Stimulant Psychosis: Symptom Profile and Acute Clinical Course

Nineteen patients seen at a psychiatric emergency service with amphetamine- or cocaine-induced psychotic disorder were assessed with structured interviews, chart review, and blood and urine testing. All had a predominance of positive symptoms from the Positive and Negative Syndrome Scale (PANSS). However, some subjects had substantial Negative Scale scores (26%), bizarre delusions (95%), and Schneiderian hallucinations (63%), mimicking a broad range of schizophrenic symptoms. Several PANSS scores were correlated with treatment intensity: Positive score with seclusion hours, General Psychopathology and Negative scores with hospitalization length, and General Psychopathology score with neuroleptic dose. Presenting symptoms may help in treatment planning.