The study of primary psychotic disorders with concurrent substance abuse in terms of their diagnostic stability

Co-morbid substance use is common among individuals presenting with symptoms of psychosis. There is a paucity of research in this area.

To study the longitudinal follow-up of patients over 1-year of first episode psychosis with concurrent substance use in terms of their diagnostic stability.

Fifty patients having at least one symptom of psychosis at first admission at a General Hospital Psychiatric Unit along with concurrent substance abuse were included and followed up for 1-year. International Classification of Disease-10, diagnostic criteria were used for diagnosis. Semi-structured sociodemographic performa to assess the sociodemographic profile. Brief Psychiatric Rating Scale and Alcohol Use Disorder Identification Test as rating scales were used for the assessment at 6 and 12 months.

Of 50 patients, 31 patients who had a diagnosis of primary psychosis retained their diagnosis at follow-up. The mean age of cases in substance-induced psychosis group was 37.47 years, which was significantly higher than in primary psychosis group at 31.52 years. However, 7 patients of the substance-induced psychosis group required a change in diagnosis to primary psychosis group. The primary psychosis group patients were significantly younger, less educated, had less family support, had greater family mental illness, had more severe symptoms, and less hallucinations.

The present study is a forerunner in this area. Salient differences indicated in the study can help in differentiating the diagnosis and in the management of cases. This is particularly relevant in the management setting and for long-term intervention purpose.