Impact of persistent substance misuse on 1-year outcome in first-episode psychosis.
BACKGROUND
Substance misuse is a common comorbid problem in people presenting with first-episode psychosis and is associated with a poor short-term outcome.


OBJECTIVE
The aim of this study is to examine differences in baseline characteristics and 1-year outcome between individuals with first-episode psychosis who have never misused substances, those who stop misusing substances after initial presentation and those who persistently misuse substances over the 1-year assessment period.


METHODS
Patients were recruited to the Northern Ireland First Episode Psychosis Study (n = 272). Clinical assessments were performed at baseline and at 1 year (n = 194) and data were collected from the case notes.


RESULTS
Individuals with persistent substance misuse had more severe depression, more positive symptoms, poorer functional outcome and greater rates of relapse at 1 year than those who stopped and those who had never misused substances. There were no differences in outcome between people who had never misused substances and those who stopped misusing after presentation.


CONCLUSIONS
These results support assertive intervention targeted at comorbid substance misuse in individuals with first-episode psychosis.
Turkington
Aidan
A
Department of Psychiatry, Queen's University, Belfast BT9 7BL, UK. aidant@doctors.org.uk
Mulholland
Ciaran C
CC
Rushe
Teresa M
TM
Anderson
Rick
R
McCaul
Rosalind
R
Barrett
Suzanne L
SL
Barr
Ruth S
RS
Cooper
Stephen J
SJ
D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D012559:Schizophrenia / Q000453:epidemiology; D012565:Schizophrenic Psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult