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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: r.cantwell@clinmed.gla.ac.uk
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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.

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