Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis

Carol L. M. Caton, Deborah S. Hasin, Patrick E. Shrout, Robert E. Drake, Boanerges Domínguez, Michael B. First, Sharon Samet, Bella Schanzer
2007 British Journal of Psychiatry  
The stability of the diagnostic distinction between a substance-induced psychosis and a primary psychotic disorder co-occurring with substance use is not established. Aims To describe DSM – IV diagnostic changes over 1 year and determine the predictive validity of baseline indicators of the substance-induced psychosis v. primary psychosis distinction. Method We conducted a 1-year follow-up study of 319 psychiatric emergency department admissions with diagnoses of early-phase psychosis and
more » ... nce use comorbidity. Results Of those with a baseline DSM—IV diagnosis of substance-induced psychosis, 25% had a diagnosis of primary psychosis at follow-up. These patients had poorer premorbid functioning, less insight into psychosis and greater family mental illness than patients with a stable diagnosis of substance-induced psychosis. Reclassifying change cases to primary psychoses on follow-up, key baseline predictors of the primary/substance-induced distinction at 1 year also included greater family history of mental illness in the primary psychosis group. Conclusions Further study of substance-induced psychoses should employ neuroscientific and behavioural approaches. Study findings can guide more accurate diagnoses at first treatment.
doi:10.1192/bjp.bp.105.015784 pmid:17267925 fatcat:rxsbhjzl4vgzphj3aeziyesesa