The impact of substance use at psychosis onset on First Episode Psychosis course: Results from a 1 year follow-up study in Bologna

Tarricone, Ilaria; Boydell, Jane; Panigada, Serena; Allegri, Fabio; Marcacci, Thomas; Minenna, Maria Gabriella; Kokona, A.; Triolo, Federico; Storbini, Viviana; Michetti, R.; Morgan, Craig; Forti, Marta Di; Murray, Robin M.; Berardi, Domenico

doi:10.1016/j.schres.2014.01.014

Cited by 15 publications

(8 citation statements)

References 18 publications

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“…The proportion of participants who were hospitalized during the past 12 months ranged from 8% to 41% . Studies including relative measures showed frequency of hospital admission two to eight times that of comparison groups not using illicit drugs . Again, studies of people who inject drugs in rural Taiwan and older people who use cannabis in the United States were exceptions, showing similar frequencies of hospital admission to the general population .…”

Section: Resultsmentioning

confidence: 98%

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Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Lewer

Freer

King³

et al. 2020

Addiction

121

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Aims To summarize evidence on the frequency and predictors of health-care utilization among people who use illicit drugs. Design Systematic search of MEDLINE, EMBASE and PsychINFO for observational studies reporting healthcare utilization published between 1 January 2000 and 3 December 2018. We conducted narrative synthesis and meta-analysis following a registered protocol (identifier: CRD42017076525). Setting and participants People who use heroin, powder cocaine, crack cocaine, methamphetamine, amphetamine, ecstasy/3,4-methylenedioxymethamphetamine (MDMA), cannabis, hallucinogens or novel psychoactive substances; have a diagnosis of 'substance use disorder'; or use drug treatment services. Measurements Primary outcomes were the cumulative incidence (risk) and rate of care episodes in three settings: primary care, hospital admissions (in-patient) and emergency department (ED).Findings Ninety-two studies were included, 84% from North America and Australia. Most studies focused on people using heroin, methamphetamine or crack cocaine, or who had a diagnosis of drug dependence. We were able to conduct a meta-analysis of rates across 25 studies reporting ED episodes and 25 reporting hospital admissions, finding pooled rates of 151 [95% confidence interval (CI) = 114-201] and 41 (95% CI = 30-57) per 100 person-years, respectively; on average 4.8 and 7.1 times more often than the general population. Heterogeneity was very high and was not explained by drugs used, country of study, recruitment setting or demographic characteristics. Predictors of health-care utilization were consistent across studies and included unstable housing, drug injection and mental health problems. Opioid substitution therapy was consistently associated with reduced ED presentation and hospital admission. There was minimal research on health-care utilization by people using ecstasy/MDMA, powder cocaine, hallucinogens or novel psychoactive substances.Conclusions People who use illicit drugs are admitted to emergency department or hospital several times more often than the general population.

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Section: Resultsmentioning

confidence: 98%

“…ED presentation was consistently associated with regular or recent injecting , sex work, diagnosed hepatitis C , diagnosed HIV , female sex , homelessness or unstable housing , crack cocaine or stimulant use , alcohol use , polydrug use and mental health problems .…”

Section: Resultsmentioning

confidence: 99%

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Lewer

Freer

King³

et al. 2020

Addiction

121

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“…Use of illicit drugs is common in non-affective psychosis (ICD-10 F20–29; ( 1 )), usually seen in about half of the patients; 40–60%, ranging from 10 to 70% ( 2 – 9 ). Illicit drug use in psychosis has clinical implications and has been associated with more relapse and re-hospitalizations, poorer social functioning, medication non-adherence, heightened suicide risk, increased treatment needs, and worse clinical outcomes ( 10 – 17 ). However, there are few clinical differences in relation to symptoms and family loading between drug-using and non-drug-using patients ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability

et al. 2014

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There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings

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“…It is clear that THC can cause acute psychotic symptoms, such as paranoia, in a dose-dependent manner (D'Souza et al, 2004;Murray et al, 2013), and those with a psychotic illness who do not stop using cannabis have a poorer prognosis on average than those who do (Tarricone et al, 2014;Alvarez-Jimenez et al, 2012), controlling for other substance use (Foti et al, 2010). What is somewhat controversial is whether to draw causal inference from the now well-replicated finding from large, prospective, longitudinal, epidemiologic studies that cannabis use, particularly heavy adolescent use of high potency cannabis, is associated with increased odds of developing schizophrenia (Andreasson et al, 1987;Arseneault et al, 2002;Di Forti et al, 2009, 2013Fergusson et al, 2003;Giordano et al, 2014;Large et al, 2011;van Os et al, 2002;Zammit et al, 2002;Stefanis et al, 2014).…”

Section: Psychotic Disorders Eden Evinsmentioning

confidence: 99%

Does Cannabis Cause, Exacerbate or Ameliorate Psychiatric Disorders? An Oversimplified Debate Discussed

Haney

Evins

2015

Neuropsychopharmacol

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There have been extensive policy shifts in the legality of recreational and therapeutic use of cannabis in the United States, as well as a steady increase in the number of people using the drug on a regular basis. Given these rapid societal changes, defining what is known scientifically about the consequences of cannabis use on mental health takes on added public health significance. The purpose of this circumspectives piece is to discuss evidence of cannabis' effects on two psychiatric conditions: post-traumatic stress disorder and psychotic disorders. Dr Haney and Dr Evins will discuss two viewpoints regarding the benefit and harm of cannabis use for these conditions, while outlining what remains unproven and requires further testing to move the field forward.

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The impact of substance use at psychosis onset on First Episode Psychosis course: Results from a 1 year follow-up study in Bologna

Cited by 15 publications

References 18 publications

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

Frequency of health‐care utilization by adults who use illicit drugs: a systematic review and meta‐analysis

The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability

Does Cannabis Cause, Exacerbate or Ameliorate Psychiatric Disorders? An Oversimplified Debate Discussed

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