Methamphetamine Use and Psychiatric Morbidity in Sri Lanka: Sociodemographic Insights from a Tertiary Care Clinic.

Methamphetamine use is increasing across South and Southeast Asia, yet evidence on user characteristics and psychiatric morbidity remains limited. This study examines the sociodemographic features, psychiatric symptoms, and their associations among methamphetamine users in Sri Lanka. A cross-sectional study was conducted among 245 consecutive patients attending the professorial psychiatry unit of a tertiary hospital in Sri Lanka. Data were collected using a structured questionnaire, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria, and the Brief Psychiatric Rating Scale (BPRS). Most participants were male (97.6%) with a mean age of 31.3 years (SD = 9.7). The mean age of initiation was 29.2 years (SD = 10.0), and 86.9% were introduced by friends. Methamphetamine dependence was 60.8%. Frequent concurrent substance use included nicotine (93.1%) and heroin (73.9%). Psychiatric comorbidities included substance-induced psychosis (10.6%) and major depression (4.9%). The mean BPRS score was 24.25 (SD = 8.0), with prevalent symptoms: suspiciousness (86%), hostility (82.5%), and depression (61.6%). Higher BPRS scores linked to younger age, family history, unemployment, recent use, and dependence; dependence predicted higher symptoms (adjusted odds ratio [AOR] = 3.62, confidence intervals [CI]: 1.82-7.19). The methamphetamine users in Sri Lanka are predominantly young males with high rates of dependence, concurrent substance use, and significant psychiatric morbidity. These findings highlight the urgent need for integrated mental health and substance use interventions and provide data relevant for national, regional, and global public health strategies.