Mary F Brunette1, Kim T Mueser2, Steven Babbin3, Piper Meyer-Kalos4, Robert Rosenheck5, Christoph U Correll6, Corrine Cather7, Delbert G Robinson6, Nina R Schooler8, David L Penn9, Jean Addington10, Sue E Estroff11, Jennifer Gottlieb2, Shirley M Glynn12, Patricia Marcy13, James Robinson14, John M Kane6. 1. Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Bureau of Mental Health Services, Department of Health and Human Services, Concord, NH, USA. Electronic address: mary.f.brunette@dartmouth.edu. 2. Center for Psychiatric Rehabilitation, Departments of Occupational Therapy, Psychiatry, and Psychology, Boston University, Boston, MA, USA. 3. University of Massachusetts, Boston, MA, USA. 4. Minnesota Center for Chemical and Mental Health, University of Minnesota, School of Social Work, St. Paul, MN, USA. 5. Yale Medical School, New Haven, CT, USA. 6. Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewis Glen Oaks, NY, USA; The Feinstein Institute for Medical Research, Manhasset, NY, USA; Hofstra North Shore LIJ School of Medicine, Departments of Psychiatry and Molecular Medicine, Hempstead, NY, USA; Albert Einstein College of Medicine, Department of Psychiatry and Behavioral Sciences, Bronx, NY, USA. 7. Massachusetts General Hospital, Boston, MA, USA. 8. Zucker Hillside Hospital, Psychiatry Research, North Shore - Long Island Jewis Glen Oaks, NY, USA; SUNY Downstate Medical Center, Department of Psychiatry, Brooklyn, NY, USA. 9. University of North Carolina-Chapel Hill, Department of Psychology, Chapel Hill, NC, USA; Australian Catholic University, School of Psychology, Melbourne, VIC, Australia. 10. Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Canada. 11. Department of Social Medicine, University of North Carolina, Chapel Hill, NC, USA. 12. Semel Institute of Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA. 13. Vanguard Research Group, NY, USA. 14. Nathan Kline Institute, Orangeburg, NY, USA.
Abstract
BACKGROUND: We assessed the prevalence and correlates of lifetime substance use disorders in people with first episode psychosis using the baseline data from the Recovery After an Initial Schizophrenia Episode (RAISE) Early Treatment Program study. METHODS: Research staff assessed 404 first episode patients at 34 community mental health centers across the United States with the Structured Clinical Interview for DSM-IV for diagnoses of psychotic and substance use disorders. Logistic regression was used to evaluate the relationships between participant characteristics and lifetime substance use disorders, followed with generalized linear mixed-effects regression models to identify unique predictors of lifetime substance use disorders. RESULTS: Approximately one-third of participants reported recent alcohol use (36.6%) and cannabis use (30.7%), and one half (51.7%) met criteria for any lifetime alcohol or drug use disorder. Lifetime substance use disorders were associated with male gender, White race, higher excited (hyperactivity, mood lability, impulsivity, hostility, and uncooperativeness), psychotic and depressive symptoms, less impaired cognition, and greater perceived stigma. Gender, race, and excited symptoms were the most consistent unique predictors of lifetime substance use disorders found in multivariate analyses. CONCLUSIONS: Half of first episode psychosis patients have co-occurring substance use disorders, which are associated with both more severe symptoms and greater perceptions of stigma. Programs aiming to serve these patients must have the skills and clinical strategies to help people with these unique characteristics.
BACKGROUND: We assessed the prevalence and correlates of lifetime substance use disorders in people with first episode psychosis using the baseline data from the Recovery After an Initial Schizophrenia Episode (RAISE) Early Treatment Program study. METHODS: Research staff assessed 404 first episode patients at 34 community mental health centers across the United States with the Structured Clinical Interview for DSM-IV for diagnoses of psychotic and substance use disorders. Logistic regression was used to evaluate the relationships between participant characteristics and lifetime substance use disorders, followed with generalized linear mixed-effects regression models to identify unique predictors of lifetime substance use disorders. RESULTS: Approximately one-third of participants reported recent alcohol use (36.6%) and cannabis use (30.7%), and one half (51.7%) met criteria for any lifetime alcohol or drug use disorder. Lifetime substance use disorders were associated with male gender, White race, higher excited (hyperactivity, mood lability, impulsivity, hostility, and uncooperativeness), psychotic and depressive symptoms, less impaired cognition, and greater perceived stigma. Gender, race, and excited symptoms were the most consistent unique predictors of lifetime substance use disorders found in multivariate analyses. CONCLUSIONS: Half of first episode psychosispatients have co-occurring substance use disorders, which are associated with both more severe symptoms and greater perceptions of stigma. Programs aiming to serve these patients must have the skills and clinical strategies to help people with these unique characteristics.
Authors: Deborah S Hasin; Jacob Borodovsky; Dvora Shmulewitz; Claire Walsh; Ofir Livne; Cara A Struble; Efrat Aharonovich; David S Fink; Alan Budney Journal: Drug Alcohol Depend Date: 2021-10-29 Impact factor: 4.492
Authors: Arnold P M van der Lee; Adriaan Hoogendoorn; Lieuwe de Haan; Aartjan T F Beekman Journal: BMC Psychiatry Date: 2021-06-29 Impact factor: 3.630