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Risk of transition to schizophrenia following first admission with substance-induced psychotic disorder: a population-based longitudinal cohort study

Published online by Cambridge University Press:  03 May 2017

H. L. Alderson ,
D. M. Semple ,
C. Blayney ,
F. Queirazza ,
V. Chekuri  and
S. M. Lawrie
H. L. Alderson*
Affiliation:
Queen Margaret Hospital, Whitefield Road, Dunfermline, Fife, KY12 0SU, UK
D. M. Semple
Affiliation:
Hairmyres Hospital, Eaglesham Road, East Kilbride, Glasgow G75 8RG, UK
C. Blayney
Affiliation:
Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK
F. Queirazza
Affiliation:
Institute of Neuroscience and Psychology, University of Glasgow, 58 Hillhead Street, Glasgow G12 8QW, UK
V. Chekuri
Affiliation:
Hairmyres Hospital, Eaglesham Road, East Kilbride, Glasgow G75 8RG, UK
S. M. Lawrie
Affiliation:
Department of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK
*
*Address for correspondence: H. L. Alderson, Department of Psychiatry, Phase 1, Queen Margaret Hospital, Whitefield Road, Dunfermline, Fife, KY12 0SU, UK. (Email: h.alderson@nhs.net)
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Abstract

Background

The potential for drugs of abuse to induce acute psychotic symptoms is well recognised. However, the likelihood of transition from initial substance-induced psychotic disorder (SIPD) to chronic psychosis is much less well understood. This study investigated the rate of SIPD transition to schizophrenia (F20), the time to conversion and other possible related factors.

Methods

Using data from the Scottish Morbidity Record, we examined all patients (n = 3486) since their first admission to psychiatric hospital with a diagnosis of SIPD [International Classification of Diseases, Tenth Revision (ICD-10) codes F10–F19, with third digit five] from January 1997 to July 2012. Patients were followed until first episode of schizophrenia (ICD-10 code F20, with any third digit) or July 2012. Any change in diagnosis was noted in the follow-up period, which ranged from 1 day to 15.5 years across the groups.

Results

The 15.5-year cumulative hazard rate was 17.3% (s.e. = 0.007) for a diagnosis of schizophrenia. Cannabis, stimulant, opiate and multiple drug-induced psychotic disorder were all associated with similar hazard rates. The mean time to transition to a diagnosis of schizophrenia was around 13 years, although over 50% did so within 2 years and over 80% of cases presented within 5 years of SIPD diagnosis. Risk factors included male gender, younger age and longer first admission.

Conclusions

SIPD episodes requiring hospital admission for more than 2 weeks are more likely to be associated with later diagnosis of schizophrenia. Follow-up periods of more than 2 years are needed to detect the majority of those individuals who will ultimately develop schizophrenia.

Keywords

Chronic psychosispsychosisschizophreniasubstance-induced psychotic disorder
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 14 , October 2017 , pp. 2548 - 2555
Copyright
Copyright © Cambridge University Press 2017 

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