Relationship between substance abuse and first-episode psychosis - a South African perspective

Background. Co-morbidity between substance abuse and psy- chotic disorders is high. Few studies have examined therelationship between first-episode psychosis and substance abuse. Several questions emerge from this common relationship and many of them remain unanswered.Objectives. To determine the effect of substance abuse on psychosis in terms of onset, duration, severity of symptoms, use of medication and outcome.Method. Thirty - three subjects with first-episode psychosis, as well as primary caregivers, were interviewed re g a rding substance abuse and its relation to illness. Thirty-six control subjects were also interv i e w e d .Results. Twenty-seven per cent of subjects abused substances in the 3 months before onset of illness, and 77.8% of the abusers w e re male. Subjects in the first-episode psychosis group were m o re likely to choose cannabis as their substance of abuse than c o n t rols. They also started abusing substances at a younger age than controls. Subjects with first-episode psychosis who abused substances presented at an earlier age than non-abusers. Substances affected symptoms at baseline presentation .Conclusions. Substance abuse has a significant impact on first- onset psychosis as far as age of onset and symptom severity are c o n c e rned. Subjects with an underlying vulnerability to psychosis seem to start abusing substances at an earlier age than the general population. Males are more likely to abuse substances than females.

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Causal attributions, pathway to care and clinical features of first-episode psychosis: A South African perspective

International Journal of Social Psychiatry ◽

10.1177/0020764010390199 ◽

2010 ◽

Vol 57 (5) ◽

pp. 538-545 ◽

Cited By ~ 36

Author(s):

Jonathan K. Burns ◽

Khatija Jhazbhay ◽

Robin A. Emsley

Keyword(s):

South African ◽

Clinical Features ◽

Causal Attributions ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

African Perspective ◽

Pathway To Care

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Does substance abuse significantly risk of relapse after treatment of first episode psychosis despite adherence to medication?

European Psychiatry ◽

10.1016/j.eurpsy.2007.01.635 ◽

2007 ◽

Vol 22 ◽

pp. S192

Author(s):

A. Malla ◽

R. Norman ◽

L. Bechard ◽

N. Schmitz ◽

R. Manchanda ◽

...

Keyword(s):

Substance Abuse ◽

First Episode Psychosis ◽

First Episode ◽

Adherence To Medication ◽

Episode Psychosis ◽

Risk Of Relapse

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Developing a job coaching programme for first onset psychosis patients in the Southwark first episode psychosis service (first)

Schizophrenia Research ◽

10.1016/s0920-9964(03)80312-2 ◽

2003 ◽

Vol 60 (1) ◽

pp. 332

Author(s):

R. Bell ◽

R.I. Ohlsen ◽

M.S. O'Toole ◽

R.G. Purvis ◽

T.M. Taylor ◽

...

Keyword(s):

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

First Onset ◽

Job Coaching

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Neurological soft signs in first-episode psychosis: A systematic review

The British Journal of Psychiatry ◽

10.1192/bjp.181.43.s50 ◽

2002 ◽

Vol 181 (S43) ◽

pp. s50-s57 ◽

Cited By ~ 132

Author(s):

Paola Dazzan ◽

Robin M. Murray

Keyword(s):

Motor Coordination ◽

First Episode Psychosis ◽

The Body ◽

First Episode ◽

Psychotic Episode ◽

Neurological Soft Signs ◽

First Psychotic Episode ◽

Cerebral Dysfunction ◽

Episode Psychosis ◽

First Onset

BackgroundNeurological soft signs (NSS) are minor neurological signs indicating non-specific cerebral dysfunction. Their presence has been documented extensively in schizophrenia but not during the first psychotic episode.AimsTo review studies that have specifically investigated NSS at the time of the first psychotic episode.MethodA review of studies investigating neurological function in first-episode psychosis, using a clinical examination.ResultsPatients with first-episode psychosis show an excess of NSS, particularly in the areas of motor coordination and sequencing, sensory integration and in developmental reflexes. Furthermore, NSS may be associated with a specific laterality pattern.ConclusionsMore studies on first-onset schizophrenia are needed, evaluating both sensory and motor neurological domains (scoring separately for the two sides of the body), integrating this knowledge with neuroimaging findings and clarifying the role of NSS as markers of cognitive dysfunction.

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Gender Differences in Schizophrenia and First-Episode Psychosis: A Comprehensive Literature Review

Schizophrenia Research and Treatment ◽

10.1155/2012/916198 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 143

Author(s):

Susana Ochoa ◽

Judith Usall ◽

Jesús Cobo ◽

Xavier Labad ◽

Jayashri Kulkarni

Keyword(s):

Gender Differences ◽

Negative Symptoms ◽

Age Of Onset ◽

Familial Risk ◽

First Episode Psychosis ◽

First Episode ◽

Neuropsychological Profile ◽

Affective Symptoms ◽

Episode Psychosis ◽

Premorbid Functioning

Recent studies have begun to look at gender differences in schizophrenia and first-episode psychosis in an attempt to explain the heterogeneity of the illness. However, a number of uncertainties remain. This paper tries to summarize the most important findings in gender differences in schizophrenia and first-psychosis episodes. Several studies indicate that the incidence of schizophrenia is higher in men. Most of the studies found the age of onset to be earlier in men than in women. Findings on symptoms are less conclusive, with some authors suggesting that men suffer more negative symptoms while women have more affective symptoms. Premorbid functioning and social functioning seem to be better in females than males. However, cognitive functioning remains an issue, with lack of consensus on differences in neuropsychological profile between women and men. Substance abuse is more common in men than women with schizophrenia and first-episode psychosis. In terms of the disease course, women have better remission and lower relapse rates. Lastly, there is no evidence of specific gender differences in familial risk and obstetric complications. Overall, gender differences have been found in a number of variables, and further study in this area could help provide useful information with a view to improving our care of these patients.

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Stressful and intrusive life events preceding first episode psychosis

Epidemiologia e Psichiatria Sociale ◽

10.1017/s1121189x00000506 ◽

2009 ◽

Vol 18 (3) ◽

pp. 221-228 ◽

Cited By ~ 24

Author(s):

David Raune ◽

Elizabeth Kuipers ◽

Paul Bebbington

Keyword(s):

Life Events ◽

Patient Group ◽

Stressful Life Events ◽

Conflicts Of Interest ◽

Statistical Significance ◽

First Episode Psychosis ◽

First Episode ◽

Episode Psychosis ◽

Comparison Groups ◽

First Onset

SUMMARYAim – To test the hypothesis that stressful life events, in particular intrusive events, would cluster before the first onset of psychosis. Method – Forty-one patients with first episode psychosis were interviewed with the Life Events and Difficulties Schedule to assess events in the year before the onset of illness. Events were rated contextually on timing, independence, threat, and intrusiveness. Within-patient group clustering was evaluated, and the patient group was compared with two general population surveys from London. Results – Events were very frequent in the year before the onset of psychosis. Stressful and intrusive events were more common in the three months before onset compared with the previous nine months, although few analyses reached conventional statistical significance. Threatening and intrusive events were much more frequent in patients than in the comparison groups. First episode psychosis patients were strikingly more likely to report an intrusive event in the three months before onset (OR=17.1, 34% v 3%), and also showed an excess between three months and one year before onset (OR=8.1, 11% v 3%). Conclusions – Events may trigger many cases of first episode psychosis. The effect emerges several months before onset, particularly if the events are intrusive. This has both theoretical and clinical implications.Declaration of Interest: DR was supported by a UK Medical Research Council studentship. The authors have no conflicts of interest in writing this paper.

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