The impact of substance use disorders on clinical outcome in 643 patients with first-episode psychosis

IntroductionSouth Africa (SA) has a high HIV prevalence and limited mental healthcare resources. Neuropsychiatric complications such as psychosis onset in people living with HIV (PLWHIV) remains poorly understood. The study aims to compare the socio-demographic, clinical, substance use, cognitive and trauma profile of PLWHIV presenting with first episode psychosis (FEP) to those with the condition but without HIV.Methods and analysisThis study will compare presentation, course, and outcome of a cohort of PLWHIV and FEP with a control group recruited over a 3-year period. We will prospectively test the hypothesis that the 2 groups are socio-demographically, clinically and cognitively distinct at illness presentation, with higher trauma burden and poorer outcomes in those with the dual burden of HIV and FEP. FEP participants, confirmed by a structured neuropsychiatric interview, will have their socio-demographic, psychosis, mood, motor, trauma and substance use variables assessed. A neuropsychological battery will be completed to assess cognition, while quality of life, psychotic symptoms and HIV markers will be measured at 3, 6 and 12 months.Ethics and disseminationThe study protocol has been reviewed and ethics approval obtained from the Biomedical Research Ethics Committee (BC 571/18) of the University of KwaZulu-Natal. The results from this investigation will be actively disseminated through peer-reviewed journal publications and conference presentations.

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Substance use disorders before, at and after first episode psychosis hospitalizations in a young national Swedish cohort

Drug and Alcohol Dependence ◽

10.1016/j.drugalcdep.2020.107919 ◽

2020 ◽

Vol 209 ◽

pp. 107919 ◽

Cited By ~ 1

Author(s):

Pontus Strålin ◽

Jerker Hetta

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

Swedish Cohort

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Substance use disorders among treatment naïve first-episode psychosis patients

Comprehensive Psychiatry ◽

10.1016/j.comppsych.2013.07.075 ◽

2014 ◽

Vol 55 (1) ◽

pp. 165-169 ◽

Cited By ~ 13

Author(s):

Prabhat Chand ◽

Jagadisha Thirthalli ◽

Pratima Murthy

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

Treatment Naïve

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How to help homeless youth suffering from first episode psychosis and substance use disorders? The creation of a new intensive outreach intervention team

Psychiatry Research ◽

10.1016/j.psychres.2019.01.076 ◽

2019 ◽

Vol 273 ◽

pp. 603-612 ◽

Cited By ~ 5

Author(s):

Virginie Doré-Gauthier ◽

Hubert Côté ◽

Didier Jutras-Aswad ◽

Clairélaine Ouellet-Plamondon ◽

Amal Abdel-Baki

Keyword(s):

Substance Use ◽

Substance Use Disorders ◽

Homeless Youth ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

The Creation ◽

Intervention Team ◽

Outreach Intervention

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Comorbidities in Patients with an At-risk Mental State and First Episode Psychosis

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2142 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S198-S198 ◽

Cited By ~ 1

Author(s):

U. Heitz ◽

J. Cherbuin ◽

S. Menghini-Müller ◽

L. Egloff ◽

S. Ittig ◽

...

Keyword(s):

Gender Differences ◽

Substance Use ◽

Anxiety Disorders ◽

Substance Use Disorders ◽

Mental State ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

Axis I ◽

At Risk Mental State

IntroductionNon-psychotic axis I diagnoses are highly prevalent in at-risk mental state (ARMS) and first episode psychosis (FEP) patients, the most common being affective and anxiety disorders. Few studies have examined differences between ARMS and FEP patients or gender effects regarding such diagnoses.ObjectiveTo examine current and lifetime comorbidities in ARMS and FEP patients. Furthermore, to examine gender differences, and differences between patients with (ARMS-T) and without later transition to psychosis (ARMS-NT).MethodsThis study was part of the Früherkennung von Psychosen (FePsy) study. Current and lifetime axis I comorbidities were assessed using the Structured Clinical Interview for DSM-IV (SCID-I).ResultsOne hundred and thirty-two ARMS and 98 FEP patients were included. Current comorbidities were present in 53.1% of FEP and 64.4% of ARMS patients, the most common being affective, anxiety and substance use disorders. Current affective disorders were significantly more common in ARMS than FEP. Lifetime comorbidities were diagnosed in 58.2% of FEP and 69.7% of ARMS patients, with significantly more affective and anxiety disorders in ARMS than FEP. Male FEP patients had more current and lifetime substance use disorders (across all substances) compared to female FEP. No differences emerged between ARMS-T and ARMS-NT.ConclusionsAs expected ARMS patients have many comorbidities, while clearly diagnosed FEP have less comorbidities. There were few gender differences in axis I comorbidities. Moreover, no differences between ARMS-T and NT emerged, suggesting that axis I comorbidities do not improve prediction of transition. Nevertheless, the high comorbidity prevalence is relevant for global functioning and clinical treatment.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The impact of substance use at psychosis onset on First Episode Psychosis course: Results from a 1 year follow-up study in Bologna

Schizophrenia Research ◽

10.1016/j.schres.2014.01.014 ◽

2014 ◽

Vol 153 (1-3) ◽

pp. 60-63 ◽

Cited By ~ 11

Author(s):

Ilaria Tarricone ◽

Jane Boydell ◽

Serena Panigada ◽

Fabio Allegri ◽

Thomas Marcacci ◽

...

Keyword(s):

Substance Use ◽

First Episode Psychosis ◽

First Episode ◽

Follow Up Study ◽

Episode Psychosis ◽

The Impact

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First episode psychosis and comorbid ADHD, autism and intellectual disability

European Psychiatry ◽

10.1016/j.eurpsy.2018.09.007 ◽

2019 ◽

Vol 55 ◽

pp. 18-22 ◽

Cited By ~ 7

Author(s):

Pontus Strålin ◽

Jerker Hetta

Keyword(s):

Substance Use ◽

Intellectual Disability ◽

Substance Use Disorders ◽

Antipsychotic Medication ◽

Neurodevelopmental Disorders ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

Self Harm ◽

Comorbid Adhd

AbstractBackground:Comorbidity between neurodevelopmental disorders and psychotic disorders is common, but little is known about how neurodevelopmental disorders influence the presentation and outcome of first episode psychosis.Methods:A nation-wide cohort (n = 2091) with a first hospitalization for psychosis between 2007–2011 and at ages between 16–25 at intake was identified from Swedish population registries. Comorbid diagnoses of neurodevelopmental disorders were identified at first psychosis hospitalization and for ADHD also by dispensations of psychostimulants before the first psychosis hospitalization.Data from the registers on hospitalizations and dispensations of antipsychotic and psychostimulant medications during the year before and 2 years after the first psychosis hospitalization were analysed. Self-harm and substance use disorders were identified by ICD10 codes at hospitalizations.Results:2.5% of the cohort was identified with a diagnosis of intellectual disability, 5.0% with autism and 8.1% with ADHD. A larger proportion of cases with Autism (OR = 1.8, p < 0.05) and intellectual disability (OR = 3.1, p < 0.01) were using antipsychotic medication year 2 compared to the rest of the cohort. Delusional disorder was more common in the autism group (OR = 2.3, p < 0.05) at first psychosis hospitalization. ADHD was associated with higher risks for substance use disorders and self-harm both before and after the first psychosis hospitalization. Year 2 substance use disorder had a OR = 2.6 (p < 0.001) and self-harm OR = 4.1 (p < 0.001).Conclusions:Psychosis with comorbid ADHD is associated with high risks for substance use disorders and for self-harm, while psychosis with comorbid autism and intellectual disability is associated with longer treatment and higher doses of antipsychotic medication.

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