Substance use and the course of early psychosis: a 2-year follow-up of first-admitted subjects.
OBJECTIVE
To examine the impact of alcohol and substance use on the early course of psychosis.


METHODS
First-admitted subjects with psychosis (n = 58) were assessed at 6-month intervals over a 2-year follow-up. Information on substance and alcohol misuse and clinical and social outcome was collected using multiple sources of information.


RESULTS
After adjustment for potential confounding factors, subjects with persistent substance misuse over the follow-up were at increased risk of readmission (OR = 3.1; 95%CI = 1.0-9.4; P = 0.05), of presenting with psychotic symptoms (OR = 4.3; 95%CI = 1.0-18.1; P = 0.04), and with a non-continuous course of illness (OR = 11; 95%CI = 1-122; P = 0.05). No significant association was found between substance misuse and social outcome, or between alcohol misuse and clinical and social outcome.


CONCLUSIONS
Persistent substance misuse after a first admission for psychosis has a deleterious impact on clinical outcome. Early identification and treatment of substance use is essential in the care of subjects with incipient psychosis.
Sorbara
F
F
Department of Psychiatry, University Victor Segalen, Bordeaux 2, France.
Liraud
F
F
Assens
F
F
Abalan
F
F
Verdoux
H
H
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology / Q000628:therapy*; D012494:Sampling Studies; D019966:Substance-Related Disorders / Q000150:complications*; D016896:Treatment Outcome