Hazardous alcohol use in a sample of first episode psychosis patients in Singapore

Abstract

BackgroundHazardous alcohol use has often been found to be more prevalent amongst psychiatric outpatients than the general population. Additionally, it has also been associated with poorer outcomes. The study aimed to investigate (1) the prevalence and (2) socio-demographic and clinical correlates of hazardous alcohol use, as well as (3) the relationship between hazardous alcohol use and quality of life in an outpatient sample with First Episode Psychosis (FEP) in Singapore.MethodsBaseline data (N = 280) was extracted from a longitudinal study investigating smoking and alcohol use amongst outpatients with FEP in a psychiatric hospital. Information on socio-demographics, hazardous alcohol use, and quality of life was collected through a self-report survey. Hazardous alcohol use was ascertained by total scores of 8 or higher on the Alcohol Use Disorders Identification Test (AUDIT). Data was analysed using logistic regression and linear regression analyses.ResultsThe prevalence of hazardous alcohol use over the past 12-month period was 12.9%. Those who had never smoked in their lifetime (vs current smokers) and those with a diagnosis of brief psychotic disorder (vs schizophrenia spectrum disorders) were found to have significantly lower odds of hazardous alcohol use. Hazardous alcohol use was also associated with lower negative symptom scores. Lastly, hazardous alcohol use was found to significantly predict lower scores on the physical health, social relationship and environment domains of quality of life.ConclusionsThe association between hazardous alcohol use and lower negative symptom scores is a surprising finding that needs to be further explored. The significant impact of hazardous alcohol use in reductions in quality of life suggests that early screening and interventions could benefit patients with hazardous alcohol use and comorbid psychosis.

Associations Between Psychiatric Disorders and Alcohol Consumption Levels in an Adult Primary Care Population

“…Informed by our bivariate analyses, we examined associations between psychiatric disorders and alcohol consumption levels, adjusting for patient characteristics. Contrary to several prior studies of specialty psychiatric treatment (Cetty et al, 2019;Hartz et al, 2014;Karpov et al, 2017;Subramaniam et al, 2017) and military (Smith et al, 2014) populations, we found that, with a few exceptions, patients with psychiatric disorders were more likely than those without to report no alcohol use relative to low-risk or unhealthy use. Specifically, patients with schizophrenia and schizoaffective disorder were about 5 times as likely as those without to report no alcohol use, while patients with depression and Psychiatric disorders were identified using ICD-9-CM and ICD-10-CM codes in the electronic health record in the year prior to (and including) the date of the alcohol screening visit.…”

“…Moreover, studies have typically focused on specialized populations, such as psychiatric treatment, young adult, or largely male military populations. These studies have generally found that patients with depression, bipolar disorder, anxiety disorder, posttraumatic stress disorder, and psychotic disorders were more likely to report unhealthy alcohol use (Cetty et al, 2019; Hartz et al, 2014; Karpov et al, 2017; Smith et al, 2014; Subramaniam et al, 2017). Other studies evaluating the reverse association have found that patients with unhealthy alcohol use were more likely to have psychiatric disorders and poorer mental health (Mäkelä et al, 2015; Ordóñez et al, 2016).…”

Association between olanzapine treatment and brain cortical thickness and gray/white matter contrast is moderated by cholesterol in psychotic disorders

“…Also, less favorable lifestyle choices such as increased alcohol consumption have by some been found to increase serum HDL-C levels 284 , and there are even studies that report a reduction in negative symptoms with alcohol intake 285 . While the latter possibility may seem intriguing to some, it is most likely linked to a reduction in secondary negative symptoms such as anxiety.…”

Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

“…Approximately 50% of individuals experiencing their first-episode psychosis (FEP) meet criteria for a lifetime alcohol use or substance use disorder (SUD; Oluwoye, Monroe-DeVita, et al, 2019; Wade et al, 2005). Although the focus has been primarily on cannabis use and its association with psychosis, other substance use, such as alcohol and tobacco, is equally, if not more, prevalent in this population (Cetty et al, 2019; Lobbana et al, 2010; Tan et al, 2019). Recently, studies have focused on the prevalence of substance use among youth and young adults with FEP and have demonstrated the subsequent impact of use on physical health, psychiatric symptoms, and treatment engagement (Abdel-Baki et al, 2017; Oluwoye, Monroe-DeVita, et al, 2019; Schoeler et al, 2016; Weibell et al, 2017).…”