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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

Information

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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References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. American Psychiatric Publishing: Washington, DC.Google Scholar
Arendt, M, Rosenberg, R, Foldager, L, Perto, G, Munk-Jorgensen, P (2005). Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases. The British Journal of Psychiatry 187, 510–515.Google Scholar
Arias, F, Szerman, N, Vega, P, Mesias, B, Basurte, I, Morant, C, Ochoa, E, Poyo, F, Babin, F (2013). [Madrid study on the prevalence and characteristics of outpatients with dual pathology in community mental health and substance misuse services]. [Spanish]. Adicciones 25, 118–127.CrossRefGoogle Scholar
Bramness, JG, Gundersen, OH, Guterstam, J, Rognli, EB, Konstenius, M, Loberg, E-M, Medhus, S, Tanum, L, Franck, J (2012). Amphetamine-induced psychosis - A separate diagnostic entity or primary psychosis triggered in the vulnerable?. BMC Psychiatry 12, 221.CrossRefGoogle ScholarPubMed
Callaghan, RC, Cunningham, JK, Allebeck, P, Arenovich, T, Sajeev, G, Remington, G, Boileau, I, Kish, SJ (2012). Methamphetamine use and schizophrenia: a population-based cohort study in California. The American Journal of Psychiatry 169, 389–396.CrossRefGoogle ScholarPubMed
Caton, CIM, Hasin, DS, Shrout, PE, Drake, RE, Dominguez, B, First, MB, Samet, S, Schanzer, B (2007). Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis. The British Journal of Psychiatry 190, 105–111.CrossRefGoogle ScholarPubMed
Chambers, RA, Krystal, JH, Self, DW (2001). A neurobiological basis for substance abuse comorbidity in schizophrenia. Biological Psychiatry 50, 71–83.CrossRefGoogle ScholarPubMed
Crebbin, K, Mitford, E, Paxton, R, Turkington, D (2009). First-episode drug-induced psychosis: a medium term follow up study reveals a high-risk group. Social Psychiatry and Psychiatric Epidemiology 44, 710–715.CrossRefGoogle ScholarPubMed
European Monitoring Centre for Drugs and Drug Addiction (2005). Differences in patterns of drug use between women and men. (http://www.emcdda.europa.eu/html.cfm/index34278EN.html) Accessed 26th August 2016.Google Scholar
Fusar-Poli, P, Bonoldi, I, Yung, AR, Borgwardt, S, Kempton, MJ, Valmaggia, L, Barale, F, Caverzasi, E, McGuire, P (2012). Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Archives of General Psychiatry 69, 220–229.CrossRefGoogle ScholarPubMed
Gee, DG, Cannon, TD (2011). Prediction of conversion to psychosis: review and future directions. Revista Brasileira de Psiquiatria 33, s129–s142.CrossRefGoogle ScholarPubMed
Glass, I (1989) Alcoholic hallucinosis: a psychiatric enigma. 1. The development of an idea. British Journal of Addiction 84, 29–41.CrossRefGoogle ScholarPubMed
Helander, A, Backberg, M, Hulten, P, Al-Saffar, Y, Beck, O (2014). Detection of new psychoactive substance use among emergency room patients: results from the Swedish STRIDA project. Forensic Science International 243, 23–29.CrossRefGoogle ScholarPubMed
Ikeda, M, Okahisa, Y, Aleksic, B, Won, M, Kondo, N, Naruse, N, Aoyama-Uehara, K, Sora, I, Iyo, M, Hashimoto, R, Kawamura, Y, Nishida, N, Miyagawa, T, Takeda, M, Sasaki, T, Tokunaga, K, Ozaki, N, Ujike, H, Iwata, N (2013). Evidence for shared genetic risk between methamphetamine-induced psychosis and schizophrenia. Neuropsychopharmacology 38, 1864–1870.CrossRefGoogle ScholarPubMed
Jordaan, GP, Warwick, JM, Nel, DG, Hewlett, R, Emsley, R (2012). Alcohol-induced psychotic disorder: brain perfusion and psychopathology - Before and after anti-psychotic treatment. Metabolic Brain Disease 27, 66–77.CrossRefGoogle ScholarPubMed
Kittirattanapaiboon, P, Mahatnirunkul, S, Booncharoen, H, Thummawomg, P, Dumrongchai, U, Chutha, W (2010). Long-term outcomes in methamphetamine psychosis patients after first hospitalisation. Drug and Alcohol Review 29, 456–461.Google Scholar
Lambert, M, Conus, P, Lubman, DI, Wade, D, Yuen, H, Moritz, S, Naber, D, McGorry, PD, Schimmelmann, BG (2005). The impact of substance use disorders on clinical outcome in 643 patients with first-episode psychosis. Acta Psychiatrica Scandinavica 112, 141–148.CrossRefGoogle ScholarPubMed
Lieberman, JA, Kane, JM, Gadaleta, D, Brenner, R, Lesser, MS, Kinon, B (1984). Methylphenidate challenge as a predictor of relapse in schizophrenia. The American Journal of Psychiatry 141, 633–8.Google ScholarPubMed
Murray, RM, Paparelli, A, Morrison, PD, Marconi, A, Di Forti, M (2013). What can we learn about schizophrenia from studying the human model, drug-induced psychosis? American Journal of Medical Genetics. Part B. Neuropsychiatric Genetics 162B, 661–670.CrossRefGoogle ScholarPubMed
Niemi-Pynttari, JA, Sund, R, Putkonen, H, Vorma, H, Wahlbeck, K, Pirkola, SP (2013). Substance-induced psychoses converting into schizophrenia: a register-based study of 18 478 Finnish inpatient cases. The Journal of Clinical Psychiatry 74, e94–e99.Google Scholar
Paparelli, A, Di Forti, M, Morrison, PD, Murray, RM (2011). Drug-induced psychosis: how to avoid star gazing in schizophrenia research by looking at more obvious sources of light. Frontiers in Behavioral Neuroscience 5, 1.Google Scholar
Perala, J, Kuoppasalmi, K, Pirkola, S, Harkanen, T, Saarni, S, Tuulio-Henriksson, A, Viertio, S, Latvala, A, Koskinen, S, Lonnqvist, J, Suvisaari, J (2010). Alcohol-induced psychotic disorder and delirium in the general population. The British Journal of Psychiatry 197, 200–206.CrossRefGoogle ScholarPubMed
Rubino, T, Zamberletti, E, Parolaro, D (2012). Adolescent exposure to cannabis as a risk factor for psychiatric disorders. The Journal of Psychopharmacology 26, 177–188.CrossRefGoogle ScholarPubMed
Sara, GE, Burgess, PM, Malhi, GS, Whiteford, HA, Hall, WC (2014 a). Cannabis and stimulant disorders and readmission 2 years after first-episode psychosis. The British Journal of Psychiatry 204, 448–453.CrossRefGoogle ScholarPubMed
Sara, GE, Burgess, PM, Malhi, GS, Whiteford, HA, Hall, WC (2014 b). The impact of cannabis and stimulant disorders on diagnostic stability in psychosis. Journal of Clinical Psychiatry 75, 349–356.CrossRefGoogle ScholarPubMed
Schuckit, MA (1983). Alcoholism and other psychiatric disorders. Hospital and Community Psychiatry 34, 1022–1027.Google ScholarPubMed
Semple, DM, McIntosh, AM, Lawrie, SM (2005). Cannabis as a risk factor for psychosis: systematic review. The Journal of Psychopharmacology 19, 187–194.CrossRefGoogle ScholarPubMed
Thirthalli, J, Benegal, V (2006). Psychosis among substance users. Current Opinion in Psychiatry 19, 239–245.CrossRefGoogle ScholarPubMed
Tucker, P (2009) Substance misuse and early psychosis. Australasian Psychiatry 17, 291–294.CrossRefGoogle ScholarPubMed
World Health Organization (1992). ICD-10: The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organisation: Geneva.Google Scholar
Zawilska, JB, Wojcieszak, J (2013). Designer cathinones – an emerging class of novel recreational drugs. Forensic Science International 231, 42–53.CrossRefGoogle ScholarPubMed
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