Correlates of substance use in a large naturalistic cohort of young people with early and emerging psychosis.
Early intervention
First-episode psychosis
Substance use
Tobacco
Ultrahigh risk
Youth
Journal
Social psychiatry and psychiatric epidemiology
ISSN: 1433-9285
Titre abrégé: Soc Psychiatry Psychiatr Epidemiol
Pays: Germany
ID NLM: 8804358
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
29
07
2022
accepted:
02
02
2023
medline:
28
8
2023
pubmed:
23
2
2023
entrez:
22
2
2023
Statut:
ppublish
Résumé
Substance use remains a barrier to recovery for young people accessing early intervention services for psychosis. While correlates of use have been explored in populations experiencing a first episode of psychosis (FEP), sample sizes have been small and less research assesses cohorts at ultrahigh risk of psychosis (UHR). This study uses data from a naturalistic cohort including UHR and FEP participants (N = 1252) to elucidate clinical correlates of use in the past 3 months of any illicit substance, amphetamine-type stimulants (ATS), cannabis, and tobacco. Moreover, network analysis based on use of these substances and additionally alcohol, cocaine, hallucinogens, sedatives, inhalants, and opioids was completed. Young people with FEP used substances at significantly higher rates than those at UHR. High concurrence of use was seen between substances. In the FEP group, participants who had used any illicit substance, ATS, and/or tobacco had increased positive symptoms and decreased negative symptoms. Young people with FEP who used cannabis had increased positive symptoms. In the UHR group, participants who had used any illicit substance, ATS, and/or cannabis in the past 3 months showed decreased negative symptoms compared to those who had not. A distinct clinical picture of more florid positive symptoms and alleviated negative symptoms seen in those who use substances in the FEP group appears muted in the UHR cohort. Treating young people at UHR in early intervention services represents the earliest opportunity to address substance use early to improve outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Substance use remains a barrier to recovery for young people accessing early intervention services for psychosis. While correlates of use have been explored in populations experiencing a first episode of psychosis (FEP), sample sizes have been small and less research assesses cohorts at ultrahigh risk of psychosis (UHR).
METHODS
METHODS
This study uses data from a naturalistic cohort including UHR and FEP participants (N = 1252) to elucidate clinical correlates of use in the past 3 months of any illicit substance, amphetamine-type stimulants (ATS), cannabis, and tobacco. Moreover, network analysis based on use of these substances and additionally alcohol, cocaine, hallucinogens, sedatives, inhalants, and opioids was completed.
RESULTS
RESULTS
Young people with FEP used substances at significantly higher rates than those at UHR. High concurrence of use was seen between substances. In the FEP group, participants who had used any illicit substance, ATS, and/or tobacco had increased positive symptoms and decreased negative symptoms. Young people with FEP who used cannabis had increased positive symptoms. In the UHR group, participants who had used any illicit substance, ATS, and/or cannabis in the past 3 months showed decreased negative symptoms compared to those who had not.
CONCLUSION
CONCLUSIONS
A distinct clinical picture of more florid positive symptoms and alleviated negative symptoms seen in those who use substances in the FEP group appears muted in the UHR cohort. Treating young people at UHR in early intervention services represents the earliest opportunity to address substance use early to improve outcomes.
Identifiants
pubmed: 36808500
doi: 10.1007/s00127-023-02436-w
pii: 10.1007/s00127-023-02436-w
pmc: PMC10460356
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1447-1456Informations de copyright
© 2023. The Author(s).
Références
Schizophr Bull. 2007 Nov;33(6):1354-63
pubmed: 17337748
Schizophr Bull. 2017 Jul 1;43(4):843-851
pubmed: 28199703
Acta Psychiatr Scand. 2017 Jul;136(1):5-15
pubmed: 28168698
Addiction. 2008 Jun;103(6):1039-47
pubmed: 18373724
Clin Pract Epidemiol Ment Health. 2006 Mar 23;2:4
pubmed: 16556300
Schizophr Res. 2008 Dec;106(2-3):363-6
pubmed: 18829260
Br J Psychiatry. 2009 Sep;195(3):242-8
pubmed: 19721115
Schizophr Res. 2009 Sep;113(2-3):129-37
pubmed: 19427172
Front Psychiatry. 2019 Feb 26;10:67
pubmed: 30863323
Psychopharmacology (Berl). 1995 Dec;122(3):263-7
pubmed: 8748395
Psychol Med. 2009 Oct;39(10):1617-26
pubmed: 19356258
Addiction. 2007 Jul;102(7):1076-84
pubmed: 17567396
Eur Psychiatry. 2003 May;18(3):133-6
pubmed: 12763300
Acta Psychiatr Scand. 2005 Aug;112(2):141-8
pubmed: 15992396
Schizophr Res. 2012 Aug;139(1-3):116-28
pubmed: 22658527
JAMA Psychiatry. 2021 Sep 1;78(9):970-978
pubmed: 34259821
Aust N Z J Public Health. 2001 Dec;25(6):494-7
pubmed: 11824981
Br J Psychiatry. 2007 Jun;190:515-20
pubmed: 17541112
Psychol Med. 2017 Oct;47(14):2461-2471
pubmed: 28424105
Aust N Z J Psychiatry. 2022 Oct;56(10):1265-1276
pubmed: 34845922
Schizophr Res. 2003 Mar 1;60(1):21-32
pubmed: 12505135
Neurosci Biobehav Rev. 2020 Sep;116:415-425
pubmed: 32679232
JAMA Psychiatry. 2018 Jun 1;75(6):555-565
pubmed: 29800949
Front Psychiatry. 2018 Nov 13;9:580
pubmed: 30483163
JAMA Psychiatry. 2013 Jan;70(1):107-20
pubmed: 23165428
Soc Psychiatry Psychiatr Epidemiol. 2020 May;55(5):527-537
pubmed: 31796983
Aust N Z J Psychiatry. 2005 Nov-Dec;39(11-12):964-71
pubmed: 16343296
BMC Psychiatry. 2015 Oct 28;15:266
pubmed: 26511605
Addict Behav. 2021 Mar;114:106735
pubmed: 33248743
Lancet Psychiatry. 2015 Aug;2(8):718-725
pubmed: 26249303
Schizophr Res. 2016 Feb;170(2-3):311-7
pubmed: 26718334
Aust N Z J Psychiatry. 2014 May;48(5):418-32
pubmed: 24589980
Psychiatry Res. 2017 Aug;254:118-125
pubmed: 28460281
Early Interv Psychiatry. 2014 May;8(2):104-12
pubmed: 24224849