Differences in Patterns of Stimulant Use and Their Impact on First-Episode Psychosis Incidence: An Analysis of the EUGEI Study.
amphetamines
first episode psychosis
methamphetamine
population attributable fractions
stimulant use
Journal
Schizophrenia bulletin
ISSN: 1745-1701
Titre abrégé: Schizophr Bull
Pays: United States
ID NLM: 0236760
Informations de publication
Date de publication:
07 09 2023
07 09 2023
Historique:
pmc-release:
19
07
2024
medline:
8
9
2023
pubmed:
19
7
2023
entrez:
19
7
2023
Statut:
ppublish
Résumé
Use of illegal stimulants is associated with an increased risk of psychotic disorder. However, the impact of stimulant use on odds of first-episode psychosis (FEP) remains unclear. Here, we aimed to describe the patterns of stimulant use and examine their impact on odds of FEP. We included patients with FEP aged 18-64 years who attended psychiatric services at 17 sites across 5 European countries and Brazil, and recruited controls representative of each local population (FEP = 1130; controls = 1497). Patterns of stimulant use were described. We computed fully adjusted logistic regression models (controlling for age, sex, ethnicity, cannabis use, and education level) to estimate their association with odds of FEP. Assuming causality, we calculated the population-attributable fractions for stimulant use associated with the odds for FEP. Prevalence of lifetime and recent stimulant use in the FEP sample were 14.50% and 7.88% and in controls 10.80% and 3.8%, respectively. Recent and lifetime stimulant use was associated with increased odds of FEP compared with abstainers [fully adjusted odds ratio 1.74,95% confidence interval (CI) 1.20-2.54, P = .004 and 1.62, 95% CI 1.25-2.09, P < .001, respectively]. According to PAFs, a substantial number of FEP cases (3.35% [95% CI 1.31-4.78] for recent use and 7.61% [95% CI 3.68-10.54] for lifetime use) could have been prevented if stimulants were no longer available and the odds of FEP and PAFs for lifetime and recent stimulant use varied across countries. Illegal stimulant use has a significant and clinically relevant influence on FEP incidence, with varying impacts across countries.
Sections du résumé
BACKGROUND
Use of illegal stimulants is associated with an increased risk of psychotic disorder. However, the impact of stimulant use on odds of first-episode psychosis (FEP) remains unclear. Here, we aimed to describe the patterns of stimulant use and examine their impact on odds of FEP.
METHODS
We included patients with FEP aged 18-64 years who attended psychiatric services at 17 sites across 5 European countries and Brazil, and recruited controls representative of each local population (FEP = 1130; controls = 1497). Patterns of stimulant use were described. We computed fully adjusted logistic regression models (controlling for age, sex, ethnicity, cannabis use, and education level) to estimate their association with odds of FEP. Assuming causality, we calculated the population-attributable fractions for stimulant use associated with the odds for FEP.
FINDINGS
Prevalence of lifetime and recent stimulant use in the FEP sample were 14.50% and 7.88% and in controls 10.80% and 3.8%, respectively. Recent and lifetime stimulant use was associated with increased odds of FEP compared with abstainers [fully adjusted odds ratio 1.74,95% confidence interval (CI) 1.20-2.54, P = .004 and 1.62, 95% CI 1.25-2.09, P < .001, respectively]. According to PAFs, a substantial number of FEP cases (3.35% [95% CI 1.31-4.78] for recent use and 7.61% [95% CI 3.68-10.54] for lifetime use) could have been prevented if stimulants were no longer available and the odds of FEP and PAFs for lifetime and recent stimulant use varied across countries.
INTERPRETATION
Illegal stimulant use has a significant and clinically relevant influence on FEP incidence, with varying impacts across countries.
Identifiants
pubmed: 37467351
pii: 7226562
doi: 10.1093/schbul/sbad013
pmc: PMC10483438
doi:
Substances chimiques
Central Nervous System Stimulants
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1269-1280Subventions
Organisme : NIMH NIH HHS
ID : U01 MH124639
Pays : United States
Organisme : NIMH NIH HHS
ID : P50 MH115846
Pays : United States
Investigateurs
Silvia Amoretti
(S)
Alvaro Andreu-Bernabeu
(A)
Grégoire Baudin
(G)
Stephanie Beards
(S)
Elena Bonora
(E)
Chiara Bonetto
(C)
Bibiana Cabrera
(B)
Angel Carracedo
(A)
Thomas Charpeaud
(T)
Javier Costas
(J)
Doriana Cristofalo
(D)
Pedro Cuadrado
(P)
Giuseppe D'Andrea
(G)
Aziz Ferchiou
(A)
Nathalie Franke
(N)
Flora Frijda
(F)
Paz Garcia-Portilla
(P)
Emiliano González
(E)
Kathryn Hubbard
(K)
Stéphane Jamain
(S)
Estela Jiménez-López
(E)
Marion Leboyer
(M)
Esther Lorente-Rovira
(E)
Camila Marcelino Loureiro
(C)
Giovanna Marrazzo
(G)
Mario Matteis
(M)
Elles Messchaart
(E)
Gisela Mezquida
(G)
Baptiste Pignon
(B)
Marta Rapado
(M)
Jean-Romain Richard
(JR)
José Juan Rodríguez Solano
(JJ)
Mirella Ruggeri
(M)
Emilio Sánchez
(E)
Crocettarachele Sartorio
(C)
Franck Schürhoff
(F)
Fabio Seminerio
(F)
Marco Seri
(M)
Rosana Shuhama
(R)
Lucia Sideli
(L)
Simona A Stilo
(SA)
Fabian Termorshuizen
(F)
Giada Tripoli
(G)
Anne-Marie Tronche
(AM)
Daniella van Dam
(D)
Elsje van der Ven
(E)
Simona Stilo
(S)
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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