Diagnostic stability in substance-induced psychosis

Area of Science:

• Psychiatry
• Addiction Medicine
• Neuroscience

Background:

• Substance-induced psychosis (SIP) can persist beyond acute intoxication, with limited understanding of its long-term trajectory.
• A substantial number of SIP cases may transition to severe mental disorders (SMD), necessitating further investigation.

Approach:

• A retrospective cohort study analyzed 116 patients diagnosed with SIP between 2002 and 2015.
• Data included sociodemographics, substance use (cannabinoids, opioids, amphetamines, cocaine, alcohol), and psychiatric history.
• Statistical analyses involved descriptive statistics, Kaplan-Meier curves, and Cox regression to assess conversion risk.

Key Points:

• The study cohort (n=116) was predominantly male (78.4%), with an average age of 33 years.
• Cannabis (60.3%) and cocaine (40.5%) were the most frequently used substances.
• The cumulative risk of conversion from SIP to SMD over 16 years was 41.6% (95% CI: 32.2-52.2).

Conclusions:

• A significant risk of progression from substance-induced psychosis to severe mental disorders exists.
• Interventions for SIP episodes should consider the potential for long-term conversion, particularly within the first three years.