Practices and Attitudes of Adult Psychiatrists Regarding Methamphetamine-Associated Psychotic Disorder: An Internet Based Survey Conducted in Turkey

Abstract

Abstract Purposes: Many variables such as psychiatric training, experiences, institution, and region characteristics may affect approaches of psychiatrists to methamphetamine-associated psychotic disorder (MAP) treatment. This study was aimed to reach adult psychiatrists actively practicing in Turkey through an internet-based survey and to determine their practices and attitudes to MAP treatment. Methods: This was an internet-based, double-blind, quantitative, cross-sectional, psychiatrist approach-based observational survey. Participants were divided into three groups based on their answers: Those who do not follow-up any MAP patient were group 1 (n=78), partially involved in the treatment process of at least one patient diagnosed with MAP were group 2 (n=128), completely involved in the treatment process of at least one patient diagnosed with MAP were group 3 (n=202). Results: There was a significant difference between the three groups in terms of age (p<0.001), working duration in psychiatry (p<0.001), and institution and psychiatric training characteristics (p<0.001). Psychotropic preferences in insomnia (p<0.001), typical oral antipsychotic choice (p<0.001), preferred doses of olanzapine/risperidone/aripiprazole/amisulpride for maintenance treatment (p<0.001), long-acting injectable antipsychotic use practices (p<0.001), non-antipsychotic psychotropic use characteristics (p<0.001), extrapyramidal system side effect experiences (p<0.001), delirium and life-threatening situations encounter rates (p<0.001) were significantly different between group 2 and group 3. While the duration of maintenance with antipsychotics in the first MAP episode was similar between group 2 and group 3 (p=0.254), it was different in the second and subsequent MAP episodes (p<0.05). The attitudes of male and female participants were similar on almost all issues. A binary logistic regression model containing the experiences of LAI antipsychotic use, extrapyramidal system side effect and delirium was created (overall p<0.001, Nagelkerke R2=0.435; Hosmer and Lemeshow test p=0.203). Conclusions: This first study in the field, which examines the current issue in detail, reveals that there are many factors that seriously affect psychiatrists' approaches to MAP treatment in Turkey. The most important result of this study is that psychiatrists make courageous decisions as their experience participating in all phases of MAP treatment increases.