Abstract
BackgroundSubstance misuse is a well-recognized co-morbidity to psychosis and has been linked to poor prognostic outcomes in patients. Researchers have yet to investigate the difference in rates and characteristics between first-episode Substance Induced Psychosis (SIP) and primary psychosis. We aimed at comparing patients with SIP to primary psychosis patients with or without substance misuse at baseline.MethodsThirty SIP patients, 45 primary psychosis patients with substance misuse (PS) and 66 primary psychosis patients without substance misuse (PNS) in a well-defined Norwegian catchment area were included from 2007–2011. Assessments included symptom levels (PANSS), diagnostic interviews (SCID), premorbid function scale (PAS) and global functioning (GAF f/s).ResultsTreated incidence for SIP was found to be 6.5/100 000 persons per year, 9.7/100 000 persons per year for PS and 24.1/100 000 persons per year for PNS (15-65 yrs). Patients who had substance misuse (PS and SIP) were more likely to be male. Duration of Untreated Psychosis (DUP) was significantly shorter in the SIP group (5.0 wks., p = 0.003) and these had more positive symptoms on the PANSS (p = 0.049). SIP patients also did poorer on early youth academic levels on the PAS.ConclusionsYearly treated incidence of SIP is 6.5/100 000 persons per year in a Norwegian catchment area. SIP patients have short DUPs, are more likely to be male, have more positive symptoms at baseline and poorer premorbid academic scores in early adolescence. Follow-up will evaluate stability of diagnosis and characteristics.
Highlights
Substance misuse is a well-recognized co-morbidity to psychosis and has been linked to poor prognostic outcomes in patients
The patients with substance misuse (PS) groups had a greater proportion of schizophreniform psychosis, whilst patients without substance misuse (PNS) patients had a higher degree of major depressive disorder
Our study showed that the treated incidence of Substance Induced Psychosis (SIP) and PS was lower than in the PNS group
Summary
Substance misuse is a well-recognized co-morbidity to psychosis and has been linked to poor prognostic outcomes in patients. Researchers have yet to investigate the difference in rates and characteristics between first-episode Substance Induced Psychosis (SIP) and primary psychosis. We aimed at comparing patients with SIP to primary psychosis patients with or without substance misuse at baseline. Distinguishing between substance-induced psychosis (SIP) and primary psychosis is crucial for understanding illness and providing optimal treatment. Substance misuse is a well-recognized co-morbidity to schizophrenia, and rates of substance use are significantly higher in psychiatric patients than in the general population [4,5,6,7]. Substance misusers are more frequently male [19,20] compared to non-users in primary psychosis. Demonstrated better cognitive performance in substance abuse groups has been linked to the necessity for social skills in obtaining illegal drugs [21], and yet there is evidence of poor academic performance [19,22]
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