Our findings are consistent with and extend the perspective of our colleagues in Japan who propose that methamphetamine can produce prolonged psychotic syndromes in some individuals lacking preexisting psychosis(29). However, the Japanese position relies almost exclusively on case-series studies of methamphetamine users admitted to psychiatric hospitals with already occurring psychotic conditions (30), which cannot provide incidence estimates of persistent psychotic syndromes in this group. Our study extends this literature by providing comparative incidence data on the occurrence of a persistent psychotic condition among individuals diagnosed with methamphetamine use disorders. Approximately 1% of the hospital patients diagnosed with methamphetamine use disorders in our study were readmitted with a subsequent schizophrenia diagnosis, and this finding suggests that methamphetamine use severe enough to warrant a hospital diagnosis might be associated with the development of a schizophrenia-like persistent psychotic syndrome in a small subset of users.