BACKGROUND: The stability of the diagnostic distinction between a substance-induced psychosis and a primary psychotic disorder co-occurring with substance use is not established. AIMS: To describe DSM-IV diagnostic changes over 1 year and determine the predictive validity of baseline indicators of the substance-induced psychosis v. primary psychosis distinction. METHOD: We conducted a 1-year follow-up study of 319 psychiatric emergency department admissions with diagnoses of early-phase psychosis and substance use comorbidity. RESULTS: Of those with a baseline DSM-IV diagnosis of substance-induced psychosis, 25% had a diagnosis of primary psychosis at follow-up. These patients had poorer premorbid functioning, less insight into psychosis and greater family mental illness than patients with a stable diagnosis of substance-induced psychosis. Reclassifying change cases to primary psychoses on follow-up, key baseline predictors of the primary/substance-induced distinction at 1 year also included greater family history of mental illness in the primary psychosis group. CONCLUSIONS: Further study of substance-induced psychoses should employ neuroscientific and behavioural approaches. Study findings can guide more accurate diagnoses at first treatment.
BACKGROUND: The stability of the diagnostic distinction between a substance-induced psychosis and a primary psychotic disorder co-occurring with substance use is not established. AIMS: To describe DSM-IV diagnostic changes over 1 year and determine the predictive validity of baseline indicators of the substance-induced psychosis v. primary psychosis distinction. METHOD: We conducted a 1-year follow-up study of 319 psychiatric emergency department admissions with diagnoses of early-phase psychosis and substance use comorbidity. RESULTS: Of those with a baseline DSM-IV diagnosis of substance-induced psychosis, 25% had a diagnosis of primary psychosis at follow-up. These patients had poorer premorbid functioning, less insight into psychosis and greater family mental illness than patients with a stable diagnosis of substance-induced psychosis. Reclassifying change cases to primary psychoses on follow-up, key baseline predictors of the primary/substance-induced distinction at 1 year also included greater family history of mental illness in the primary psychosis group. CONCLUSIONS: Further study of substance-induced psychoses should employ neuroscientific and behavioural approaches. Study findings can guide more accurate diagnoses at first treatment.
Authors: Paola Salvatore; Ross J Baldessarini; Mauricio Tohen; Hari-Mandir K Khalsa; Jesus Perez Sanchez-Toledo; Carlos A Zarate; Eduard Vieta; Carlo Maggini Journal: J Clin Psychiatry Date: 2010-07-13 Impact factor: 4.384
Authors: Robert E Drake; Carol L M Caton; Haiyi Xie; Eustace Hsu; Prakash Gorroochurn; Sharon Samet; Deborah S Hasin Journal: Am J Psychiatry Date: 2011-03-31 Impact factor: 18.112
Authors: Paola Salvatore; Ross J Baldessarini; Mauricio Tohen; Hari-Mandir K Khalsa; Jesus Perez Sanchez-Toledo; Carlos A Zarate; Eduard Vieta; Carlo Maggini Journal: J Clin Psychiatry Date: 2008-12-30 Impact factor: 4.384