Grant Sara1, Julia Lappin2, Timothy Dobbins3, Adrian J Dunlop4, Louisa Degenhardt5. 1. Northern Clinical School, Sydney Medical School, University of Sydney, Kolling Building Level 7, Royal North Shore Hospital, Reserve Road, St Leonards, NSW 2065, Australia; InforMH, Health System Information and Performance Reporting Branch, NSW Ministry of Health, PO Box 169, North Ryde, NSW 1670, Australia. Electronic address: Grant.Sara@sydney.edu.au. 2. National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW 2052, Australia; Department of Psychiatry, University of NSW, Sydney NSW 2052, Australia. Electronic address: j.lappin@unsw.edu.au. 3. National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW 2052, Australia. Electronic address: t.dobbins@unsw.edu.au. 4. Drug and Alcohol Clinical Services, Hunter New England Local Health District, Locked Bag 1, New Lambton, NSW 2305, Australia; School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Centre for Brain and Mental Health, University of Newcastle and Hunter Medical Research Institute, Level 5,McAuley Building, Mater Hospital, Waratah, NSW 2298, Australia. Electronic address: Adrian.Dunlop@hnehealth.nsw.gov.au. 5. National Drug and Alcohol Research Centre, University of NSW, Sydney, NSW 2052, Australia. Electronic address: l.degenhardt@unsw.edu.au.
Abstract
AIM: To describe health service contact in the two years prior to a first hospital admission with amphetamine-related psychosis, and to identify possible opportunities for early intervention. METHOD: Routine health data collections were used to identify 6130 persons aged 16-65 who had a first hospital admission with amphetamine-related psychosis in New South Wales (NSW), Australia, between 2005 and 2016. Health service contacts in the two years prior to first admission were identified, using public hospital, emergency department and community mental health data. Prior care was compared to 41,444 people with first psychosis admissions without amphetamine diagnoses. RESULTS: Two thirds of people with amphetamine-related psychosis had health service contact in the two years prior to their first psychosis admission. Of these, 45% had ED contacts and 30% had prior general hospital admissions. The likelihood of contact escalated throughout the two years prior to admission. Prior substance-related conditions, infectious diseases, injuries and accidents were common. Compared to other first psychosis admissions, people with amphetamine-related psychoses were less likely to have prior specialised mental health care (OR 0.84, 95% CI 0.78, 0.89) and more likely to have prior general health care (OR 1.40, 95% CI 1.29, 1.51). CONCLUSION: Emergency departments and units treating people with infectious diseases or injuries should consider strategies to detect amphetamine and other substance use. Early detection and referral to specialist mental health or drug and alcohol care may prevent some amphetamine-related psychoses. Crown
AIM: To describe health service contact in the two years prior to a first hospital admission with amphetamine-related psychosis, and to identify possible opportunities for early intervention. METHOD: Routine health data collections were used to identify 6130 persons aged 16-65 who had a first hospital admission with amphetamine-related psychosis in New South Wales (NSW), Australia, between 2005 and 2016. Health service contacts in the two years prior to first admission were identified, using public hospital, emergency department and community mental health data. Prior care was compared to 41,444 people with first psychosis admissions without amphetamine diagnoses. RESULTS: Two thirds of people with amphetamine-related psychosis had health service contact in the two years prior to their first psychosis admission. Of these, 45% had ED contacts and 30% had prior general hospital admissions. The likelihood of contact escalated throughout the two years prior to admission. Prior substance-related conditions, infectious diseases, injuries and accidents were common. Compared to other first psychosis admissions, people with amphetamine-related psychoses were less likely to have prior specialised mental health care (OR 0.84, 95% CI 0.78, 0.89) and more likely to have prior general health care (OR 1.40, 95% CI 1.29, 1.51). CONCLUSION: Emergency departments and units treating people with infectious diseases or injuries should consider strategies to detect amphetamine and other substance use. Early detection and referral to specialist mental health or drug and alcohol care may prevent some amphetamine-related psychoses. Crown