Diagnostic stability in substance-induced psychosis

Area of Science:

• Psychiatry
• Neuroscience
• Addiction Medicine

Background:

• Substance-induced psychosis (SIP) is a distinct condition from other psychoses, characterized by its onset during substance abuse but persistence after cessation.
• Limited understanding exists regarding the long-term trajectory of SIP, raising concerns about potential progression to severe mental disorders (SMD).

Purpose of the Study:

• To investigate the conversion rate of substance-induced psychosis (SIP) to severe mental disorders (SMD) in a defined patient population.
• To identify potential sociodemographic and clinical factors associated with the progression from SIP to SMD.

Main Methods:

• A retrospective cohort follow-up study design was employed.
• Data from 116 patients diagnosed with SIP and discharged from a psychiatric hospital between 2002 and 2015 were analyzed.
• Statistical methods included descriptive analysis, Kaplan-Meier survival curves, and Cox regression to assess conversion risk and influencing factors.

Main Results:

• The study cohort consisted of 116 patients, with 78.4% males, an average age of 33 years, and 44% single.
• Cannabis (60.3%) and cocaine (40.5%) were the most frequently used substances.
• The cumulative risk of conversion from SIP to an SMD over 16 years was 41.6% (95% CI: 32.2-52.2), with a mean follow-up of 36.43 months.

Conclusions:

• A substantial proportion of patients with substance-induced psychosis (SIP) are at risk of developing severe mental disorders (SMD).
• The findings highlight the importance of considering the potential for long-term psychiatric morbidity in patients presenting with SIP.
• Interventions for SIP episodes should acknowledge and address the significant risk of progression to SMD, particularly within the first three years.