Predictors of substance use reduction in an epidemiological first-episode psychosis cohort

Authors

  • Shane Rebgetz,

    Corresponding author
    1. Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Queensland University of Technology, Brisbane
    2. Queensland Health, Metro-North Health Service District, Redcliffe-Caboolture Mental Health Service, Caboolture, Queensland, Australia
    • Corresponding author: Mr Shane Rebgetz, Queensland University of Technology and Queensland Health, Locked Mail Bag 4, Caboolture, Qld. 4510, Australia. Email: shane_rebgetz@health.qld.gov.au

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  • Philippe Conus,

    1. Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Prilly
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  • Leanne Hides,

    1. Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Queensland University of Technology, Brisbane
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  • David J. Kavanagh,

    1. Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Queensland University of Technology, Brisbane
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  • Sue Cotton,

    1. Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
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  • Benno G. Schimmelmann,

    1. University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland
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  • Patrick D. McGorry,

    1. Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia
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  • Martin Lambert

    1. Psychosis Early Detection and Intervention Centre (PEDIC), Department for Psychiatry and Psychotherapy, Centre for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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  • Declaration of conflict of interest:
  • The study was conducted at EPPIC in Melbourne, and was supported by Eli Lilly Australia in the frame of an investigator initiated trial; however, this company did not have any involvement in the study design, in the collection, analysis and interpretation of data, in the writing of the report and in the decision to submit the paper for publication.

Abstract

Aim

To assess the predictors of a significant decrease or cessation of substance use (SU) in a treated epidemiological cohort of first-episode psychosis (FEP) patients.

Method

Participants were FEP patients of the Early Psychosis Prevention and Intervention Centre in Australia. Patients' medical files were reviewed using a standardized file audit. Data on 432 patients with FEP and baseline co-morbid substance use disorder (SUD) were available for analysis. Predictors of reduction/cessation of SU at follow up were examined using logistic regression analyses.

Results

In univariate analyses, a reduction/cessation of SU was predicted by baseline measures reflecting higher education, employment, accommodation with others, cannabis use disorder (CUD) only (rather than poly-SUDs), better global functioning and better premorbid social and occupational functioning, later age at onset of psychosis, and a diagnosis of non-affective psychosis. In multivariate analysis, CUD alone and better premorbid social and occupational functioning remained significant predictors.

Conclusions

Addressing SUDs and social and occupational goals in people with FEP may offer opportunities to prevent SUDs becoming more severe or entrenched. Further longitudinal research on recovery from SU and FEP is needed to disentangle directions of influence and identify key targets for intervention.

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