Substance Use and Abuse in First-Episode Psychosis: Prevalence Before and After Early Intervention

Archie, Suzanne; Rush, Brian; Akhtar–Danesh, Noori; Norman, Ross; Malla, Ashok; Roy, Paul; Zipursky, Robert B.

doi:10.1093/schbul/sbm011

Cited by 90 publications

(94 citation statements)

References 46 publications

(60 reference statements)

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“…[Additional information on these studies, including methodological and measurement details and substance abuse, mental health, and functional outcomes, is included in an online appendix to this article at ps.psychiatryonline.org.] Archie and colleagues (11), using data from four psychosis treatment centers in Canada (Toronto, London, Hamilton, and Ottawa), conducted a prospective cohort study on 200 clients with first-episode psychosis. At baseline, 32 (18%) clients met criteria for heavy drinking, 48 (26%) met criteria for hazardous drinking, and 69 (17%) met criteria for drug abuse.…”

Section: Resultsmentioning

confidence: 99%

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Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Wisdom

Manuel²,

Drake³

2011

Psychiatric Services

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Objective People experiencing a first episode of psychosis frequently have co-occurring substance use disorders, usually involving alcohol and cannabis, which put them at risk for prolonged psychosis, psychotic relapse, and other adverse outcomes. Yet few studies of first-episode psychosis have addressed the course of substance use disorders and the re sponse to specialized substance abuse treatments. Methods The authors searched MEDLINE, PsycINFO, and other medical databases for English-language articles published between 1990 and 2009. Included studies addressed two research questions. First, do some clients become abstinent after a first episode of psychosis without specialized substance abuse treatments? Second, for clients who continue to use substances after a first episode of psychosis, does the addition of specialized substance abuse treatment enhance outcomes? Results Nine studies without specialized substance abuse treatment and five with specialized substance abuse treatment assessed the course of substance use (primarily cannabis and alcohol) after a first episode of psychosis. Many clients (approximately half) became abstinent or significantly reduced their alcohol and drug use after a first episode of psychosis. The few available studies of specialized substance abuse treatments did not find better rates of ab stinence or reduction. Conclusions Experience, education, treatment, or other factors led many clients to curtail their substance use disorders after a first episode of psychosis. Specialized interventions for others need to be developed and tested.

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Section: Resultsmentioning

confidence: 99%

“…The proportions are similar for alcohol use disorders (7–9,13,14). Smaller but significant proportions have use disorders related to cocaine, amphetamines, barbiturates, and other drugs (7,8,11,15,16). Overall, approximately half of all clients with first episodes of psychosis present for treatment with a current substance use disorder.…”

mentioning

confidence: 99%

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Wisdom

Manuel²,

Drake³

2011

Psychiatric Services

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“…As a matter of fact, some authors support a shorter duration of the illness (Dubertret et al, 2006) for substance-induced psychosis compared with primary psychotic disorders, especially when associated with protracted abstinence from substances (Dawe et al, 2011) and early intervention (Archie et al, 2007;Marshall and Rathbone, 2011).…”

Section: Introductionmentioning

confidence: 99%

Does substance use disorder affect clinical expression in first-hospitalization patients with schizophrenia? Analysis of a prospective cohort

Picci

Versino

Oliva

et al. 2013

Psychiatry Research

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Introduction. Although several papers reported a wide range of negative outcomes among patients with both schizophrenia and SUD, only a few studies evaluated the impact of SUD on psychopathology and thus on the length of first-hospitalization. Objectives.To compare clinical expression of first-episode of schizophrenia between inpatients with and without SUD, giving close attention to the length of stay.Methods. 130 inpatients at first-episode of schizophrenia were assigned to SUD or not SUD group depending on SUD diagnosis and were assessed through BPRS at admission, during hospitalization and at discharge. Cross-sectional and longitudinal statistical analysis were performed to investigate differences between groups and also a linear regression was used to evaluate relationship between length of stay and BPRS scores.Results. During the hospitalization there was a more marked improvement of BPRS total score in patients without SUD with a lower length of hospitalization (P<0.001). BPRS score during hospitalization was predictor of higher length of stay.Discussion. The higher severity of psychopathology during the hospitalization suggest possible overlaps of substance induced and withdrawal symptoms. Conversely, higher levels of conceptual disorganization during the whole period of hospitalization also support a more severe and pharmacho-resistant expression of schizophrenia among SUD patients.

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“…It occurs in up to half of people with first episode psychosis (Wisdom et al, 2011;Green et al, 2005;Addington and Addington, 2007;Wade et al, 2005;Grech et al, 2005;Archie et al, 2007) and schizophrenia (Regier et al, 1990;Kavanagh et al, 2004;Moore et al, 2012b). People with psychosis use cannabis at least ten times more frequently than the general population of the same age (Green et al, 2005;Koskinen et al, 2010;Degenhardt and Hall, 2012b).…”

Section: Substance Comorbidity In Psychosismentioning

confidence: 99%

“…Between 80% and 100% of people with psychosis who use stimulants also report concurrent cannabis use (Wade et al, 2005;Tosato et al, 2013;Arndt et al, 1992;Baeza et al, 2009;Barrigon et al, 2010;Bersani et al, 2002;Brown, 1998;Dekker et al, 2012;Archie et al, 2007).…”

Section: The Overlap Between Cannabis and Stimulant Use Disordersmentioning

confidence: 99%

Stimulant use disorders and psychosis: prevalence, correlates and impacts

Sara¹

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Substance Use and Abuse in First-Episode Psychosis: Prevalence Before and After Early Intervention

Abstract: Substance use and abuse decreased significantly after 12 months of EI services; EI services may be able to detect and to reduce substance use among FEP patients before it becomes a more serious disorder.

Cited by 90 publications

References 46 publications

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Substance Use Disorder Among People With First-Episode Psychosis: A Systematic Review of Course and Treatment

Does substance use disorder affect clinical expression in first-hospitalization patients with schizophrenia? Analysis of a prospective cohort

Stimulant use disorders and psychosis: prevalence, correlates and impacts

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