Grant E Sara1, Philip M Burgess1, Gin S Malhi1, Harvey A Whiteford1, Wayne C Hall1. 1. Grant E. Sara, MB BS, MM, MM (Psychotherapy), FRANZCP, InforMH, Mental Health and Drug and Alcohol Office, NSW Health, Discipline of Psychiatry, Sydney Medical School, University of Sydney, and School of Population Health, University of Queensland, Brisbane, Queensland; Philip M. Burgess, MA, PhD, School of Population Health, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Gin S. Malhi, MBChB, BSc, MD, FRCPsych, FRANZCP, Discipline of Psychiatry, Sydney Medical School, University of Sydney, Royal North Shore Hospital, and CADE Clinic, Department of Academic Psychiatry, Royal North Shore Hospital, Sydney, New South Wales; Harvey A. Whiteford, MB BS, MPH, MD, FRANZCP, Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland; Wayne C. Hall, MSc, PhD, Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: Few studies have examined the impact of stimulant use on outcome in early psychosis. Ceasing substance use may lead to positive outcomes in psychosis. AIMS: To examine whether baseline cannabis or stimulant disorders and ongoing drug use predict readmission within 2 years of a first psychosis admission. METHOD: Predictors of readmission were examined with Cox regression in 7269 people aged 15-29 years with a first psychosis admission. RESULTS: Baseline cannabis and stimulant disorders did not predict readmission. A stimulant disorder diagnosis prior to index psychosis admission predicted readmission, but a prior cannabis disorder diagnosis did not. Ongoing problem drug use predicted readmission. The lowest rate of readmission occurred in people whose baseline drug problems were discontinued. CONCLUSIONS: Prior admissions with stimulant disorder may be a negative prognostic sign in first-episode psychosis. Drug use diagnoses at baseline may be a good prognostic sign if they are identified and controlled. Royal College of Psychiatrists.
BACKGROUND: Few studies have examined the impact of stimulant use on outcome in early psychosis. Ceasing substance use may lead to positive outcomes in psychosis. AIMS: To examine whether baseline cannabis or stimulant disorders and ongoing drug use predict readmission within 2 years of a first psychosis admission. METHOD: Predictors of readmission were examined with Cox regression in 7269 people aged 15-29 years with a first psychosis admission. RESULTS: Baseline cannabis and stimulant disorders did not predict readmission. A stimulant disorder diagnosis prior to index psychosis admission predicted readmission, but a prior cannabis disorder diagnosis did not. Ongoing problem drug use predicted readmission. The lowest rate of readmission occurred in people whose baseline drug problems were discontinued. CONCLUSIONS: Prior admissions with stimulant disorder may be a negative prognostic sign in first-episode psychosis. Drug use diagnoses at baseline may be a good prognostic sign if they are identified and controlled. Royal College of Psychiatrists.