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Substance use and the course of early psychosis: a 2-year follow-up of first-admitted subjects

Published online by Cambridge University Press:  16 April 2020

F. Sorbara ,
F. Liraud ,
F. Assens ,
F. Abalan  and
H. Verdoux
F. Sorbara
Affiliation:
Department of Psychiatry, University Victor Segalen Bordeaux 2, France Hôpital Charles Perrens, Bordeaux, France
F. Liraud
Affiliation:
Department of Psychiatry, University Victor Segalen Bordeaux 2, France Hôpital Charles Perrens, Bordeaux, France
F. Assens
Affiliation:
Hôpital Charles Perrens, Bordeaux, France
F. Abalan
Affiliation:
Hôpital Charles Perrens, Bordeaux, France
H. Verdoux*
Affiliation:
Department of Psychiatry, University Victor Segalen Bordeaux 2, France Hôpital Charles Perrens, Bordeaux, France
*
*E-mail address: Address: University Department of Psychiatry, Hôpital Charles Perrens, 121, rue de la Béchade, 33076 Bordeaux cedex, France. helene.verdoux@ipso.u-bordeaux2.fr
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Abstract

Objective

To examine the impact of alcohol and substance use on the early course of psychosis.

Methods: First-admitted subjects with psychosis (n = 58) were assessed at 6-month intervals over a 2-year follow-up. Information on substance and alcohol misuse and clinical and social outcome was collected using multiple sources of information.

Results

After adjustment for potential confounding factors, subjects with persistent substance misuse over the follow-up were at increased risk of readmission (OR = 3.1; 95%CI = 1.0-9.4; P = 0.05), of presenting with psychotic symptoms (OR = 4.3; 95%CI = 1.0-18.1; P = 0.04), and with a non-continuous course of illness (OR = 11; 95%CI = 1-122; P = 0.05). No significant association was found between substance misuse and social outcome, or between alcohol misuse and clinical and social outcome.

Conclusions

Persistent substance misuse after a first admission for psychosis has a deleterious impact on clinical outcome. Early identification and treatment of substance use is essential in the care of subjects with incipient psychosis.

Keywords

PsychosisFirst episodeSubstance useOutcome
Type
Short communication
Information
European Psychiatry , Volume 18 , Issue 3 , May 2003 , pp. 133 - 136
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS 2003

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References

Addington, J, Addington, D. Effect of substance misuse in early psychosis. Br J Psychiatry 1998;172(Suppl 33):134–6.CrossRefGoogle ScholarPubMed
American Psychiatric Association. DSM-III-R. Diagnostic and statistical manual of mental disorders. 3rd ed. revised. Washington (DC): APA; 1987.Google Scholar
Arndt, S, Tyrrell, G, Flaum, M, Andreasen, Nc. Comorbidity of substance abuse and schizophrenia: the role of pre-morbid adjustment. Psychol Med 1992;22:379–88.CrossRefGoogle ScholarPubMed
Ashton, C. Pharmacology and effects of cannabis: a brief review. Br J Psychiatry 2001;178:101–6.CrossRefGoogle ScholarPubMed
Breier, A, Schreiber, M, Dyer, J, Pickar, D. National Institute of Mental Health Longitudinal study of schizophrenia. Arch Gen Psychiatry 1991;48:239–46.CrossRefGoogle ScholarPubMed
Cantwell, R, Brewin, J, Glazebrook, C, Dalkin, T, Fox, R, Medley, I, et al.Prevalence of substance misuse in first-episode psychosis. Br J Psychiatry 1999;174:150–3.Google ScholarPubMed
Chetty, M, Miller, R, Moodley, Sv. Smoking and body weight influence the clearance of chlorpromazine. Eur J Clin Pharmacol 1994;46: 523–6.Google ScholarPubMed
Dixon, L, Haas, G, Weiden, Pj, Sweeney, J, Frances, Aj. Drug abuse in schizophrenic patients: clinical correlates and reasons for use. Am J Psychiatry 1991;148:224–30.Google ScholarPubMed
Edwards, J, Maude, D, Mcgorry, Pd, Harrigan, Sm, Cocks, Jt. Prolonged recovery in first-episode psychosis. Br J Psychiatry Suppl 1998;172: 107–16.CrossRefGoogle ScholarPubMed
Golstein, H. Multilevel models in educational and social research. London: Griffin; 1987.Google Scholar
Hambrecht, M, Hafner, H. Substance abuse and the onset of schizophrenia. Biol Psychiatry 1996;40:1155–63.CrossRefGoogle ScholarPubMed
Haywood, T, Kravitz, H, Grossman, L, Cavanaugh, J, Davis, J, Lewis, D. Predicting the “revolving door” phenomenon among patients with schizophrenic, schizoaffective, and affective disorders. Am J Psychiatry 1995;152:856–61.Google ScholarPubMed
Ho, A, Tsuang, J, Liberman, R, Wang, R, Wilkins, J, Eckman, T, et al.Achieving effective treatment of patients with chronic psychotic illness and comorbid substance dependence. Am J Psychiatry 1999;156: 1765–70.Google ScholarPubMed
Kirkpatrick, B, Amador, Xf, Flaum, M, Yale, Sa, Gorman, Jm, Carpenter Jr, Wt, et al.The deficit syndrome in the DSM-IV field trial: I. Alcohol and other drug abuse. Schizophrenia Res 1996;20:69–77.CrossRefGoogle ScholarPubMed
Lecrubier, Y, Seehan, D,Weiller, E,Amorin, P, Bonora, I, Seehan, K, et al.The Mini International Neuropsychiatric Interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. Eur Psychiatry 1997;12:224–31.CrossRefGoogle Scholar
Linszen, D, Lenior, M. Early psychosis and substance abuse. In: McGorry, P, Jackson, H, editors. Early psychosis and substance abuse. Cambridge: Cambridge University Press; 1999. p. 363–76.Google Scholar
Linszen, Dh, Dingemans, P, Lenior, M. Cannabis abuse and the course of recent-onset schizophrenic disorders. Arch Gen Psychiatry 1994; 51:273–9.CrossRefGoogle ScholarPubMed
McGorry, Pd, Bell, Rc, Dudgeon, Pl, Jackson, HJ. The dimensional structure of first episode psychosis: an exploratory factor analysis. Psychol Med 1998;28:935–47.CrossRefGoogle ScholarPubMed
Owen, R, Fisher, E, Booth, B, Cuffel, B. Medication noncompliance and substance abuse among patients with schizophrenia. Psychiatr Serv 1996;47:853–8.Google ScholarPubMed
Rabinowitz, J, Bromet, E, Lavelle, J, Carlson, G, Kovasznay, B, Schwartz, JE. Prevalence and severity of substance use disorders and onset of psychosis in first-admission psychotic patients. Psychol Med 1999;28:1411–9.CrossRefGoogle Scholar
Statacorp. Stata Statistical Software: Release 7.0. STATA corporation, College Station, TX. 2001.Google Scholar
Tanda, G, Pontieri, F, Di Chiara, G. Cannabinoid and heroin activation of mesolimbic dopamine transmission by a common µ1 opoid receptor mechanism. Science 1997;276:2048–50.CrossRefGoogle Scholar
Van Os, J, Bak, M, Hanssen, M, Bijl, RV, De Graaf, R, Verdoux, H. Cannabis and psychosis: a longitudinal population-based study. Am J Epidemiol 2002;156:319–27.CrossRefGoogle ScholarPubMed
Verdoux, H, Bergey, C, Assens, F, Abalan, F, Gonzales, B, Pauil-lac, P, et al.Prediction of duration of psychosis before first admission. Eur Psychiatry 1998;13:346–52.CrossRefGoogle ScholarPubMed
Verdoux, H, Liraud, F, Gonzales, B, Assens, F, Abalan, F, Van Os, J. Suicidality and substance misuse in first-admitted subjects with psychotic disorder. Acta Psychiatr Scand 1999;100:389–95.Google ScholarPubMed
Verdoux, H, Lengronne, J, Liraud, F, Gonzales, B, Assens, F, Abalan, F, et al.Medication adherence in psychosis: predictors and impact on outcome. A 2-year follow-up of first-admitted subjects. Acta Psychiatr Scand 2000;102:203–10.Google ScholarPubMed
Verdoux, H, Liraud, F, Bergey, C, Assens, F, Abalan, F, Van Os, J. Is the association between duration of untreated psychosis and outcome confounded? A two year follow-up study of first-admitted patients. Schizophrenia Res 2001;49:231–41.CrossRefGoogle ScholarPubMed
Verdoux, H, Gindre, C, Sorbara, F, Tournier, M, Swendsen, D. Cannabis use and the expression of psychosis vulnerability in daily life. Psychol Med 2003;33:23–32.Google Scholar
WHO. WHO coordinated multi-center study on the course and outcome of schizophrenia. Geneva: WHO; 1992.Google Scholar
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