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Do former substance users with psychosis differ in their symptoms or function from non-substance users? A systematic
Pal Gupta1, Katherine Mullin, Olav Nielssen
1The Prince of Wales Hospital, Randwick, Australia.
The Australian and New Zealand Journal of Psychiatry
|January 24, 2013
Summary
Patients with psychosis who stopped substance use showed no significant differences in symptoms or function compared to those without substance use history. This indicates substance use history is not a poor prognostic indicator if use ceases.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neuroscience
Background:
- Psychosis is a severe mental health condition.
- Substance use disorders (SUDs) are common comorbidities in patients with psychosis.
- The impact of past substance use on psychosis outcomes is not fully understood.
Purpose of the Study:
- To compare symptom severity and functional outcomes in patients with psychosis who have ceased substance use versus those with no history of substance use.
- To determine if a history of substance use is a negative prognostic factor in psychosis.
Main Methods:
- A meta-analysis was conducted on 20 peer-reviewed studies.
- Databases searched included EMBASE, MEDLINE, and PsycINFO.
- Key outcomes analyzed were positive symptoms, negative symptoms, depression, and global function.
Main Results:
- Former substance users were younger and more likely to be male than non-substance users.
- No significant differences were found in positive symptoms, negative symptoms, or global function between groups.
- Depressive symptom severity varied: lower in first-episode former users, higher in non-first-episode former users. Higher quality studies showed less severe positive symptoms in former users.
Conclusions:
- A history of substance use does not appear to be a poor prognostic indicator for patients with psychosis who are able to cease substance use.
- These findings suggest that recovery and symptom management are achievable regardless of past substance use history.
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