Abstract
BackgroundUse of psychoactive substances is a common finding in studies on first-episode psychosis (FEP), and this has prognostic implications. We know very little about psychoactive substance use (SU) among patients with FEP in the Eastern Cape province (EC) of South Africa (SA).AimThe study seeks to determine SU prevalence and associated features among inpatients with non-affective FEP in an acute mental health unit (MHU) in Nelson Mandela Bay, EC.SettingResearchers conducted a retrospective clinical file review of a 12-month admission cohort of patients with FEP, without a concurrent mood episode, to the Dora Nginza Hospital MHU. Information collected included SU history, psychiatric diagnoses, and demographics. Data were then subjected to statistical analysis.MethodsResearchers conducted a retrospective clinical file review of a 12-month admission cohort of patients with FEP, without a concurrent mood episode, to the Dora Nginza Hospital MHU. Information collected included SU history, psychiatric diagnoses and demographics. Data were then subjected to statistical analysis.ResultsA total of 117 patients (86 [73.5%] males; 31 [26.5%] females) aged 18–60 years (mean 29 years) met the inclusion criteria. After controlling for missing information, 95 of 117 (81.2%) patients had a history of active or previous SU, 82 of 90 (91.1%) were single and 61 of 92 (66.3%) were unemployed. A significant association was found between SU and unemployment (p < 0.001), as well as male sex (p < 0.001). The most common substances used were cannabis (59.8%), followed by alcohol (57.3%) and stimulants (46.4%).ConclusionIn keeping with national and international literature, the results of this study showed a high prevalence of substance use in South African patients with first-episode psychosis. The high prevalence of lifetime substance use in this cohort compared to previous studies in South Africa requires further investigation and highlights the urgent need for dual diagnosis services in the Eastern Cape province.
Highlights
IntroductionThe prevalence of substance use (SU) among patients presenting with first-episode psychosis (FEP) ranges from 30% to 75% across studies and countries.[1,9,14,15,16] The wide variation is possibly because of a combination of methodological inconsistencies, as well as cultural and environmental differences between countries, especially regarding the availability of illicit substances.[16] The types of substances used by people with FEP vary across studies, but cannabis and alcohol tend to be the most frequently reported.[2,15,17,18] http://www.sajpsychiatry.org
In keeping with national and international literature, this study showed a high prevalence of substance use in patients with first-episode psychosis (FEP)
The study findings highlight the need for mental health services in the Eastern Cape province (EC) to focus on dual diagnosis in order to address the challenge of substance abuse and its association with FEP
Summary
The prevalence of SU among patients presenting with FEP ranges from 30% to 75% across studies and countries.[1,9,14,15,16] The wide variation is possibly because of a combination of methodological inconsistencies, as well as cultural and environmental differences between countries, especially regarding the availability of illicit substances.[16] The types of substances used by people with FEP vary across studies, but cannabis and alcohol tend to be the most frequently reported.[2,15,17,18] http://www.sajpsychiatry.org. Use of psychoactive substances is a common finding in studies on firstepisode psychosis (FEP), and this has prognostic implications. We know very little about psychoactive substance use (SU) among patients with FEP in the Eastern Cape province (EC) of South Africa (SA)
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