Substance-Induced Psychoses: A Critical Review of the Literature

Fiorentini, A.; Volonteri, L.S.; Dragogna, Filippo; Rovera, Chiara; Maffini, M.; Mauri, Massimo C.; Altamura, Carlo

doi:10.2174/1874473711104040228

Cited by 80 publications

(56 citation statements)

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“…However, there are other contributing factors for agitated behavior in patients with underlying psychotic disorders which can either be present or not at each episode of acute agitation. Other conditions, such as substance use disorders or iatrogenic causes, may concur as well [5-7]. …”

Section: Introductionmentioning

confidence: 99%

State of Acute Agitation at Psychiatric Emergencies in Europe: The STAGE Study

San¹,

Marksteiner²,

Zwanzger³

et al. 2016

CPEMH

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Background:Agitation is an array of syndromes and types of behaviors that are common in patients with psychiatric disorders. In Europe, the estimation of prevalence of agitation has been difficult due to the lack of standard studies or systematic data collection done on this syndrome.Objective:An observational, cross-sectional, multicenter study aimed to assess the prevalence of agitation episodes in psychiatric emergencies in different European countries.Method:For 1 week, all episodes of acute agitation that were attended to at the psychiatric emergency room (ER) or Acute Inpatient Unit (AIU) in the 27 participating centers were registered. The clinical characteristics and management of the agitation episode were also described. A descriptive analysis was performed.Results:A total of 334 agitation episodes out of 7295 psychiatric emergencies were recorded, giving a prevalence rate of 4.6% (95% CI: 4.12-5.08). Of them, 172 [9.4% (95% CI: 8.2-10.9)] were attended at the ER and 162 [2.8% (95% CI: 2.4-3.3)] at AIU. Only data from 165 episodes of agitation (those with a signed informed consent form) was registered and described in this report. The most common psychiatric conditions associated with agitation were schizophrenia, bipolar disorder and personality disorder. The management of agitation included from non-invasive to more coercive measures (mechanical, physical restraint or seclusion) that were unavoidable in more than half of the agitation episodes (59.5%).Conclusion:The results show that agitation is a common symptom in the clinical practice, both in emergency and inpatient psychiatric departments. Further studies are warranted to better recognize (using a standardized definition) and characterize agitation episodes.

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Section: Introductionmentioning

confidence: 99%

State of Acute Agitation at Psychiatric Emergencies in Europe: The STAGE Study

San¹,

Marksteiner²,

Zwanzger³

et al. 2016

CPEMH

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“…Too, what complicates the situation further, are data which show that about 50% of the patients who suffer from schizophrenia are also substance abusers at some time during their illness [45,46]. It is now known that substances with psychomimetic properties such as cocaine are used and abused worldwide and consumption of such substances can and will induce psychotic reactions including primary psychotic disease [47,48,49,50,51,52,53,54,55,56,57,58]. …”

Section: Introductionmentioning

confidence: 99%

Sex-Specific Brain Deficits in Auditory Processing in an Animal Model of Cocaine-Related Schizophrenic Disorders

Broderick

Rosenbaum

2013

Brain Sciences

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Cocaine is a psychostimulant in the pharmacological class of drugs called Local Anesthetics. Interestingly, cocaine is the only drug in this class that has a chemical formula comprised of a tropane ring and is, moreover, addictive. The correlation between tropane and addiction is well-studied. Another well-studied correlation is that between psychosis induced by cocaine and that psychosis endogenously present in the schizophrenic patient. Indeed, both of these psychoses exhibit much the same behavioral as well as neurochemical properties across species. Therefore, in order to study the link between schizophrenia and cocaine addiction, we used a behavioral paradigm called Acoustic Startle. We used this acoustic startle paradigm in female versus male Sprague-Dawley animals to discriminate possible sex differences in responses to startle. The startle method operates through auditory pathways in brain via a network of sensorimotor gating processes within auditory cortex, cochlear nuclei, inferior and superior colliculi, pontine reticular nuclei, in addition to mesocorticolimbic brain reward and nigrostriatal motor circuitries. This paper is the first to report sex differences to acoustic stimuli in Sprague-Dawley animals (Rattus norvegicus) although such gender responses to acoustic startle have been reported in humans (Swerdlow et al. 1997 [1]). The startle method monitors pre-pulse inhibition (PPI) as a measure of the loss of sensorimotor gating in the brain's neuronal auditory network; auditory deficiencies can lead to sensory overload and subsequently cognitive dysfunction. Cocaine addicts and schizophrenic patients as well as cocaine treated animals are reported to exhibit symptoms of defective PPI (Geyer et al., 2001 [2]). Key findings are: (a) Cocaine significantly reduced PPI in both sexes. (b) Females were significantly more sensitive than males; reduced PPI was greater in females than in males. (c) Physiological saline had no effect on startle in either sex. Thus, the data elucidate gender-specificity to the startle response in animals. Finally, preliminary studies show the effect of cocaine on acoustic startle in tandem with effects on estrous cycle. The data further suggest that hormones may play a role in these sex differences to acoustic startle reported herein.

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“…It is also arguable that a difference in the clinical history of the two samples (SCZ - CA and SCZ + CA vs. SIPD) may account for our PET results; schizophrenic patients tend to have a longer and more continuous medication history compared to SIPD, which is more likely linked with poor adherence to medications and nonchronic prescriptions [4]. …”

Section: Discussionmentioning

confidence: 99%

“…Several hypotheses have been put forward to explain the relationship between schizophrenia and substance abuse [4]. Despite the high prevalence and the proposed impact of cannabis abuse as a relevant risk factor for the development of psychosis, particularly schizophrenia, there is still little knowledge about the influence of substance abuse on brain morphology and metabolism.…”

Section: Introductionmentioning

confidence: 99%

Brain Metabolism in Substance-Induced Psychosis and Schizophrenia: A Preliminary PET Study

et al. 2014

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Introduction: The relation between schizophrenia and cannabis abuse has been widely discussed from etiopathogenetic, psychopathological and neurometabolic points of view. Relatively little has been written about the differences between schizophrenia with co-occurrent cannabis abuse and substance-induced psychotic disorder (SIPD). Given these premises, our study aims to investigate the psychopathological and neurometabolic features of these clinical entities. Methods: We enrolled patients experiencing an acute psychotic episode, affected either by schizophrenia with or without cannabis abuse (SCZ +/- CA; n = 5 and n = 5, respectively) with recent onset (<5 years of illness) or by SIPD (n = 6), as diagnosed by the Structured Clinical Interview for DSM-IV Axis I. Patients affected by SIPD were all cannabis abusers. All patients were assessed with the PANSS (Positive and Negative Scale for Schizophrenia), urinary toxicological tests and brain 18-FDG-PET scanning in resting condition. Statistical analysis (ANOVA) was performed with Statistical Parametric Mapping SPM8 and Scenium software. Results: Bilateral hypermetabolism in the posterior cingulum and the precuneus (p < 0.001) was observed in SIPD patients compared to patients with schizophrenia, with or without cannabis abuse. Conclusions: Our preliminary PET findings suggest that substance abuse may cause increased brain metabolism in patients with induced psychosis but not in those with schizophrenia. These differences in brain metabolism were found in the posterior cingulum and precuneus, which are two core regions of the default mode network in humans. © 2014 S. Karger AG, Basel

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Substance-Induced Psychoses: A Critical Review of the Literature

Cited by 80 publications

References 0 publications

State of Acute Agitation at Psychiatric Emergencies in Europe: The STAGE Study

State of Acute Agitation at Psychiatric Emergencies in Europe: The STAGE Study

Sex-Specific Brain Deficits in Auditory Processing in an Animal Model of Cocaine-Related Schizophrenic Disorders

Brain Metabolism in Substance-Induced Psychosis and Schizophrenia: A Preliminary PET Study

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