Does substance use disorder affect clinical expression in first-hospitalization patients with schizophrenia? Analysis of a prospective cohort

Picci, Rocco Luigi; Versino, Elisabetta; Oliva, Francesco; Giaretto, Roberta M.; Ostacoli, Luca; Trivelli, Federica; Venturello, S.; Furlan, Pier Maria

doi:10.1016/j.psychres.2013.08.043

Cited by 17 publications

(12 citation statements)

References 71 publications

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“…It may precede or follow the onset of psychotic symptoms or the onset of both may coincide (19)(20)(21). Patients with SUD often show worse pre-morbid adjustment, an earlier schizophrenic onset (21), and worse psychotic symptoms than patients without SUD (22). Schizophrenia-SUD comorbidity decreases treatment adherence (23,24), worsens psychosis outcomes (25), and increases the odds for relapse (26)(27)(28), rehospitalisation (27), and suicide attempt (29).…”

Section: Introductionmentioning

confidence: 99%

Aripiprazole Long-Acting Injection During First Episode Schizophrenia—An Exploratory Analysis

Giordano¹,

Tomassini²,

Cuomo

et al. 2020

Front. Psychiatry

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Background: Long-acting injectable (LAI) aripiprazole was found to be efficacious in schizophrenia. In common clinical practice, the use of LAIs is often restricted to chronic patients with frequent relapses and poor adherence. Recently, some investigators advanced the idea of early LAI use also in young people with schizophrenia at their first psychotic episode (FEP). Objective: Our study aimed to assess the effect of LAI aripiprazole once monthly (AOM) in the treatment of FEP in patients aged 18-26 years. Methods: We included 50 patients with DSM-5 schizophrenia as assessed with SCID, and used the Clinical Global Impressions Scale-Severity of Illness (CGI-S) and the Positive and Negative Syndrome Scale (PANSS) to assess symptom severity and the World Health Organization Quality of Life (WHOQOL), the Short Form Health Survey (SF-36) and the Personal and Social Performance Scale (PSP) to assess quality of life (QoL) and global health perception at baseline and 3, 6, 9, and 12 months after the first AOM injection. Results: AOM was associated with a progressive improvement, compared to baseline, of both positive (p < 0.001) and negative (p < 0.001) symptoms and in general psychopathology (p < 0.001) and decrease in global severity (p < 0.001). We also observed progressive improvement in QoL and social and personal functioning. Treatment adherence was 78% at study endpoint. Our results support that AOM may improve psychotic symptoms, QoL and social functioning in young FEP patients. Further studies should compare AOM to its oral formulation in the treatment of young patients with schizophrenia at the outset of their illness.

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Section: Introductionmentioning

confidence: 99%

Aripiprazole Long-Acting Injection During First Episode Schizophrenia—An Exploratory Analysis

Giordano¹,

Tomassini²,

Cuomo

et al. 2020

Front. Psychiatry

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“…CM is also associated with the occurrence of comorbid disorders, such as posttraumatic stress disorder (PTSD) and substance abuse, and with a higher severity of depressive and dissociative symptoms in patients with a psychotic disorder . These comorbidities as well as the severity of depressive symptoms come along with a worse prognosis and with poorer treatment outcomes . CM is further related to alterations of the HPA axis, with a tendency towards lower levels of glucocorticoids in psychosis patients who have been exposed to CM .…”

Section: Introductionmentioning

confidence: 99%

Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta‐analysis

Thomas

Höfler

Schäfer

et al. 2019

Acta Psychiatr Scand

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Objective Childhood maltreatment (CM) plays an important role in the aetiology and course of psychotic disorders and is associated with characteristics that could be relevant for treatment. We aimed to conduct a systematic review and meta‐analysis on the association between CM and treatment outcome in psychotic disorders. Methods Treatment outcome was defined as change in psychotic symptoms or in social or occupational functioning between first and last reported measurement in the course of a pharmacological and/or psychological treatment. Results Twelve treatment results from seven studies (636 patients, average treatment duration: 59.2 weeks) were included. CM was related to poorer treatment outcomes in psychotic disorders (OR = 1.51, 95% CI = [1.08, 2.10]). There is evidence that this association might increase with illness duration and increasing age and might be stronger in schizophrenia samples. Conclusions Childhood maltreatment is highly understudied with regard to treatment outcome in psychotic disorders. The need for more studies is emphasized by the fact that this meta‐analysis reveals evidence for a poorer treatment response in patients with CM. If this association is confirmed, the identification of patients with CM and the consideration of associated clinical and biological conditions could contribute to improve treatment outcome in psychotic disorders.

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“…In addition to all above, various clinical and patient related factors have been found to be associated with long psychiatric hospitalizations. Schizophrenia or non-affective psychosis [ 9 , 23 , 24 ], the severity of mental illness [ 29 ], presence of comorbid physical illness [ 30 , 31 ] and comorbid substance use disorders [ 29 ], have been found to predict lengthier LOS. Involuntary admissions and a history of recurrent hospitalizations have also been linked to longer LOS [ 24 , 27 , 28 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Length of stay of psychiatric admissions in a general hospital in Ethiopia: a retrospective study

Addisu

Wondafrash

Chemali

et al. 2015

Int J Ment Health Syst

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BackgroundIn sub-Saharan Africa, the number of psychiatric beds per population is disproportionately low. Moreover, there is a lack of data regarding the patterns of psychiatric admissions and the factors leading to long psychiatric hospitalization in this region. This study aimed to investigate the average length of stay (LOS) and the factors associated with prolonged hospitalizations.MethodsA ten-year retrospective chart review of patients admitted to the psychiatric facility of Jimma University Specialized Hospital in southwest Ethiopia was conducted. The medical charts of 846 admissions spanning the period from January 2001 to December 2010 were reviewed. LOS greater than 21 days was considered as a cut-off point for lengthier stay. Bivariate and multivariable logistic regression analyses were conducted to identify factors independently associated with LOS.ResultsThe most common discharge diagnoses were schizophrenia and other psychotic disorders (27.6%), and bipolar disorder (23.4%). A global clinical rating taken on discharge showed 90.3% improved outcome. The median (25th, 75th percentiles) LOS was 22 (15, 36) days. Patients with major depressive disorder [aOR = 0.51 (0.32 – 0.81)] and brief psychotic disorder [aOR = 0.52 (0.33 – 0.84)] were less likely than patients with schizophrenia and other psychotic disorders to have long hospital stays. Presence of extrapyramidal side-effects and out of pocket expenditures predicted LOS.ConclusionsPatients with psychoses and bipolar disorder have lengthier hospital stays burdening the cost of care of psychiatric treatment in a general hospital setting. Our findings call for identifying those cases quickly, attending to their needs with evidence-based efficient treatment and for improving and developing an aftercare system such that the utilization of acute inpatient beds, already a scarce resource, could achieve higher efficiency.

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Does substance use disorder affect clinical expression in first-hospitalization patients with schizophrenia? Analysis of a prospective cohort

Cited by 17 publications

References 71 publications

Aripiprazole Long-Acting Injection During First Episode Schizophrenia—An Exploratory Analysis

Aripiprazole Long-Acting Injection During First Episode Schizophrenia—An Exploratory Analysis

Childhood maltreatment and treatment outcome in psychotic disorders: a systematic review and meta‐analysis

Length of stay of psychiatric admissions in a general hospital in Ethiopia: a retrospective study

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