Comorbid substance abuse and brain morphology in recent-onset psychosis.
The aim of the presented study was to compare schizophrenia and schizoaffective patients early in the course of the disease with and without comorbid substance abuse disorder (SUD vs. NSUD) with regard to brain morphology. In a prospective design 41 patients (20 SUD vs. 21 NSUD) diagnosed as recent-onset schizophrenia or schizoaffective disorder consecutively admitted to hospital received standardized psychopathological evaluation (BPRS, SANS, MADRS, CGI, GAF) and MRI scanning with volumetric measurement of superior temporal gyrus (STG), amygdala-hippocampal complex, and cingulum. Patients with SUD (primarily cannabis) were significantly younger, predominantly male and had a lower socioeconomic status. Despite less attentional impairment (SANS subscore) and elevated anxiety/depression (BPRS subscore) in patients with SUD compared to NSUD, no other psychopathological differences could be detected. There were no differences in the assessed temporolimbic brain morphology between the two subgroups. In conclusion, in this study substance abuse in recent-onset psychosis had no effect on brain morphology and the earlier onset of psychosis in patients with comorbid SUD could not be explained by supposed accentuated brain abnormalities in temporolimbic regions.
Wobrock
Thomas
T
Department of Psychiatry and Psychotherapy, Georg-August-University Göttingen, von-Siebold-Strasse 5, 37075 Göttingen, Germany. twobroc@gwdg.de
Sittinger
Helmut
H
Behrendt
Bernd
B
D'Amelio
Roberto
R
Falkai
Peter
P
D000293:Adolescent; D000328:Adult; D000679:Amygdala / Q000473:pathology; D001921:Brain / Q000473:pathology*; D015897:Comorbidity; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000453:epidemiology / Q000473:pathology* / Q000523:psychology; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000473:pathology* / Q000523:psychology; D013702:Temporal Lobe / Q000473:pathology; D013997:Time Factors; D055815:Young Adult