126 – Persistent drug abuse in first episode psychosis – 1- and 2-year outcome

Abstract

Yale University School of Medicine, New Haven, CT, USAPresenting Author details: tklarsen@online.noArmauer Hansensv 20, 4068 Stavanger, Norway,Tel.: +47 90832795.Background: Abuse of drugs and alcohol is common in first episodepsychosis and frequently linked to poorer outcome [1]**. However,these results are mostly based on samples that are small and/or havelimitedgeneralizability.Theobjectiveofthisistolookat1-and2-yearoutcome in patients with first episode non-affective psychosis withemphasis on the predictive power of abuse of drugs and/or alcoholmeasured at index admission.Methods:Afollow-upstudywithaclinicalepidemiologicalsampleoffirst episode psychosis in patients recruited from four sites [sf1] inScandinavia (three in Norway and one in Denmark). All patients wereassessed on abuse of drugs/alcohol; premorbid functioning, socialfunctioning, and symptom level at admission and symptomatic andfunctional outcome after 1 and 2 years of treatment. All patients wereoffered a similar treatment package containing antipsychotics, familywork and individual psychotherapy.Results: Drug and alcohol abuse at index admission predicted a greaternumber of relapses, poorer social functioning (GAF) and less stableemploymentstatusatboth1-and 2-yearfollow-up.Approximately50%hadstoppedabusingdrugsat1-and2-yearsfollow-up.Persistentabusersat 2 years of follow-up were more often chronically psychotic, had ahighernumberofrelapsesandmoresymptoms(positiveandexcitement)compared to non-abusers. Similar results were found for 1-year follow-up.Thesmallgroup(6%)thatstartedabusingdrugshadmoredepressivesymptoms and the lowest GAF-scores.Conclusions: Persistent abuse is a difficult and significant problem infirst episode psychosis and this study demonstrated poorer outcome inpersistent abusers. However, almost 50% of our sample stopped theabuse during the first 2 years after index admission.Reference:[1] Larsen TK, Melle I, Auestad B, et al. Substance abuse in first-episode non-affective psychosis. Schizophr Res 2006; 88: 55–62.doi:10.1016/j.schres.2007.12.193127 – SUICIDALITY IN FIRST EPISODE PSYCHOSISR. McCaul