Impact of tobacco, alcohol and cannabis use on treatment outcomes among patients experiencing first episode psychosis: Data from the national RAISE‐ETP study

Oluwoye, Oladunni; Monroe-DeVita, Maria; Burduli, Ekaterina; Chwastiak, Lydia; McPherson, Sterling; McClellan, Jon; McDonell, Michael G.

doi:10.1111/eip.12542

Cited by 58 publications

(45 citation statements)

References 24 publications

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“…In addition, cannabis users showed more severe positive symptoms and general severity of psychopathology (higher scores on the BPRS) at baseline. These findings are in line with previous research where consumers were characterized by presenting more serious symptoms. This would indicate that since the beginning of the illness, the severity of symptoms is greater in the group of patients who use cannabis, which allows for several interpretations.…”

Section: Discussionsupporting

confidence: 93%

Stopping cannabis use benefits outcome in psychosis: findings from 10‐year follow‐up study in the PAFIP‐cohort

Setién-Suero

Neergaard

Foz

et al. 2019

Acta Psychiatr Scand

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Objective: To examine the long-term (up to 10 years) patterns related to cannabis use in a sample of patients with first episode of psychosis (FEP) and the effect that consumption might have on clinical, functioning, and neurocognition at long-term. Methods: Cannabis use was described in 209 FEP patients. Patients were divided into three groups according to cannabis use: persistent users, ex-users, and never-users. Groups were longitudinally (baseline and 10-year follow-up) compared on clinical, functional, and cognitive variables. Results: Clinical differences at 10-year follow-up were observed between persistent cannabis users and the other two groups (ex-users and never-users), showing persistent users more severe symptoms (BPRS: x 2 = 15.583, P ≤ 0.001; SAPS: x 2 = 12.386, P = 0.002) and poorer functionality (DAS: x 2 = 6.067, P = 0.048; GAF: x 2 = 6.635, P = 0.033). Patients who stopped cannabis use prior to the reassessment showed a similar pattern to those who had never consumed. Conclusion: The use of cannabis could negatively affect the evolution of the psychotic disorder. Perhaps the negative effects caused by cannabis use could be reversed with the cessation of consumption. It is necessary to make an effort in the intervention toward an early withdrawal from the use of cannabis, since this could play an important role in the prognosis of the disease. Significant outcomes• Cannabis FEP patients have a worse course of the disease. • FEP patients who abandon cannabis do not differ from those who had never consumed. Limitations• The quality and quantity of cannabis used was not taken into account. This is a limitation, particularly because it has been found that cannabis potency can influence patient outcome.

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Section: Discussionsupporting

confidence: 93%

Stopping cannabis use benefits outcome in psychosis: findings from 10‐year follow‐up study in the PAFIP‐cohort

Setién-Suero

Neergaard

Foz

et al. 2019

Acta Psychiatr Scand

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“…These findings should be interpreted with caution as we did not find a further significant effect using regression modeling. Nevertheless, the connection between cannabis use and positive psychotic symptoms has been previously found 42,43 although this relationship is unclear. 44,45 To our knowledge, the finding that EPP patients who use alcohol only may express fewer positive symptoms at entry to care is novel.…”

Section: Discussionmentioning

confidence: 96%

A Retrospective Study of the Clinical Characteristics Associated with Alcohol and Cannabis use in Early Phase Psychosis

et al. 2020

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Objective: Alcohol and cannabis misuse are common in patients with early phase psychosis (EPP); however, research has tended to focus primarily on cannabis misuse and EPP outcomes, with a relative lack of data on alcohol misuse. This retrospective cross-sectional EPP study investigated the relationship between cannabis, alcohol, and cannabis combined with alcohol misuse, on age, gender, psychotic, depressive and anxiety symptom severity, and social/occupational functioning, at entry to service. Methods: Two-hundred and sixty-four EPP patients were divided into 4 groups based on substance use measured by the Alcohol, Smoking and Substance Involvement Screening Test: (1) no to low-level cannabis and alcohol misuse (LU), (2) moderate to high alcohol misuse only (AU), (3) moderate to high cannabis misuse only (CU), and (4) moderate to high alcohol and cannabis misuse (AU + CU). Results: We found significant between group differences in age (with the AU group being the oldest and AU + CU group the youngest) as well as gender (with the CU group having the highest percentage of men). There were also group differences in positive psychotic symptoms (lowest in AU group), trait anxiety (highest in AU + CU group), and social/occupational functioning (highest in AU group). Further regression analyses revealed a particularly strong relationship between AU + CU group and trait anxiety (3-fold increased odds of clinical trait anxiety for combined misuse of alcohol and cannabis compared to non/low users). Conclusions: This study demonstrates the unique demographic and clinical characteristics found in the EPP population at entry to care associated with alcohol and cannabis misuse both separately and in combination. This work highlights the importance of including the assessment of alcohol misuse in addition to cannabis misuse in future treatment guidelines and research.

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“…Unhealthy lifestyle behaviors may impact mental health and suicidal behavior by influencing emotions and judgement. Studies have demonstrated that adolescents with first-episode psychosis have a high prevalence of tobacco, alcohol and cannabis use, selective dietary habits, lower physical activity, and lower level of activity during leisure time ( 27 – 30 ). Other studies have demonstrated a close relationship between cannabis use, hypomania, mania, and suicide risk in adolescents ( 31 , 32 ).…”

Section: Lifestyle Behavior and Suicide In Adolescents And Young Peopmentioning

confidence: 99%

Lifestyle Interventions and Prevention of Suicide

et al. 2018

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Over the past years, there has been a growing interest in the association between lifestyle psychosocial interventions, severe mental illness, and suicide risk. Patients with severe mental disorders have higher mortality rates, poor health states, and higher suicide risk compared to the general population. Lifestyle behaviors are amenable to change through the adoption of specific psychosocial interventions, and several approaches have been promoted. The current article provides a comprehensive review of the literature on lifestyle interventions, mental health, and suicide risk in the general population and in patients with psychiatric disorders. For this purpose, we investigated lifestyle behaviors and lifestyle interventions in three different age groups: adolescents, young adults, and the elderly. Several lifestyle behaviors including cigarette smoking, alcohol use, and sedentary lifestyle are associated with suicide risk in all age groups. In adolescents, growing attention has emerged on the association between suicide risk and internet addiction, cyberbullying and scholastic and family difficulties. In adults, psychiatric symptoms, substance and alcohol abuse, weight, and occupational difficulties seems to have a significant role in suicide risk. Finally, in the elderly, the presence of an organic disease and poor social support are associated with an increased risk of suicide attempt. Several factors may explain the association between lifestyle behaviors and suicide. First, many studies have reported that some lifestyle behaviors and its consequences (sedentary lifestyle, cigarette smoking underweight, obesity) are associated with cardiometabolic risk factors and with poor mental health. Second, several lifestyle behaviors may encourage social isolation, limiting the development of social networks, and remove individuals from social interactions; increasing their risk of mental health problems and suicide.

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Impact of tobacco, alcohol and cannabis use on treatment outcomes among patients experiencing first episode psychosis: Data from the national RAISE‐ETP study

Abstract: Tobacco, alcohol and cannabis use are common in youth seeking treatment for FEP. Tobacco smoking was associated with more negative clinical outcomes. These findings have implications for including interventions targeting these areas of substance use within current CSC models.

Cited by 58 publications

References 24 publications

Stopping cannabis use benefits outcome in psychosis: findings from 10‐year follow‐up study in the PAFIP‐cohort

Stopping cannabis use benefits outcome in psychosis: findings from 10‐year follow‐up study in the PAFIP‐cohort

A Retrospective Study of the Clinical Characteristics Associated with Alcohol and Cannabis use in Early Phase Psychosis

Lifestyle Interventions and Prevention of Suicide

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