A Thompson1,2, S Marwaha3,4, C Winsper3, L Everard5, P B Jones6,7, D Fowler8,9, T Amos10, N Freemantle11, S P Singh3,5, M Marshall12, V Sharma13, M Birchwood3. 1. Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK. andrew.d.thompson@warwick.ac.uk. 2. North Warwickshire Early Intervention in Psychosis Service, Coventry and Warwickshire Partnership NHS Trust, Coventry, UK. andrew.d.thompson@warwick.ac.uk. 3. Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK. 4. Affective Disorders Service, Tile Hill, Coventry and Warwickshire NHS Partnership Trust, Coventry, UK. 5. The Early Intervention in Psychosis Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK. 6. Department of Psychiatry, University of Cambridge, Cambridge, UK. 7. CAMEO, Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK. 8. School of Medicine, University of East Anglia, Norwich, UK. 9. Academic Unit of Psychiatry and Department of Psychology, University of Sussex, Brighton, UK. 10. Academic Unit of Psychiatry, University of Bristol, Bristol, UK. 11. Department of Primary Care and Population Health, UCL Medical School (Royal Free Campus), London, UK. 12. School of Medicine, The University of Manchester, Manchester, UK. 13. Early Intervention Service, Cherry Bank Resource Centre, Cheshire and Wirral Partnership NHS Foundation Trust, Ellesmere Port, UK.
Abstract
OBJECTIVE: The incidence and outcome of first-episode substance-induced psychotic disorder (SIPD) are unclear. The study aimed to compare the 1-year outcomes of those given a SIPD diagnosis by clinicians compared to other psychosis diagnoses in a first-episode cohort. METHOD: Data were from a large (n = 1027) cohort of first-episode psychosis (FEP) patients admitted to early intervention services in the UK (National EDEN). Diagnosis, including that of SIPD, was made by treating psychiatrists at baseline using ICD10 criteria. Details on symptoms, functioning, quality of life, relapse and recovery were available at baseline and 12 months. RESULTS: There were 67 cases of SIPD (6.5% of the cohort). At baseline, SIPD patients were no different to other psychoses on symptoms, functioning and quality of life. At 12 months, there was no difference in SIPD and other psychoses on functioning, quality of life or relapse and recovery rates. Levels of psychotic and general symptomatology were similar but depressive symptoms were higher in the SIPD group. CONCLUSIONS: First-episode psychosis patients with a diagnosis of SIPD do not appear to have better outcomes than those with other primary psychotic diagnoses. The higher levels of depressive symptoms may be a specific marker in these patients.
OBJECTIVE: The incidence and outcome of first-episode substance-induced psychotic disorder (SIPD) are unclear. The study aimed to compare the 1-year outcomes of those given a SIPD diagnosis by clinicians compared to other psychosis diagnoses in a first-episode cohort. METHOD: Data were from a large (n = 1027) cohort of first-episode psychosis (FEP) patients admitted to early intervention services in the UK (National EDEN). Diagnosis, including that of SIPD, was made by treating psychiatrists at baseline using ICD10 criteria. Details on symptoms, functioning, quality of life, relapse and recovery were available at baseline and 12 months. RESULTS: There were 67 cases of SIPD (6.5% of the cohort). At baseline, SIPD patients were no different to other psychoses on symptoms, functioning and quality of life. At 12 months, there was no difference in SIPD and other psychoses on functioning, quality of life or relapse and recovery rates. Levels of psychotic and general symptomatology were similar but depressive symptoms were higher in the SIPD group. CONCLUSIONS: First-episode psychosispatients with a diagnosis of SIPD do not appear to have better outcomes than those with other primary psychotic diagnoses. The higher levels of depressive symptoms may be a specific marker in these patients.
Authors: David Beckmann; Kelsey Leigh Lowman; Jessica Nargiso; James McKowen; Lisa Watt; Amy M Yule Journal: Child Adolesc Psychiatr Clin N Am Date: 2019-09-23