Psychiatric symptoms and HPA axis function in adolescent methamphetamine users.

Methamphetamine (METH) is a widely abused drug. However, little is known about the effects of chronic METH consumption on HPA axis function and psychiatric symptomatology in adolescent METH users. The current study evaluated psychiatric symptoms and changes in the stress response of adolescent METH users. Forty-one adolescent METH users and 75 comparison subjects in the same age range (ages 12-23 years) were recruited. Each subject completed the Symptom Checklist-90R (SCL-90) and was evaluated using the Brief Psychiatric Rating Scale. In addition, the subjects completed the Trier Social Stress Test (TSST) and had salivary cortisol levels measured 30 min before, immediately after, and 60 min after the TSST. Adolescent METH users showed greater severity of symptoms across all measures of the SCL-90. Younger female METH users had the most symptoms. Furthermore, the METH users exhibited significantly enhanced cortisol levels immediately following the TSST (+31%, p = 0.03). Adolescent METH use is associated with greater psychiatric symptoms and enhanced cortisol secretion following a social stressor, particularly in younger female METH users. The psychiatric symptoms may reflect altered prefrontal cortical function resulting from chronic stress/drug use and the resulting glucocorticoid exposure. The results further suggest that treatment approaches should focus on stress-coping strategies to decrease the probability of relapse.