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30-03-2011 | Mental health | Article

Substance abuse linked to involuntary hospitalization in FEP patients

Abstract

Free abstract

MedWire News: Substance abuse is associated with an increased risk for involuntary hospitalization in patients with first-episode psychosis (FEP), study results show.

The findings emphasize the importance of treating substance abuse in FEP patients to improve outcomes, say the researchers.

Anne Opsal, from the University of Oslo in Norway, and team studied 103 FEP patients, aged 15-65 years, who were enrolled in a comprehensive early psychosis treatment program.

All of the participants were assessed at enrollment using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning Scale (GAF).

Substance abuse (alcohol and illegal drugs) for the 6-month period prior to the start of treatment was assessed using the Clinician Rating Scale (CRS).

In total, 25 patients met the criteria for substance abuse, with cannabis and stimulants being the most commonly abused substances (both at 44%), followed by opioids (32%) and alcohol (28%).

Over a follow-up period of 2 years, the researchers found that 72% of FEP patients with a history of substance abuse experienced at least one involuntary hospitalization compared with just 31% of those who did not abuse substances.

After accounting for duration of untreated psychosis and other potential confounding factors, the researchers found that FEP patients with a history of substance abuse were 5.2 times more likely to experience involuntary hospitalization during follow-up than those without such a history.

The team also notes that increased baseline PANSS scores were independently associated with an increased risk for involuntary admission during follow-up.

Writing in the journal Acta Psychiatrica Scandinavica, Opsal and team conclude: "Patients with defined comorbid substance use disorders and FEP are likely to experience poorer treatment response than those with psychosis alone."

They recommend: "To adequately treat patients experiencing FEP, clinicians must simultaneously emphasize treatment of the substance-abuse disorders as well as the psychotic illness."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Mark Cowen

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