Substance abuse and psychosis

Cannabis and Psychosis

Psychosis and cannabis use may overlap in multiple ways in young people. Research suggests that cannabis use increases risk for having psychotic symptoms, both attenuated (subthreshold) and acute. Cannabis use may also exacerbate psychosis symptoms among young people with underlying psychosis risk and psychotic disorders. Although there are suggestions for treating co-occurring psychosis and cannabis use in young people (e.g., incorporating cannabis use assessment and treatment strategies into specialized early psychosis care), there are many gaps in clinical trial research to support evidence-based treatment of these overlapping concerns.

Life time use of illicit substances among adolescents and young people hospitalized in psychiatric hospital

Adolescents are known to be particularly vulnerable, compared to children and adults, to initiation of substance use and progression to problematic use. This study aimed to examine the prevalence and type of illicit drug use in a population of adolescents and young adults who were hospitalized in a psychiatric hospital. The purpose of the study was also to find the link between age, sex, type of admission and particular mental disorders and using psychoactive substances at least once in a lifetime. A 12-month retrospective cross-sectional analysis of medical records compiled for adolescent and youth psychiatric patients who had been admitted to the Regional Psychiatric Hospital in Olsztyn, Poland, between October 1, 2018, and September 30, 2019, was conducted. After analyzing the available medical records, 506 cases were included and analyzed. Data for the study were collected in an Excel spreadsheet from discharge reports, including data from psychiatric examinations, especially anamnesis. Subsequently, statistical calculations were performed. Lifetime prevalence of any illicit substance use (34.0%) was common. The most frequently used drug was Cannabis (29.2%), the next New Psychoactive Substance-NPS (14.2%) and Amphetamine (13.0%). The higher number of people declaring to take illicit substances was proportional to the increasing age. Except for the group 10-15 years, the subject group was dominated by males. The highest, statistically significant percentage of patients who declared taking illicit substances in general, was found in people with diagnoses F20-F29 (schizophrenia, schizotypal and delusional disorders) (55%), additionally, we found a statistically significant association between NPS use and these diagnoses. Only in the group of patients diagnosed with eating disorders no one declared taking psychoactive substances. However, the correlation between taking illicit drugs and the subgroups with diagnosed psychiatric diseases should be treated with caution because of the small sample size in some cases. Our findings have shown the significant prevalence of the phenomenon in this population. These data highlight the need to explore this population at high risk carefully.

Cannabis and Psychosis

Psychosis and cannabis use may overlap in multiple ways in young people. Research suggests that cannabis use increases risk for having psychotic symptoms, both attenuated (subthreshold) and acute. Cannabis use may also exacerbate psychosis symptoms among young people with underlying psychosis risk and psychotic disorders. Although there are suggestions for treating co-occurring psychosis and cannabis use in young people (e.g., incorporating cannabis use assessment and treatment strategies into specialized early psychosis care), there are many gaps in clinical trial research to support evidence-based treatment of these overlapping concerns.

Schizophrenia and Psychosis: Diagnosis, Current Research Trends, and Model Treatment Approaches with Implications for Transitional Age Youth

This article reviews the current state of diagnosis and treatment of schizophrenia, describing the recent proliferation of research in high-risk psychosis spectrum conditions, which are different from childhood-onset and early onset schizophrenia, and findings of psychotic-like experiences in the normal population. Taken from adult and childhood literature, clinical quandaries in accurate diagnosis, and treatment gaps in co-occurring, or sometimes confounding, conditions are discussed. Thoughts on the impact of schizophrenia on an emerging adulthood trajectory are offered. Recent best practices in the treatment of schizophrenia are consistent with a recovery-oriented model of mental health services for transitional age youth.

A retrospective analysis focusing on a group of patients with dual diagnosis treated by both mental health and substance use services

OBJECTIVE

To highlight which demographic, familial, premorbid, clinical, therapeutic, rehabilitative, and assistance factors were related to dual diagnosis, which, in psychiatry, means the co-occurrence of both mental disorder and substance use in the same patient.

METHODS

Our sample (N=145) was chosen from all outpatients with a dual diagnosis treated from January 1, 2012 to July 31, 2012 by both the Mental Health Service and the Substance Use Service of Modena and Castelfranco Emilia, Italy. Patients who dropped out during the study period were excluded. Demographic data and variables related to familial and premorbid history, clinical course, rehabilitative programs, social support and nursing care, and outcome complications were collected. The patients' clinical and functioning conditions during the study period were evaluated.

RESULTS

Our patients were mostly men suffering from a cluster B personality disorder. Substance use was significantly more likely to precede psychiatric disease (P<0.001), and 60% of the sample presented a positive familial history for psychiatric or addiction disease or premorbid traumatic factors. The onset age of substance use was related to the period of psychiatric treatment follow-up (P<0.001) and the time spent in rehabilitative facilities (P<0.05), which, in turn, was correlated with personality disorder diagnosis (P<0.05). Complications, which presented in 67% of patients, were related to the high number of psychiatric hospitalizations (P<0.05) and professionals involved in each patient's treatment (P<0.05). Males more frequently presented familial, health, and social complications, whereas females more frequently presented self-threatening behavior (P<0.005).

CONCLUSION

It was concluded that the course of dual diagnosis may be chronic, severe, and disabling, requiring many long-term therapeutic and rehabilitative programs to manage various disabilities.