Drugs and Psychosis Project: A multi‐centre European study on comorbidity

Baldacchino, Alex; Blair, Hannah A.; Scherbaum, Norbert; Grosse-Vehne, Eva; Riglietta, Marco; Tidone, L.; Criaco, Caterina; Marelli, Maria C.; Sommer, Borge; Tan, Liz; Little, H.J.; Ghodse, Hamid

doi:10.1111/j.1465-3362.2009.00063.x

Cited by 8 publications

(7 citation statements)

References 41 publications

(58 reference statements)

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“…This problem is difficult to address, as there is the need to compromise between inclusion criteria and recruitment of adequate numbers. It was also felt that analysis should not group the cohort into drug users and non-drug users since one aim of this study was to understand further the psychopathology and outcomes of a cannabis only using psychotic population than that with other drugs contributing in the overall picture of the cohort description (Baldacchino et al, 2009a).…”

Section: Limitations Of Study: Methodological Dilemmasmentioning

confidence: 99%

“…Reasons for non-participation and exclusion are included in Table 1. Further details of the baseline characteristics of these patients can be found elsewhere (Baldacchino et al, 2009a).…”

Section: Participantsmentioning

confidence: 99%

“…Outcomes were investigated based on the patterns of illicit substance use at baseline. Detailed information on the baseline data is reported elsewhere (Baldacchino et al, 2009a).…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes for psychotic and co-morbid patients admitted to acute psychiatric wards in four European centres – follow-up to 6 months

Baldacchino

Blair

Sommer

et al. 2012

Mental Health and Substance Use

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This study was conducted with the aim of identifying the outcome and characteristics of patients admitted to acute psychiatric wards with a diagnosis of psychotic illness and substance misuse. In this multi-centre collaborative and opportunistic study, patients were allocated into four cohorts based on the type of drug use and then were followed up 1 and 6 months later. The total PANSS score improved significantly by the 6 month follow-up in all but the cannabis using cohort, which initially had the lowest symptom level. All cohorts improved significantly in levels of general symptoms, and three out of the four groups improved in the levels of positive symptoms (the cannabis and other drug cohorts were nearing significance at p ¼ 0.02). The biggest contrast between the groups was in the levels of negative symptoms. These improved only in the non-drug using cohort; however, even with this significant improvement, levels did not reach the lower levels initially evident in the cannabis only using cohort. Psychopathology and recovery processes of psychotic patients admitted to acute psychiatric wards will differ depending on their use of illicit substances. In particular, those who use cannabis but not other illicit substances are likely to have lower levels of negative symptoms.

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Section: Limitations Of Study: Methodological Dilemmasmentioning

confidence: 99%

“…Reasons for non-participation and exclusion are included in Table 1. Further details of the baseline characteristics of these patients can be found elsewhere (Baldacchino et al, 2009a).…”

Section: Participantsmentioning

confidence: 99%

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Clinical outcomes for psychotic and co-morbid patients admitted to acute psychiatric wards in four European centres – follow-up to 6 months

Baldacchino

Blair

Sommer

et al. 2012

Mental Health and Substance Use

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“…[12345] Cannabis is a known risk factor for schizophrenia, although the exact neurobiological process through which the effects on psychosis occur is not well understood. Cannabis is also of particular interest in both the first-episode psychosis (FEP)[67] and the ultra high risk (UHR) populations.…”

Section: Transition To Psychosis and Cannabismentioning

confidence: 99%

Cannabis and psychosis: Neurobiology

Shrivastava¹,

Johnston

Terpstra

et al. 2014

Indian J Psychiatry

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Cannabis is a known risk factor for schizophrenia, although the exact neurobiological process through which the effects on psychosis occur is not well-understood. In this review, we attempt to develop and discuss a possible pathway for the development of psychosis. We examine the neurobiological changes due to cannabis to see if these changes are similar to those seen in schizophrenic patients the findings show similarities; however, these mere similarities cannot establish a ‘cause-effect’ relationship as a number of people with similar changes do not develop schizophrenia. Therefore, the ‘transition-to-psychosis’ due to cannabis, despite being a strong risk factor, remains uncertain based upon neurobiological changes. It appears that other multiple factors might be involved in these processes which are beyond neurobiological factors. Major advances have been made in understanding the underpinning of marijuana dependence, and the role of the cannabinoid system, which is a major area for targeting medications to treat marijuana withdrawal and dependence, as well as other addictions is of now, it is clear that some of the similarities in the neurobiology of cannabis and schizophrenia may indicate a mechanism for the development of psychosis, but its trajectories are undetermined.

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“…For instance, Katz et al (2008) found that comorbid patients were younger than nonabusers, and that they were more often males, unmarried, and of Western origin. In a multi-center European study about comorbidity between drugs and psychosis, researchers found that substance users were younger than non-users but that they did not significantly differ with respect to the other socio-demographic measures (Baldacchino et al, 2009). A comparison of patients with comorbid SUD, patients with SUD but no other mental disorder, and patients with mental disorders but no SUD showed several demographic and clinical differences and a higher risk for suicide in DD patients than in the other two groups .…”

mentioning

confidence: 99%

Sex Differences in First-Admission Psychiatric Inpatients With and Without a Comorbid Substance Use Disorder

Gramaglia

Bert²,

Lombardi³

et al. 2014

Journal of Addiction Medicine

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Objectives : We assessed gender differences in a sample of first-admission psychiatric inpatients with and without comorbid Substance Use Disorder (SUD) to identify possible risk factors and targets for gender-tailored treatment interventions. Methods:A retrospective study of first admissions to the University Psychiatry Ward, "Maggiore della Carità" Hospital, Novara, Italy, between 2003 and2012. The clinical charts of patients with (N=362) and without comorbid SUD (N=1111) were reviewed.Results: Differences in employment, educational, and marital statuses were found between male and female psychiatric patients with and without comorbid SUD. Having a degree was a protective factor for males, while it was a risk factor for females. Being divorced and having family problems were both risk factors for comorbidity in females. Regarding the diagnosis, results overlapped in males and females, and both affective and other disorders were risk factors for a comorbid SUD. Conclusions:A significant difference between male and female psychiatric patients with a comorbid SUD was the males' overall poorer psychosocial functioning. Marital status and family problems were risk factors for comorbid SUD in females. Both males and females showed various pathways of access to and choices of substances and, eventually, experienced different impacts on their lives. Hospitalization might help to set up a targeted intervention for patients with comorbidity, while accounting for gender differences. With respect to males, a treatment approach focused on the substance alone might help improve their functioning; females might have a greater benefit from a treatment approach focused on distress, family problems, and relational issues. 3The co-occurrence of severe mental health conditions with a drug abuse or dependence disorder (substance use disorder, SUD) is referred to as Dual Diagnosis (DD). Psychiatric patients with a comorbid SUD represent up to half of the patients in most mental health treatment systems, and comorbidity is associated with several significant implications with respect to symptoms, course, morbidity, treatment effectiveness and adherence, social issues (e.g. legal problems), use of psychiatric and emergency room services, and regrettably, with common negative outcomes (Owen et al., 1996; Kovasznay et al., 1997; Margolese et al., 2004; Ziedonis, 2004; Tosato et al., 2013).The co-morbidity rate of SUD and major mental problems in Europe is generally not as high as in US according to various studies, and it ranges from 20% to 65% (Kessler et al., 1996;Teesson et al., 2000; Mueser et al., 2003). Additionally, comorbidity rates between psychiatric illness and SUD appear to be particularly high in inpatient, crisis team (38-50%), and forensic settings (Drake et al., 2004).Comparisons between psychiatric patients with a comorbid SUD and those without show differences in socio-demographic, clinical, substance-related characteristics, and other background variables. For instance, Katz et al. (2008) found that com...

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Drugs and Psychosis Project: A multi‐centre European study on comorbidity

Abstract: Cross-cultural differences in the sociodemographic characteristics of the comorbid patient population give us a better insight into this heterogenous group.

Cited by 8 publications

References 41 publications

Clinical outcomes for psychotic and co-morbid patients admitted to acute psychiatric wards in four European centres – follow-up to 6 months

Clinical outcomes for psychotic and co-morbid patients admitted to acute psychiatric wards in four European centres – follow-up to 6 months

Cannabis and psychosis: Neurobiology

Sex Differences in First-Admission Psychiatric Inpatients With and Without a Comorbid Substance Use Disorder

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