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Substance misuse in first-episode psychosis: 15-month prospective follow-up study
D Wade1, S Harrigan, J Edwards
1ORYGEN Youth Health and Department of Psychiatry, University of Melbourne, Parkville, and Department of Medicine, University of Melbourne at St Vincent's Hospital, Fitzroy, Victoria, Australia. dwade@unimelb.edu.au
The British Journal of Psychiatry : the Journal of Mental Science
|September 2, 2006
Summary
Substance misuse in first-episode psychosis increases risks for hospitalization and symptom relapse. However, it does not appear to affect remission rates or the time it takes to achieve remission.
Area of Science:
- Psychiatry
- Addiction Medicine
- Clinical Psychology
Background:
- Understanding substance misuse in first-episode psychosis (FEP) is crucial for identifying associated risks.
- Prospective studies are needed to clarify the impact of comorbid substance misuse on FEP outcomes.
Purpose of the Study:
- To investigate the effects of substance misuse on inpatient admission, remission, and relapse of positive symptoms in FEP.
- To determine if substance misuse independently influences recovery trajectories in FEP patients.
Main Methods:
- A prospective 15-month follow-up study.
- Involved 103 patients diagnosed with first-episode psychosis.
- Recruitment from three distinct mental health services.
Main Results:
- Substance misuse independently predicted higher rates of inpatient admission and relapse of positive symptoms.
- A shorter time to relapse of positive symptoms was observed in patients with substance misuse.
- No significant association was found between substance misuse and remission or time to remission of positive symptoms.
- Heavy substance misuse showed a stronger association with adverse outcomes, including admission and relapse.
Conclusions:
- Substance misuse is an independent risk factor complicating recovery in first-episode psychosis.
- Early intervention for substance misuse may be critical for improving outcomes in FEP.
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