title: The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis.
abstract: Substance use is common in first-episode psychosis (FEP) and has been linked to poorer outcomes with more severe psychopathology and higher relapse rates. Early substance discontinuation appears to improve symptoms and function. However, studies vary widely in their methodology, and few have examined patients longitudinally, making it difficult to draw conclusions for practice and treatment. We aimed to investigate the relationship between substance use and early abstinence and the long-term course of illness in a representative sample of FEP patients. Out of 301 included patients, 266 could be divided into 4 groups based on substance use patterns during the first 2 years of treatment: persistent users, episodic users, stop-users and nonusers. Differences in clinical and functional measures during the follow-up period were assessed using linear mixed effects models for the analysis of repeated measures data. Patients who stopped using substances within the first 2 years after diagnosis had outcomes similar to those who had never used with fewer symptoms than episodic or persistent users. Both episodic and persistent users had lower rates of symptom remission than nonusers, and persistent users also had more negative symptoms than those who stopped using. Our findings emerge from one of very few long-term longitudinal studies examining substance use cessation in FEP with 10-year follow-up. The results convey hope that the detrimental effects of substance abuse on mental health may be significantly reversed if one stops the abuse in time. This can help patients who struggle with addiction with their motivation to embrace abstinence.
authors.affiliation: Regional Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.|Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Weibell
authors.affiliation: Regional Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Wenche Ten Velden
authors.initials: WTV
authors.lastname: Hegelstad
authors.affiliation: Department of Mathematics and Natural Sciences, University of Stavanger, Stavanger, Norway.|Research Department, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Auestad
authors.affiliation: SERAF, Norwegian Centre for Addiction Research, Oslo, Norway.|Institute of Psychiatry, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Bramness
authors.affiliation: Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
authors.forename: Julie
authors.initials: J
authors.lastname: Evensen
authors.affiliation: Psychiatric Research Unit, Zealand Region, Psychiatry East and Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark.
authors.forename: Ulrik
authors.initials: U
authors.lastname: Haahr
authors.affiliation: Regional Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.|Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Inge
authors.initials: I
authors.lastname: Joa
authors.affiliation: Regional Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.|Faculty of Social Sciences, University of Stavanger, Stavanger, Norway.
authors.forename: Jan Olav
authors.initials: JO
authors.lastname: Johannessen
authors.affiliation: Regional Centre for Clinical Research in Psychosis, Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.|Institute of Psychiatry, University of Bergen, Bergen, Norway.
authors.forename: Tor Ketil
authors.initials: TK
authors.lastname: Larsen
authors.affiliation: Institute of Psychiatry, Faculty of Medicine, University of Oslo, Oslo, Norway.|Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Melle
authors.affiliation: Institute of Psychiatry, Faculty of Medicine, University of Oslo, Oslo, Norway.|Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
authors.forename: Stein
authors.initials: S
authors.lastname: Opjordsmoen
authors.affiliation: Department of Psychology, University of Oslo, Oslo, Norway.|Vestre Viken Hospital Trust, Drammen, Norway.
authors.forename: Bjørn Rishovd
authors.initials: BR
authors.lastname: Rund
authors.affiliation: Psychiatric Research Unit, Zealand Region, Psychiatry East and Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Roskilde, Denmark.|Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen N, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Simonsen
authors.affiliation: Institute of Psychiatry, Faculty of Medicine, University of Oslo, Oslo, Norway.|Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
authors.forename: Per
authors.initials: P
authors.lastname: Vaglum
authors.affiliation: Department of Psychiatry, Yale University, New Haven, CT.
authors.forename: Thomas
authors.initials: T
authors.lastname: McGlashan
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia.|Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: McGorry
authors.affiliation: Institute of Psychiatry, Faculty of Medicine, University of Oslo, Oslo, Norway.|Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
authors.forename: Svein
authors.initials: S
authors.lastname: Friis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003718:Denmark / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011618:Psychotic Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D012559:Schizophrenia / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D055815:Young Adult
keywords: negative symptoms; psychosis; schizophrenia; substance abuse