Course of substance misuse and daily tobacco use in first-episode psychosis.
BACKGROUND
Study of the course of substance misuse and daily tobacco use in first-episode psychosis may enhance detection and treatment of these substance-related problems.


METHODS
This 15-month follow-up study examined the course of substance misuse and daily tobacco use in 103 individuals treated for first-episode psychosis.


RESULTS
Three-quarters (72.6%) of patients with lifetime substance misuse, or half (51.5%) of all patients, continued substance misuse (primarily cannabis) during the 15-month follow-up period. There was a significant reduction in the rate of any substance misuse (70.9% versus 53.4%) but not daily tobacco use (76.7% versus 75.7%) between baseline and 15-month follow-up. Patients who continued substance misuse showed a significant reduction in the severity and frequency of substance use between baseline and follow-up. Patients who continued substance misuse were more likely to be younger, male and single, less likely to have completed secondary school, and more likely to have had more severe cannabis use prior to entry to treatment compared to patients who ceased substance misuse.


CONCLUSIONS
A significant proportion of young patients treated for first-episode psychosis are at risk of mental and physical health problems associated with substance misuse and/or regular tobacco use.
Wade
Darryl
D
ORYGEN Youth Health, Locked Bag 10, Parkville, VIC 3052, Australia. dwade@unimelb.edu.au
Harrigan
Susy
S
Edwards
Jane
J
Burgess
Philip M
PM
Whelan
Greg
G
McGorry
Patrick D
PD
D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology* / Q000534:rehabilitation; D001315:Australia; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology / Q000534:rehabilitation; D008432:Mathematical Computing; D010343:Patient Admission / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000534:rehabilitation; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation