Antti Mustonen1, Solja Niemelä2, John J McGrath3, Graham K Murray4, Tanja Nordström5, Pirjo Mäki6, Jouko Miettunen5, James G Scott7. 1. Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. Electronic address: antti.mustonen@student.oulu.fi. 2. Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Lapland Hospital District, Rovaniemi, Finland. 3. Queensland Brain Institute, The University of Queensland, St. Lucia, Queensland, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia; National Centre for Register-Based Research, Aarhus University, Business and Social Sciences, Aarhus, Denmark. 4. Department of Psychiatry, University of Cambridge, Cambridge, UK. 5. Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. 6. Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, the Northern Ostrobothnia Hospital District, Finland; Department of Psychiatry, Länsi-Pohja healthcare district, Finland; Department of Psychiatry, the Middle Ostrobothnia Central Hospital, Soite, Finland; Mental Health Services, Basic Health Care District of Kallio, Finland; Department of Psychiatry, Kainuu Central Hospital, Kainuu social and healthcare district, Kajaani, Finland; Mental Health Services, Joint Municipal Authority of Wellbeing in Raahe District, Finland. 7. Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia; Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia; Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
Abstract
BACKGROUND: Cross-sectional studies have suggested inhalant use is associated with psychosis. This association was examined in a longitudinal study accounting for other substance use and potential confounders. METHODS: We used a prospective sample (N = 6542) from the Northern Finland Birth Cohort 1986. Self-report questionnaires on substance use and psychotic experiences were completed when the cohort members were 15-16 years old. Inhalant use was categorized into four groups (never, once, 2-4 times, 5 times or more). Subsequent psychosis diagnoses (ICD-10) until age 30 years were obtained from national registers. Cox regression analysis was used to examine the association between adolescent inhalant use and risk of psychosis. RESULTS: During the observation period 124 individuals were diagnosed with incident psychosis. Overall, there were 225 (3.4%) subjects with any inhalant use, 18 (8.0%) of whom were diagnosed with psychosis during the follow up. Of non-inhalant users (n = 6317) 106 (1.7%) were diagnosed with psychosis. Compared to non-users, those using inhalants had increased risk of incident psychosis with most frequent inhalant use associated with the greatest risk (unadjusted HR = 9.46; 3.86-23.20). After adjusting for baseline psychotic experiences, other substance use, comorbid mental disorder and parental substance abuse, the increased risk of psychosis persisted (HR = 3.06; 1.05-8.95). Furthermore, a dose-response effect between inhalant use and risk of psychosis was identified (OR = 2.34; 1.83-2.99). CONCLUSIONS: Inhalant use in adolescence was independently associated with incident psychosis. The adverse health outcomes associated with adolescent inhalant use provide compelling reasons for implementation of policies to reduce the use of volatile substances in adolescents. Crown
BACKGROUND: Cross-sectional studies have suggested inhalant use is associated with psychosis. This association was examined in a longitudinal study accounting for other substance use and potential confounders. METHODS: We used a prospective sample (N = 6542) from the Northern Finland Birth Cohort 1986. Self-report questionnaires on substance use and psychotic experiences were completed when the cohort members were 15-16 years old. Inhalant use was categorized into four groups (never, once, 2-4 times, 5 times or more). Subsequent psychosis diagnoses (ICD-10) until age 30 years were obtained from national registers. Cox regression analysis was used to examine the association between adolescent inhalant use and risk of psychosis. RESULTS: During the observation period 124 individuals were diagnosed with incident psychosis. Overall, there were 225 (3.4%) subjects with any inhalant use, 18 (8.0%) of whom were diagnosed with psychosis during the follow up. Of non-inhalant users (n = 6317) 106 (1.7%) were diagnosed with psychosis. Compared to non-users, those using inhalants had increased risk of incident psychosis with most frequent inhalant use associated with the greatest risk (unadjusted HR = 9.46; 3.86-23.20). After adjusting for baseline psychotic experiences, other substance use, comorbid mental disorder and parental substance abuse, the increased risk of psychosis persisted (HR = 3.06; 1.05-8.95). Furthermore, a dose-response effect between inhalant use and risk of psychosis was identified (OR = 2.34; 1.83-2.99). CONCLUSIONS: Inhalant use in adolescence was independently associated with incident psychosis. The adverse health outcomes associated with adolescent inhalant use provide compelling reasons for implementation of policies to reduce the use of volatile substances in adolescents. Crown
Authors: James G Scott; Lori Matuschka; Solja Niemelä; Jouko Miettunen; Brett Emmerson; Antti Mustonen Journal: Front Psychiatry Date: 2018-11-20 Impact factor: 4.157