Substance-induced Psychosis in Youth

Beckmann, David; Lowman, Kelsey; Nargiso, Jessica E.; McKowen, James; Watt, Lisa; Yule, Amy

doi:10.1016/j.chc.2019.08.006

Cited by 29 publications

(29 citation statements)

References 44 publications

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“…There is a clear need for a new diagnostic framework that provides reliable, unambiguous clinical criteria to differentiate between comorbid conditions (ie, schizophrenia patients with SUD) and clinically distinct psychoses associated with substance use, given that 1/3 of individuals with SIP develop a severe mental illness, schizophrenia spectrum disorders, or bipolar disorders, within 2 to 3 years. 33,99 Moreover, psychotic phenomena following substance use in patients with a primary diagnosis of mood disorder or borderline personality disorder need to be recognized and clearly distinguished from other forms of psychoses, with relevant consequences in terms of treatment. Also, early differential diagnosis and staging between persistent psychoses associated with substance use (ie, SREP) and transient psychotic states occurring during substance intoxication/withdrawal is necessary.…”

Section: Resultsmentioning

confidence: 99%

“…Subjects with chronic and heavy substance use (cannabis, amphetamines, psychedelics, and cocaine) are at highest risk. 33 There is a growing recognition that substance use is associated with the emergence of psychosis, which develops during the use of the substance, and may or may not subside following withdrawal or abstinence. Subjects with SIP often call the police or ambulance and present in emergency rooms because they or family/friends feel a need for urgent intervention.…”

Section: Substance Use Disorders: the New Scenariomentioning

confidence: 99%

“…52 Patients with SIP had more visual hallucinations, a higher prevalence of suicidal thoughts during the previous year, more violent behavior, family history of substance use, and higher levels of insight. 33 Other systematic studies aiming to characterize SIP as defined by DSM-5 and persistent, atypical psychotic disorders associated with substance use (ie, SREP) are lacking, and descriptions are mostly anecdotal. We briefly discuss possible distinctive clinical and psychopathological features associated with SREP (Figure 1), as reported in existing descriptive studies.…”

Section: Srep: Clinical and Psychopathological Characteristicsmentioning

confidence: 99%

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Substance-related exogenous psychosis: a postmodern syndrome

Martinotti

Risio²,

Vannini

et al. 2020

CNS Spectr.

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There is growing recognition that substance use is associated with the emergence of psychosis.Elements of post-modernity dominate contemporary social contexts and operate as existential background factors that contribute to the emergence of substance-related psychotic phenomena, particularly use of potent and highly rewarding novel psychoactive substances (NPS). About 25% of first-episode psychoses are substance-induced (SIP). DSM-5 SIP diagnosis is based on the assumption that symptoms are transient and disappear after sustained abstinence. This narrowed definition does not consider the issue of persistent SIP. There is a clear need for a new diagnostic framework that provides reliable, unambiguous clinical criteria to differentiate between comorbid conditions (i.e., schizophrenia patients with a substance use disorder) and substance-related psychoses. In the present contribution, we aim to outline a novel and separate clinical entity: substancerelated exogenous psychosis (SREP). Within this diagnostic category, we refer to both transientand persistent psychoses associated with substance use. SREP is conceived as a distinct psychoticdisorder with psychopathological specificities that clearly differentiate it from schizophrenia. We address differences in terms of clinical presentation, epidemiology, etiological models and treatment response. SREP is characterized by altered states of consciousness, persecutory delusions, visual and cenesthetic hallucinations, impulsivity and psychomotor agitation, affectiveand negative symptoms, a pervasive feeling of unreality and intact insight. Delusions are typically secondary to abnormal perception resulting from a characteristic “sensorialization” of the world. Longitudinal studies are warranted to substantiate our hypothesis of a novel diagnostic categoryand support the clinical validity of SREP. This may have important implications in terms of early differential diagnosis and staging (i.e., between comorbid conditions, persistent and transientsubstance-related psychotic states) as well as choice of treatment interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Substance Use Disorders: the New Scenariomentioning

confidence: 99%

Section: Srep: Clinical and Psychopathological Characteristicsmentioning

confidence: 99%

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Substance-related exogenous psychosis: a postmodern syndrome

Martinotti

Risio²,

Vannini

et al. 2020

CNS Spectr.

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“…According to the DSM‐5, between 7% and 25% of people who present with an initial episode of psychosis have SIPD 6 . People with heavy substance use, especially marijuana, amphetamine, psychedelics, cocaine, and novel psychoactive substances, are at higher risk, 7–11 whereas the effect of alcohol and opiates is milder in terms of specific psychotic symptoms 12 . A recent study showed that after the first SIP episode, 26% of the sample received a diagnosis of full‐blown schizophrenia within 5 years, with the use of cannabis and the abuse of multiple substances being mostly associated with a worse prognosis 13 .…”

Section: Introductionmentioning

confidence: 99%

Long‐acting second‐generation and oral antipsychotics for substance use disorders and psychotic symptoms: Prescribing attitudes among Italian psychiatrists

Corbo

Martinotti

Aguglia

et al. 2021

Perspect Psychiatr Care

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Purpose To explore Italian psychiatrists' attitudes toward the off‐label use of second generation antipsychotics (SGAs) in patients with substance use disorder and psychotic symptoms. Design and Methods A sample of 300 Italian psychiatrists associated with the Italian Society of Neuropsychopharmacology was randomly selected to complete a survey about the off‐label prescription of SGAs. Findings Oral aripiprazole (32.7%), olanzapine (30.2%), and quetiapine (25.2%) were considered “appropriate.” Long‐acting antipsychoticss were generally considered “inappropriate.” Practice Implications Our findings reflect a substantial level of uncertainty and a lack of coherent clinical guidance within the realm of dual diagnosis treatment. Therefore, they emphasize the need to develop specific guidelines to improve the management of pharmacotherapy among this population.

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“…Psychosis is a condition which is the most severe clinical outcome of these disorders (2). Psychotic attacks can be triggered directly by cannabis use and/or cannabis use may cause an early occurrence of a possible psychotic attack (3,4). Sudden onset of mood lability and paranoid symptoms are clear features of cannabis-induced psychosis.…”

Section: Introductionmentioning

confidence: 99%

Ekbom Sendromu Belirtileri ve Trifluoperazin Kullanımı ile Tedavisi

Örüm

2020

Medical Records

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Substance use may result in schizophrenia. Ekbom syndrome is characterized by the conviction of being infested by invisible mites or insects, despite clear evidence of the contrary and can be seen in schizophrenia. These patients usually go to non-psychiatric physicians and have lost faith in psychiatric treatment during psychiatric admission. Therefore, early diagnosis and subsequent psychiatric treatment are important. Antipsychotics can be used for treatment, but drug response characteristics vary. Conventional antipsychotics can be considered when there is no response with the commonly used drugs. In this case report, we present a male patient with Ekbom syndrome who had symptomatic improvement with short-term trifluoperazine therapy..

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Substance-induced Psychosis in Youth

Cited by 29 publications

References 44 publications

Substance-related exogenous psychosis: a postmodern syndrome

Substance-related exogenous psychosis: a postmodern syndrome

Long‐acting second‐generation and oral antipsychotics for substance use disorders and psychotic symptoms: Prescribing attitudes among Italian psychiatrists

Ekbom Sendromu Belirtileri ve Trifluoperazin Kullanımı ile Tedavisi

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