Comparison of psychiatric disorders in a sample of Egyptian patients with methamphetamine use disorder (MUD) versus opioid use disorder (OUD): rate and addiction severity

Abstract Background Substance use disorder (SUD) represents a growing challenge to public health worldwide. In Egypt, reported prevalence ranges from 7.25% to 14.5%, and the condition is commonly linked with co-occurring psychiatric disorders and adverse physical health outcomes. Methamphetamine (METH), a powerful central nervous system stimulant, is known to induce neurotoxic effects, impair cognitive function, and increase vulnerability to psychiatric conditions including anxiety, depression, and psychosis. In parallel, opioid use disorder (OUD) is associated with multiple psychological disturbances, largely mediated through its action on mu (µ), delta (δ), and kappa (κ) opioid receptors in the nervous system. The present study aimed to evaluate differences in the prevalence of psychiatric and personality disorders between individuals with methamphetamine use disorder (MUD) and those with opioid use disorder, as well as to explore their relationship with addiction severity. Methods A comparative cross-sectional design was employed, involving 45 patients with methamphetamine use disorder and 45 patients with opioid use disorder. Assessment tools included the Arabic versions of the Structured Clinical Interview for DSM Disorders (SCID-I and SCID-II) alongside the Addiction Severity Index (ASI). Results Findings indicated that psychotic disorders were more frequently observed in the methamphetamine group (42.2%) compared with the opioid group (13.3%). Similarly, bipolar affective disorder was more prevalent among methamphetamine users (15.56%) than opioid users (2.22%). Conversely, depressive disorders were markedly higher in the opioid group (40%) relative to the methamphetamine group (2.22%). Anxiety disorders were identified in 26.6% of individuals with methamphetamine use disorder, whereas no cases were reported among those with opioid use disorder. Borderline personality disorder was also notably more common in the methamphetamine group (66.6%) compared to the opioid group (26.6%). Conclusions Overall, methamphetamine use disorder was associated with higher rates of psychosis, bipolar disorder, anxiety disorders, and borderline personality disorder. In contrast, individuals with opioid use disorder demonstrated greater addiction severity as measured by the Addiction Severity Index.