牙科表徵引導診斷甲基安非他命誘發之精神病

Dental Manifestations Leading to Diagnosis of Methamphetamineinduced Psychotic Disorder

背景：甲基安非他命會造成精神病、情緒障礙，及生理上的影響。目前對甲基安非他命相關的疾患，有許多不同的理論、治療、基因篩檢正在發展中，顯示甲基安非他命誘發之精神病，與原發的精神分裂症或情感性精神分裂症，或有不同的病因。個案報告：一位33歲女性病人被診斷為情感性精神分裂症10年來，病情常起伏，經觀察其牙齒表現，追溯到她仍持續使用甲基安非他命，故修改其診斷為甲基安非他命誘發之精神病疾患。結論：甲基安非他命造成的牙齒表現，可以作為診斷甲基安非他命相關疾患的一個重要線索，協助鑑別診斷。

Background:Methamphetamine is commonly used worldwide. It can cause psychiatric disorders as well as cardiovascular, dermatologic, and neurological symptoms. Different hypotheses, genes, and treatment focus have been developed for methamphetamine-induced psychotic disorder, implying the different etiology of methamphetamine-induced psychotic disorder and schizophrenia or schizoaf- fective disorder. Case Report:A 33-year-old female patient who had been diag- nosed with schizoaffective disorder for 10 years. Her symptoms were fluctuated under antipsychotics treatment. When she voluntarily came to our hospital, her dental presentations (meth mouth), reminded us her continuous use of metham- phetamine. Her diagnosis was revised from schizoaffective disorder to metham- phetamine-induced psychotic disorder. Conclusion:Differentiating metham- phetamine-induced psychotic disorder from primary psychotic disorder in clinical practice has been a serious challenge. Meth mouth could be a clue in correctly di- agnosing methamphetamine related disorder.