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Stuart and colleagues protocol for a systematic review of psychological treatment for methamphetamine use  is a timely and relevant response to a significant gap in guidance for treatment of psychological sequelae arising from psychostimulant use. Given that levels of psychological distress and clinical mental health symptoms are very common in people who use methamphetamine, there is an urgent need for psychological treatment guidelines for this population.
While many psychological interventions to date have also targeted comorbid anxiety and depressive symptoms, psychotic symptoms are also highly prevalent, clinically challenging and often poorly addressed. Methamphetamine-associated psychosis has been associated with significant morbidity, including increased agitation and violence, presentation to acute health services, and considerable health service burden . A subset of individuals may also be at risk of developing more persistent psychotic symptoms, later transitioning to a diagnosis of chronic psychotic disorder.
To date, the presence of psychotic symptoms has either been excluded, or not routinely screened for, in the majority of studies of psychological treatment for methamphetamine use. For instance, some studies have excluded participants with recent antipsychotic medication use, while measurement of psychotic symptoms or clinical assessments of psychotic disorder are typically absent [4-7]. On the other hand, many pharmacological inte...
To date, the presence of psychotic symptoms has either been excluded, or not routinely screened for, in the majority of studies of psychological treatment for methamphetamine use. For instance, some studies have excluded participants with recent antipsychotic medication use, while measurement of psychotic symptoms or clinical assessments of psychotic disorder are typically absent [4-7]. On the other hand, many pharmacological interventions targeting methamphetamine-associated psychosis do not detail the psychological components of treatment. This therefore poses a challenge for reviewers seeking to evaluate psychosis as an outcome measure.
Clinicians working with this population struggle with the management of this syndrome, and need guidance in evidence-based approaches. The findings of this review will be important in shaping best practice for co-morbidity in this population, so we encourage the authors to consider how to include guidance on psychological interventions for methamphetamine-associated psychosis within the scope of their protocol.
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