Impact of the course of substance use disorder on symptomatic and functional outcome in first-episode psychosis

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Objectives: Prevalence of substance use disorders (SUD) in First-Episode Psychosis (FEP) is high and usually associated with poor clinical outcome. Our study examined the impact of the course of SUD on outcome in a sample of youth with FEP. Methods: A prospective longitudinal study of 2 years follow-up of 212 FEP, between 18 to 30 years old, admitted to an early psychosis program in Montreal. Results: Cannabis is the first substance abused (42.9% at baseline), followed by alcohol (19.3%). The SUD rate decreases over time by approximately 30%, especially cannabis. Subjects with persistent SUD at 1 and 2 years follow-up have more symptoms and have a worse functional outcome. The Outcomes of those with remitted SUD is somewhat similar to those who never had a SUD. Patients with an active SUD during follow-up were heavier users of emergency and hospitalization services compared those who had never had a SUD or who stopped. Persistence of SUD was associated with more severe dependence, homelessness and cluster B personality traits or disorders, Those who stopped misuse were rather living with family and supported financially by them. Conclusions: A specific intervention for co-morbidity during the first years, targeting those with predictors of persistence, could increase the proportion of youth with FEP who stop substance abuse/dependency and possibly improve their outcome.

Poster First Author: 
Amal Abdel-Baki
Additional Authors: 
Clairélaine Ouellet-Plamondon
Conference Presented At: 
IAYMH 2015
Poster Date: 
October, 2015
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