Schizophrenia Bulletin Advance Access originally published online on March 3, 2007
Schizophrenia Bulletin 2007 33(6):1354-1363; doi:10.1093/schbul/sbm011
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Substance Use and Abuse in First-Episode Psychosis: Prevalence Before and After Early Intervention
2 Department of Psychiatry and Behavioural Neurosciences, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
3 Cleghorn Program for Early Intervention in Psychosis, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
4 Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
5 Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
6 School of Nursing, McMaster University, Hamilton, Ontario, Canada
7 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
8 Department of Psychiatry
9 Department of Epidemiology & Biostatistics, University of Western Ontario, London, Ontario, Canada
10 PEPP Psychosis Program, London Health Sciences Centre, London, Ontario, Canada
11 Department of Psychiatry, McGill University, Montreal, Quebec, Canada
12 Douglas Hospital Research Centre, Montreal, Quebec, Canada
13 Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
14 Champlain District Regional First Episode Psychosis Program, The Ottawa Hospital, Ottawa, Ontario, Canada
1 To whom correspondence should be addressed; 25 Charlton Avenue East, Suite 703, Hamilton, Ontario, Canada L8N 1Y2; tel: 1-905-540-6586, fax: 1-905-525-2805, e-mail: archies{at}mcmaster.ca.
Despite the high prevalence of substance abuse among first-episode psychosis (FEP) populations, few studies examine whether early intervention (EI) improves substance abuse. Objective: To examine the prevalence and pattern of substance use and abuse among an FEP sample over 12 months. Methods: All the participants were diagnosed with a first episode of a schizophrenia spectrum disorder. The participants were followed prospectively. The prevalence rates of substance use and abuse from this sample were compared before and after 12 months of EI services and were compared with rates observed in a sample from the general population. Results: A total of 200 participants (80.0% males; mean age 24 years) entered the study: 183 participants completed all the assessments at baseline, 131 participants completed all the assessments at 12 months. At baseline, the findings showed similar prevalence rates between the FEP sample and the general sample for lifetime cannabis use (60% vs 55%, respectively) and hazardous alcohol use (26% vs 21%) but significantly different prevalence rates for lifetime hallucinogen (29% vs 15%; P < .001) and cocaine use (20% vs 14%; P < .001). At 12 months, the prevalence rates for drug abuse (P < .01), hazardous alcohol use (P < .01), and concurrent drug abuse and hazardous alcohol use (P < .05) were significantly lower than at baseline. Conclusion: Substance use and abuse decreased significantly after 12 months of EI services; EI services may be able to detect and to reduce substance use among FEP patients before it becomes a more serious disorder.
Keywords: schizophreniform / cannabis / hallucinogens / alcohol