Substance abuse in first episode psychosis: Baseline characteristics and clinical outcome

IntroductionThere are high rates of substance use disorders (SUD) amongst first episode psychosis (FEP). SUD have been linked to better premorbid adjustment, more severe positive and negative symptoms at presentation and poorer symptomatic and functional outcome [1]. Moreover, shorter duration of untreated psychosis (DUP) has been described as an important predictor of outcome in FEP [2].AimsWith this study, we want to know which baseline characteristics and clinical outcomes differ between FEP patients with and without substance use.MethodsOne hundred and seventy-five FEP were consecutively admitted to Hospital del Mar since January 2008 to September 2014 and entered the FEP programme of the institution. The included evaluation was socio-demographic and clinical data at baseline and 1 year follow-up. We studied differences in age, gender, DUP, GAF scores at baseline and 1 year follow-up and PANSS subscale scores at base and 1 year follow-up between substance users and non-users.ResultsCannabis: we found that users were significative younger (P < 0.01), had a higher proportion of males (P < 0.01) and a significative shorter DUP in users (P = 0.008).Alcohol: we found that users were significative younger (P < 0.009), had a higher proportion of males (P < 0.003) and a significative lower PANNS negative scores at baseline (P = 0.01) and 1 year follow-up (P = 0.03).ConclusionsIn our sample of first episode psychosis, cannabis and alcohol use is linked with a younger age and a high proportion of males. Moreover, it seems that cannabis use could be associated with a shorter DUP.References not available.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

Early Psychosis Prevention and Intervention Centre long-term follow-up study of first-episode psychosis: methodology and baseline characteristics

Early Intervention in Psychiatry ◽

10.1111/j.1751-7893.2007.00008.x ◽

2007 ◽

Vol 1 (1) ◽

pp. 49-60 ◽

Cited By ~ 31

Author(s):

Lisa P. Henry ◽

Meredith G. Harris ◽

G. Paul Amminger ◽

Hok Pan Yuen ◽

Susy M. Harrigan ◽

...

Keyword(s):

First Episode Psychosis ◽

Early Psychosis ◽

First Episode ◽

Prevention And Intervention ◽

Follow Up Study ◽

Episode Psychosis ◽

Long Term Follow Up ◽

Baseline Characteristics

Download Full-text

Patterns and predictors of hospitalisation in first-episode psychosis

The British Journal of Psychiatry ◽

10.1192/bjp.178.6.518 ◽

2001 ◽

Vol 178 (6) ◽

pp. 518-523 ◽

Cited By ~ 47

Author(s):

Attila Sipos ◽

Glynn Harrison ◽

David Gunnell ◽

Shazad Amin ◽

Swaran P. Singh

Keyword(s):

Negative Symptoms ◽

First Episode Psychosis ◽

Psychiatric Services ◽

First Episode ◽

Psychotic Episode ◽

Duration Of Untreated Illness ◽

Specialist Services ◽

Increased Risk ◽

Episode Psychosis

BackgroundLittle is known about predictors of hospitalisation in patients with first-episode psychosis.AimsTo identify the pattern and predictors of hospitalisation of patients with a first psychotic episode making their first contact with specialist services.MethodThree-year follow-up of a cohort of 166 patients with a first episode of psychosis making contact with psychiatric services in Nottingham between June 1992 and May 1994.ResultsEighty-eight (53.0%) patients were admitted within 1 week of presentation; 32 (19.3%) were never admitted during the 3 years of follow-up. Manic symptoms at presentation were associated with an increased risk of rapid admission and an increased overall risk of admission; negative symptoms and a longer duration of untreated illness had an increased risk of late admission.ConclusionsCommunity-oriented psychiatric services might only delay, rather than prevent, admission of patients with predominantly negative symptoms and a longer duration of untreated illness. First-episode studies based upon first admissions are likely to be subject to selection biases, which may limit their representativeness.

Download Full-text

Exploring the relationship between recency and frequency of cannabis use and diminished expression and apathy as two dimensions of negative symptoms in first episode psychosis. A one-year follow-up study

Schizophrenia Research ◽

10.1016/j.schres.2021.08.004 ◽

2021 ◽

Vol 236 ◽

pp. 89-96

Author(s):

Henrik Myhre Ihler ◽

Trine Vik Lagerberg ◽

Siv Hege Lyngstad ◽

Ingrid Melle ◽

Kristin Lie Romm

Keyword(s):

Negative Symptoms ◽

First Episode Psychosis ◽

Two Dimensions ◽

Cannabis Use ◽

First Episode ◽

Follow Up Study ◽

Episode Psychosis ◽

One Year ◽

The Relationship

Download Full-text

Cognitive functioning in patients with first-episode psychosis stratified by level of negative symptoms: A 1-year follow-up study

Psychiatry Research ◽

10.1016/j.psychres.2019.112554 ◽

2019 ◽

Vol 281 ◽

pp. 112554 ◽

Cited By ~ 1

Author(s):

Magnus Johan Engen ◽

Carmen Simonsen ◽

Ingrid Melle ◽

Ann Færden ◽

Siv Hege Lyngstad ◽

...

Keyword(s):

Cognitive Functioning ◽

Negative Symptoms ◽

First Episode Psychosis ◽

First Episode ◽

Follow Up Study ◽

Episode Psychosis

Download Full-text

Resting-state functional connectivity of the striatum predicts improvement in negative symptoms and general functioning in patients with first-episode psychosis: A 1-year naturalistic follow-up study

IBRO Reports ◽

10.1016/j.ibror.2019.07.1458 ◽

2019 ◽

Vol 6 ◽

pp. S462-S463

Author(s):

Sanghoon Oh ◽

Minah Kim ◽

Tae Young Lee ◽

Taekwan Kim ◽

Jun Soo Kwon

Keyword(s):

Functional Connectivity ◽

Resting State ◽

Negative Symptoms ◽

First Episode Psychosis ◽

First Episode ◽

Resting State Functional Connectivity ◽

Follow Up Study ◽

Episode Psychosis ◽

General Functioning

Download Full-text

S121. OPUS 20, 20 YEAR FOLLOW-UP ON THE OPUS TRIAL

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.187 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S81-S82

Author(s):

Marie Starzer ◽

Carsten Hjorthøj ◽

Nikolai Albert ◽

Merete Nordentoft ◽

Helene Lund Sørensen

Keyword(s):

Negative Symptoms ◽

Participation Rate ◽

First Episode ◽

Episode Psychosis ◽

Health Project ◽

Gaf Scores ◽

Positive And Negative Symptoms ◽

Over Time

Abstract Background Since the first OPUS trial 20 years ago, structured clinical assessments have been collected from a cohort of first episode psychosis patients at 2, 5 and 10 years follow-up. They found that the symptomatology of patients clustered in distinct groups, and they were able to determine stable long-term trajectories of positive and negative symptoms. The Suffolk County Medical health project has followed patients after a first episode psychosis for 20 years. They also found a stable course of trajectories but with an overall significant worsening of symptom severity over time. The 20 year OPUS follow-up will give us the first opportunity to assess the long term outcome in a large representative cohort treated within modern mental health services with treatment available for all. Methods From 1998 to 2000 578 participants were randomized to OPUS or TAU. Baseline characteristics of the cohort were as follows: mean age 26.6 years, 59% were males, 66% had a diagnosis of schizophrenia and 27% had a secondary diagnosis of alcohol or substance abuse At the 20 year follow-up the investigators will be blinded to the original treatment allocation. The patients who wish to participate will be assessed using SAPS, SANS, SCAN, PSP and GAF. Socio-demographic factors and suicidal ideation will be register via self report. Cognitive function will be tested using BACS and all participants will be asked to fill out a number of self-rating questioners including WHO quality of life-BREF, self-perceived health, strengths and difficulties, the parenting scale and self-perceived negative symptoms. Using national Danish registers we can collect information on all former participants regarding the use of psychiatric and general healthcare services, medication, supported housing or homelessness, employment status, substance abuse and mortality. Results The OPUS 20 study started collecting data in Jan 2018. We are attempting to contact as many patients as possible from the 578 participants in the original OPUS cohort. At the time of writing we had included data and attempted contact to 322 participants. Overall 104 people (31,7%) have agreed to participate in the interviews. In the follow-up 10 years ago, the participation-rate was 60% so this is a big drop in participation rate. 41 (14%) have died, 31 (9,5%) were lost due to emigration, homelessness or hidden identity and/or disempowerment. 70 (21,3%) didn’t wish to participate and 76 (23,2%) never responded. Discussion Psychotic disorders and schizophrenia in particular are associated with progressive worsening of symptoms and profound social impairment, and as such are still very stigmatized. Results from the 10 year OPUS follow-up found stable trajectories of positive and negative symptoms over time, with a tendency of reduction and stabilization of positive symptoms but less variation of negative symptoms. They found poor but stable social functioning with a mean GAF score of 55 after 10 years. The Suffolk County mental health project also found stable trajectories of psychopathology measured with SAPS and SANS. They however found progressive worsening of GAF scores declining form 49 points at the beginning to 36 after 20 years. So far we have seen stable GAF scores and SAPS and SANS scores compared to OPUS 10. This gives rise to some optimism about the prognosis for schizophrenia compared to the findings of the Suffolk study. In our study the extensive interviews combined with the data collected form Danish registers give us a unique opportunity to look at the long term course of illness after FEP. The ability to test if previous findings are robust over time will be essential to the development of targeted interventions, differentiated to the needs of different patient groups.

Download Full-text

Relapse After First-Episode Psychosis: A 3-Year Follow-Up

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.113 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S276-S276

Author(s):

E. Pereira ◽

M. Mota Oliveira ◽

R. Guedes ◽

M.J. Peixoto ◽

I. Ferraz ◽

...

Keyword(s):

Psychotic Disorders ◽

Statistical Significance ◽

First Episode Psychosis ◽

Response To Treatment ◽

First Episode ◽

Final Sample ◽

Episode Psychosis ◽

Competing Interest ◽

Relapse Rates

IntroductionRelapse after first-episode psychosis (FEP) is a frequent problem, which can lead to patients’ poorer functioning and response to treatment. Its prevention is one of the most important and challenging targets in the treatment of psychotic disorders.ObjectivesTo characterize and evaluate relapse rates after FEP, during the course of 3 years, of a group of patients admitted at a psychiatry department.MethodsA retrospective observational study was conducted. Patients with a FEP between ages 18 to 40, admitted at the Clinic of Psychiatry and Mental Health at São João Hospital Centre between January 1, 2007 and September 30, 2013. Only patients with, at least, 3 years of follow-up at the clinic were included.ResultsFinal sample of 58 patients, 39 of which were male (mean age = 26.4 years). Forty patients were excluded by not completing the 3 years follow-up at our department. The cumulative relapse rates were 32.8% at 12 months, 53.4% at 24 months and 63.8% at 36 months. Patients with at least one relapse were younger (25.78 years vs. 27.52 years) and had shorter periods of first hospitalization (19.25 days vs. 23.52 days). These data did not reach statistical significance. Non-adherence to prescribed medication was described in 73.0% (n = 27) of patients at the time of relapse. Eight of them (21.6%) presented with cannabis use.ConclusionsAlthough no statistical significance was reached, our findings are consistent with other studies. A future study with a bigger sample would be important in achieving statistical significant results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text