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Prevalence of substance misuse in first-episode psychosis

Published online by Cambridge University Press:  02 January 2018

Roch Cantwell ,
John Brewin ,
Cristine Glazebrook ,
Tim Dalkin ,
Richard Fox ,
Ian Medley  and
Glynn Harrison
Roch Cantwell*
Affiliation:
Department of Psychological Medicine, University of Glasgow
John Brewin
Affiliation:
Department of Psychiatry, University of Nottingham
Cristine Glazebrook
Affiliation:
Department of Psychiatry, University of Nottingham
Tim Dalkin
Affiliation:
Royal Edinburgh Hospital, Morningside Terrace, Edinburgh
Richard Fox
Affiliation:
Department of Psychiatry, University of Nottingham
Ian Medley
Affiliation:
Department of Psychiatry, University of Nottingham
Glynn Harrison
Affiliation:
Division of Psychiatry, University of Bristol
*
Dr R. Cantwell, University Department of Psychological Medicine, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow GI2 0XH. e-mail: [email protected]
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Abstract

Background

Reports suggest a high prevalence of substance misuse in psychotic disorders but few studies examine comorbidity at onset of psychosis.

Aims

To identify the prevalence and pattern of substance use and misuse in first-episode psychosis, and relationships with diagnosis, mode of presentation and demographic variables.

Method

Consensus diagnoses for 168 subjects presenting with first-episode psychosis were made using ICD–10 diagnostic criteria. Information on substance use and misuse was obtained from multiple sources. We examined associations between substance misuse, diagnosis and demographic factors.

Results

Criteria for drug use, drug misuse or alcohol misuse were met by 37% of the sample. One-year prevalence rates were 19.5% (drug misuse) and 11.7% (alcohol misuse). Thirteen subjects (8.4%) received a primary diagnosis of substance-related psychotic disorder; a significant increase compared with an earlier cohort from the same catchment area. Drug misuse was associated with younger age of onset of psychosis, male gender and non–African–Caribbean ethnicity.

Conclusions

This study confirms high rates of substance misuse at onset of psychosis. There is evidence for an increase in diagnosis of substance-related psychotic disorders over time. Those most at risk of substance misuse are young males.

Type
Papers
Information
The British Journal of Psychiatry , Volume 174 , Issue 2 , February 1999 , pp. 150 - 153
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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Footnotes

Declaration of interest Funding provided by Trent Regional Health Authority.

References

Breakey, W. R., Goodell, H., Lorenz, P. C., et al (1974) Hallucinogenic drugs as precipitants of schizophrenia. Psychological Medicine, 4, 255–261.Google Scholar
Brewer, C. (1993) Hair analysis as a tool for monitoring and managing patients on methadone maintenance: a discussion. forensic Science International, 63, 277–283.Google Scholar
Brewin, J., Cantwell, R., Dalkin, T., et al (1997) Incidence of schizophrenia in Nottingham. A comparison of two cohorts, 1978–80 and 1992–94. British Journal of Psychiatry, 171, 140–144.Google Scholar
Chick, J., Badawy, A. & Borg, S. (1993) Identification of excessive drinking and alcohol problems. Alcohol & Alcoholism (suppl. 2), 121–125.Google Scholar
Cuffel, B. J. (1992) Prevalence estimates of substance abuse in schizophrenia and their correlates. Journal of Nervous and Mental Disease, 180, 589–592.Google Scholar
Cuffel, B. J., Shumway, M., Chouljian, T. L., et al (1994) A longitudinal study of substance use and community violence in schizophrenia. Journal of Nervous and Mental Disease, 182, 704–708.Google Scholar
Drake, R. E. & Wallach, M. A. (1989) Substance abuse among the chronic mentally ill. Hospital and Community Psychiatry, 40, 1041–1046.Google Scholar
Duke, P. J., Pantells, C. & Barnes, T. R. E. (1994) South Westminster schizophrenia survey. Alcohol use and its relationship to symptoms, tardive dyskinesia and illness onset. British Journal of Psychiatry, 164, 630–636.Google Scholar
Hambrecht, M. & Hafner, H. (1996) Substance abuse and the onset of schizophrenia. Biological Psychiatry, 40, 1155–1163.Google Scholar
Harrison, G., Giazebrook, C., Brewin, J., et al (1997) Increased incidence of psychotic disorders in migrants from the Caribbean to the United Kingdom. Psychological Medicine, 27, 799–806.Google Scholar
Jebiensky, A., Sartorius, N., Ernberg, G., et al (1992) Schizophrenia: Manifestations, Incidence and Course in Different Cultures. A World Health Organization Ten Country Study (Psychological Medicine Monograph Supplement 20). Cambridge: Cambridge University Press.Google Scholar
King, M., Coker, E., Leavey, G., et al (1994) Incidence of psychotic illness in London: comparison of ethnic groups. British Medical Journal, 309, 1115–1119.Google Scholar
Linszen, D. H., Dingemans, P. M. & Lenior, M. E. (1994) Cannabis abuse and the course of recent-onset schizophrenic disorders. Archives of General Psychiatry, 51, 273–279.Google Scholar
Maisto, S. A., McKay, J. R. & Connors, G. J. (1990) Self-report issues in substance abuse: state of the art and future directions. Behavioural Assessment, 12, 117–134.Google Scholar
Menezes, P. R., Johnson, S., Thornicroft, G., et al (1994) Drug and alcohol problems among individuals with severe mental illnesses in south London. British Journal of Psychiatry, 168, 612–619.CrossRefGoogle Scholar
Mueser, K. T., Yarnold, P. R., Levinson, D. F., et al (1990) Prevalence of substance abuse in schizophrenia: demographic and clinical correlates. Schizophrenia Bulletin, 16, 31–56.CrossRefGoogle ScholarPubMed
Regier, D. A., Farmer, M. E., Rae, D. S., et al (1990) Comorbidity of mental disorders with alcohol and other drug abuse: results from the Epidemiological Catchment Area (ECA) study. Journal of the American Medical Association, 264, 2511–2518.Google Scholar
Selzer, J. A. & Lieberman, J. A. (1993) Schizophrenia and substance abuse. Psychiatric Clinics of North America, 16, 401–412.Google Scholar
Shaner, A., Khalsa, M. E., Roberts, L., et al (1993) Unrecognised cocaine use among schizophrenic patients. American Journal of Psychiatry: 150, 758–762.Google Scholar
Singh, S. P., Cantwell, R., Amin, S., et al (1998) ICD–10 acute and substance-related psychoses: diagnostic stability at 3 years. Schizophrenia Research, 29, 22.Google Scholar
Strakowski, S. M., Tohen, M., Stoll, A. L., et al (1993) Comorbidity in psychosis at first hospitalization. American Journal of Psychiatry, 150, 752–757.Google ScholarPubMed
Wilkins, J. N., Shaner, A. L., Patterson, C. M., et al (1991) Discrepancies between patient report, clinical assessment, and urine analysis in psychiatric patients during inpatient admission. Psychopharmocology Bulletin, 27, 149–154.Google ScholarPubMed
World Health Organization (1993) The Tenth Revision of the International Classification of Disease and Related Health Problems (ICD–10): (a) Diagnostic Criteria for Research; (b) Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. Geneva: WHO.Google Scholar
World Health Organization (1994) Schedules for Clinical Assessment in Neuropsychiatry, Version 2. Geneva: WHO.Google Scholar
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