell, Michael; Degenhardt, Louisa.

In: EClinicalMedicine, 17.10.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Mental health outcomes associated with of the use of amphetamines

T2 - A systematic review and meta-analysis

AU - McKetin, Rebecca

AU - Leung, Janni

AU - Stockings, Emily

AU - Huo, Yan

AU - Foulds, James

AU - Lappin, Julia M.

AU - Cumming, Craig

AU - Arunogiri, Shalini

AU - Young, Jesse T.

AU - Sara, Grant

AU - Farrell, Michael

AU - Degenhardt, Louisa

PY - 2019/10/17

Y1 - 2019/10/17

N2 - Background: The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. Methods: A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. Findings: 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95%CI 1.3–3.3), violence (OR = 2.2, 95%CI 1.2–4.1; adjusted OR [AOR] = 1.4, 95%CI 0.8–2.4), suicidality OR = 4.4, 95%CI 2.4–8.2; AOR = 1.7, 95%CI 1.0–2.9) and depression (OR = 1.6, 95%CI 1.1–2.2; AOR = 1.3, 95%CI 1.2–1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95%CI 1.9–4.8; AOR = 2.4, 95%CI 1.6–3.5), violence (OR = 6.2, 95%CI 3.1–12.3), and suicidality (OR = 2.3, 95%CI 1.8–2.9; AOR = 1.5, 95%CI 1.3–1.8). Interpretation: Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.

AB - Background: The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. Methods: A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. Findings: 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95%CI 1.3–3.3), violence (OR = 2.2, 95%CI 1.2–4.1; adjusted OR [AOR] = 1.4, 95%CI 0.8–2.4), suicidality OR = 4.4, 95%CI 2.4–8.2; AOR = 1.7, 95%CI 1.0–2.9) and depression (OR = 1.6, 95%CI 1.1–2.2; AOR = 1.3, 95%CI 1.2–1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95%CI 1.9–4.8; AOR = 2.4, 95%CI 1.6–3.5), violence (OR = 6.2, 95%CI 3.1–12.3), and suicidality (OR = 2.3, 95%CI 1.8–2.9; AOR = 1.5, 95%CI 1.3–1.8). Interpretation: Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.

KW - Amphetamines

KW - Anxiety

KW - Depression

KW - Mental health

KW - Methamphetamine

KW - Psychosis

KW - Substance use

KW - Suicidality

KW - Violence

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U2 - 10.1016/j.eclinm.2019.09.014

DO - 10.1016/j.eclinm.2019.09.014

M3 - Article

JO - EClinicalMedicine

JF - EClinicalMedicine

SN - 2589-5370

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