Substance Use Disorder Among People with First-episode Psychosis: a Systematic Review of Course and Treatment

Overview

Journal Psychiatr Serv

Specialty Psychiatry

Date 2011 Sep 3

PMID 21885577

Citations 36

Authors

Jennifer P Wisdom

Jennifer I Manuel

Robert E Drake

Affiliations

Soon will be listed here.

Abstract

Objective: People experiencing a first episode of psychosis frequently have co-occurring substance use disorders, usually involving alcohol and cannabis, which put them at risk for prolonged psychosis, psychotic relapse, and other adverse outcomes. Yet few studies of first-episode psychosis have addressed the course of substance use disorders and the response to specialized substance abuse treatments.

Methods: The authors searched MEDLINE, PsycINFO, and other medical databases for English-language articles published between 1990 and 2009. Included studies addressed two research questions. First, do some clients become abstinent after a first episode of psychosis without specialized substance abuse treatments? Second, for clients who continue to use substances after a first episode of psychosis, does the addition of specialized substance abuse treatment enhance outcomes?

Results: Nine studies without specialized substance abuse treatment and five with specialized substance abuse treatment assessed the course of substance use (primarily cannabis and alcohol) after a first episode of psychosis. Many clients (approximately half) became abstinent or significantly reduced their alcohol and drug use after a first episode of psychosis. The few available studies of specialized substance abuse treatments did not find better rates of abstinence or reduction.

Conclusions: Experience, education, treatment, or other factors led many clients to curtail their substance use disorders after a first episode of psychosis. Specialized interventions for others need to be developed and tested.

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References

Saunders J, Aasland O, Babor T, De la Fuente J, Grant M . Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993; 88(6):791-804. DOI: 10.1111/j.1360-0443.1993.tb02093.x. View

Kavanagh D, Waghorn G, Jenner L, Chant D, Carr V, Evans M . Demographic and clinical correlates of comorbid substance use disorders in psychosis: multivariate analyses from an epidemiological sample. Schizophr Res. 2004; 66(2-3):115-24. DOI: 10.1016/s0920-9964(03)00130-0. View

Gumley A, OGrady M, McNay L, Reilly J, Power K, Norrie J . Early intervention for relapse in schizophrenia: results of a 12-month randomized controlled trial of cognitive behavioural therapy. Psychol Med. 2003; 33(3):419-31. DOI: 10.1017/s0033291703007323. View

Wade D, Harrigan S, Edwards J, Burgess P, Whelan G, McGorry P . Course of substance misuse and daily tobacco use in first-episode psychosis. Schizophr Res. 2005; 81(2-3):145-50. DOI: 10.1016/j.schres.2005.09.010. View

Mauri M, Volonteri L, De Gaspari I, Colasanti A, Brambilla M, Cerruti L . Substance abuse in first-episode schizophrenic patients: a retrospective study. Clin Pract Epidemiol Ment Health. 2006; 2:4. PMC: 1435752. DOI: 10.1186/1745-0179-2-4. View

Cleary M, Hunt G, Matheson S, Walter G . Psychosocial treatments for people with co-occurring severe mental illness and substance misuse: systematic review. J Adv Nurs. 2008; 65(2):238-58. DOI: 10.1111/j.1365-2648.2008.04879.x. View

Baeza I, Graell M, Moreno D, Castro-Fornieles J, Parellada M, Gonzalez-Pinto A . Cannabis use in children and adolescents with first episode psychosis: influence on psychopathology and short-term outcome (CAFEPS study). Schizophr Res. 2009; 113(2-3):129-37. DOI: 10.1016/j.schres.2009.04.005. View

Goodman L, Rosenberg S, Mueser K, Drake R . Physical and sexual assault history in women with serious mental illness: prevalence, correlates, treatment, and future research directions. Schizophr Bull. 1997; 23(4):685-96. DOI: 10.1093/schbul/23.4.685. View

Swofford C, Kasckow J, INDERBITZIN L . Substance use: a powerful predictor of relapse in schizophrenia. Schizophr Res. 1996; 20(1-2):145-151. DOI: 10.1016/0920-9964(95)00068-2. View

10.

Archie S, Rush B, Akhtar-Danesh N, Norman R, Malla A, Roy P . Substance use and abuse in first-episode psychosis: prevalence before and after early intervention. Schizophr Bull. 2007; 33(6):1354-63. PMC: 2779870. DOI: 10.1093/schbul/sbm011. View

11.

Rasanen P, Tiihonen J, Isohanni M, Rantakallio P, Lehtonen J, Moring J . Schizophrenia, alcohol abuse, and violent behavior: a 26-year followup study of an unselected birth cohort. Schizophr Bull. 1998; 24(3):437-41. DOI: 10.1093/oxfordjournals.schbul.a033338. View

12.

Wade D, Harrigan S, McGorry P, Burgess P, Whelan G . Impact of severity of substance use disorder on symptomatic and functional outcome in young individuals with first-episode psychosis. J Clin Psychiatry. 2007; 68(5):767-74. DOI: 10.4088/jcp.v68n0517. View

13.

Sorbara F, Liraud F, Assens F, Abalan F, Verdoux H . Substance use and the course of early psychosis: a 2-year follow-up of first-admitted subjects. Eur Psychiatry. 2003; 18(3):133-6. DOI: 10.1016/s0924-9338(03)00027-0. View

14.

Lambert M, Conus P, Lubman D, Wade D, Yuen H, Moritz S . The impact of substance use disorders on clinical outcome in 643 patients with first-episode psychosis. Acta Psychiatr Scand. 2005; 112(2):141-8. DOI: 10.1111/j.1600-0447.2005.00554.x. View

15.

Drake R, Essock S, Shaner A, Carey K, Minkoff K, Kola L . Implementing dual diagnosis services for clients with severe mental illness. Psychiatr Serv. 2001; 52(4):469-76. DOI: 10.1176/appi.ps.52.4.469. View

16.

Wade D, Harrigan S, Edwards J, Burgess P, Whelan G, McGorry P . Patterns and predictors of substance use disorders and daily tobacco use in first-episode psychosis. Aust N Z J Psychiatry. 2005; 39(10):892-8. DOI: 10.1080/j.1440-1614.2005.01699.x. View

17.

Linszen D, Dingemans P, Lenior M . Cannabis abuse and the course of recent-onset schizophrenic disorders. Arch Gen Psychiatry. 1994; 51(4):273-9. DOI: 10.1001/archpsyc.1994.03950040017002. View

18.

Nimwegen L, de Haan L, van Beveren N, van den Brink W, Linszen D . Adolescence, schizophrenia and drug abuse: a window of vulnerability. Acta Psychiatr Scand Suppl. 2005; (427):35-42. DOI: 10.1111/j.1600-0447.2005.00543.x. View

19.

Grech A, van Os J, Jones P, Lewis S, Murray R . Cannabis use and outcome of recent onset psychosis. Eur Psychiatry. 2005; 20(4):349-53. DOI: 10.1016/j.eurpsy.2004.09.013. View

20.

Barnett J, Werners U, Secher S, Hill K, Brazil R, Masson K . Substance use in a population-based clinic sample of people with first-episode psychosis. Br J Psychiatry. 2007; 190:515-20. DOI: 10.1192/bjp.bp.106.024448. View