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Managing drug-induced psychosis.
Leonardo Baldaçara1,2, Artur Ramos3, João Maurício Castaldelli-Maia3,4
1Federal University of Tocantins, Palmas, Brazil.
International Review of Psychiatry (Abingdon, England)
|February 1, 2024
Summary
Substance-induced psychosis, often from drug abuse, can lead to severe addiction and a higher risk of developing schizophrenia or bipolar disorder. Early intervention and relapse prevention are key for managing this condition.
Area of Science:
- Psychiatry
- Neuroscience
- Addiction Medicine
Background:
- Substance-induced psychosis (SIP) is a secondary psychotic disorder linked to drug abuse.
- SIP is distinct from primary psychosis, with differing symptom profiles and family histories.
- Individuals with SIP have a higher risk of developing severe drug addiction and primary psychotic disorders.
Purpose of the Study:
- To delineate the characteristics of substance-induced psychosis.
- To explore the association between SIP and the development of schizophrenia spectrum disorder and bipolar illness.
- To outline effective treatment and management strategies for SIP.
Main Methods:
- Comparative analysis of SIP patients versus primary psychosis patients.
- Longitudinal assessment of outcomes, including conversion to schizophrenia or bipolar disorder.
- Review of current treatment protocols for acute intoxication, withdrawal, and long-term management.
Main Results:
- SIP patients show poorer family history, higher insight, fewer positive/negative symptoms, more depressive symptoms, and greater anxiety than primary psychosis patients.
- SIP is strongly associated with developing bipolar illness or schizophrenia spectrum disorder, particularly with early-onset substance abuse and cannabis use.
- Self-harm episodes post-SIP significantly increase the likelihood of developing schizophrenia or bipolar disorder.
- Conversion rates to schizophrenia or bipolar disorder can reach up to one in three individuals.
Conclusions:
- Substance-induced psychosis carries a significant risk of conversion to primary psychotic disorders like schizophrenia and bipolar illness.
- Effective management requires addressing acute intoxication, withdrawal, and implementing robust relapse prevention strategies.
- Vigilant monitoring for suicidal behavior and dynamic assessment are crucial components of care for individuals with SIP.
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