The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis

Melissa A Weibell; Wenche Ten Velden Hegelstad; Bjørn Auestad; Jørgen Bramness; Julie Evensen; Ulrik Haahr; Inge Joa; Jan Olav Johannessen; Tor Ketil Larsen; Ingrid Melle; Stein Opjordsmoen; Bjørn Rishovd Rund; Erik Simonsen; Per Vaglum; Thomas McGlashan; Patrick McGorry; Svein Friis

doi:10.1093/schbul/sbw179

The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis

Melissa A Weibell, Wenche Ten Velden Hegelstad, Bjørn Auestad, Jørgen Bramness, Julie Evensen, Ulrik Haahr, Inge Joa, Jan Olav Johannessen, Tor Ketil Larsen, Ingrid Melle, Stein Opjordsmoen, Bjørn Rishovd Rund, Erik Simonsen, Per Vaglum, Thomas McGlashan, Patrick McGorry, Svein Friis

Department of Clinical Medicine

28 Citations (Scopus)

Abstract

Substance use is common in first-episode psychosis (FEP) and has been linked to poorer outcomes with more severe psychopathology and higher relapse rates. Early substance discontinuation appears to improve symptoms and function. However, studies vary widely in their methodology, and few have examined patients longitudinally, making it difficult to draw conclusions for practice and treatment. We aimed to investigate the relationship between substance use and early abstinence and the long-term course of illness in a representative sample of FEP patients. Out of 301 included patients, 266 could be divided into 4 groups based on substance use patterns during the first 2 years of treatment: persistent users, episodic users, stop-users and nonusers. Differences in clinical and functional measures during the follow-up period were assessed using linear mixed effects models for the analysis of repeated measures data. Patients who stopped using substances within the first 2 years after diagnosis had outcomes similar to those who had never used with fewer symptoms than episodic or persistent users. Both episodic and persistent users had lower rates of symptom remission than nonusers, and persistent users also had more negative symptoms than those who stopped using. Our findings emerge from one of very few long-term longitudinal studies examining substance use cessation in FEP with 10-year follow-up. The results convey hope that the detrimental effects of substance abuse on mental health may be significantly reversed if one stops the abuse in time. This can help patients who struggle with addiction with their motivation to embrace abstinence.

Original language	English
Journal	Schizophrenia Bulletin
Volume	43
Issue number	4
Pages (from-to)	843-851
Number of pages	9
ISSN	0586-7614
DOIs	https://doi.org/10.1093/schbul/sbw179
Publication status	Published - 1 Jul 2017

Keywords

Journal Article

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/schbul/sbw179

sbw179.pdfFinal published version, 696 KB

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472130/pdf/sbw179.pdf

Cite this

Weibell, M. A., Hegelstad, W. T. V., Auestad, B., Bramness, J., Evensen, J., Haahr, U., Joa, I., Johannessen, J. O., Larsen, T. K., Melle, I., Opjordsmoen, S., Rund, B. R., Simonsen, E., Vaglum, P., McGlashan, T., McGorry, P., & Friis, S. (2017). The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis. Schizophrenia Bulletin, 43(4), 843-851. https://doi.org/10.1093/schbul/sbw179

Weibell, MA, Hegelstad, WTV, Auestad, B, Bramness, J, Evensen, J, Haahr, U, Joa, I, Johannessen, JO, Larsen, TK, Melle, I, Opjordsmoen, S, Rund, BR, Simonsen, E, Vaglum, P, McGlashan, T, McGorry, P & Friis, S 2017, 'The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis', Schizophrenia Bulletin, vol. 43, no. 4, pp. 843-851. https://doi.org/10.1093/schbul/sbw179

@article{e1550fc5fff14e00a809e2517de210f9,

title = "The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis",

abstract = "Substance use is common in first-episode psychosis (FEP) and has been linked to poorer outcomes with more severe psychopathology and higher relapse rates. Early substance discontinuation appears to improve symptoms and function. However, studies vary widely in their methodology, and few have examined patients longitudinally, making it difficult to draw conclusions for practice and treatment. We aimed to investigate the relationship between substance use and early abstinence and the long-term course of illness in a representative sample of FEP patients. Out of 301 included patients, 266 could be divided into 4 groups based on substance use patterns during the first 2 years of treatment: persistent users, episodic users, stop-users and nonusers. Differences in clinical and functional measures during the follow-up period were assessed using linear mixed effects models for the analysis of repeated measures data. Patients who stopped using substances within the first 2 years after diagnosis had outcomes similar to those who had never used with fewer symptoms than episodic or persistent users. Both episodic and persistent users had lower rates of symptom remission than nonusers, and persistent users also had more negative symptoms than those who stopped using. Our findings emerge from one of very few long-term longitudinal studies examining substance use cessation in FEP with 10-year follow-up. The results convey hope that the detrimental effects of substance abuse on mental health may be significantly reversed if one stops the abuse in time. This can help patients who struggle with addiction with their motivation to embrace abstinence.",

keywords = "Journal Article",

author = "Weibell, {Melissa A} and Hegelstad, {Wenche Ten Velden} and Bj{\o}rn Auestad and J{\o}rgen Bramness and Julie Evensen and Ulrik Haahr and Inge Joa and Johannessen, {Jan Olav} and Larsen, {Tor Ketil} and Ingrid Melle and Stein Opjordsmoen and Rund, {Bj{\o}rn Rishovd} and Erik Simonsen and Per Vaglum and Thomas McGlashan and Patrick McGorry and Svein Friis",

note = "{\textcopyright} The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: [email protected].",

year = "2017",

month = jul,

day = "1",

doi = "10.1093/schbul/sbw179",

language = "English",

volume = "43",

pages = "843--851",

journal = "Schizophrenia Bulletin",

issn = "0586-7614",

publisher = "Oxford University Press",

number = "4",

}

TY - JOUR

T1 - The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis

AU - Weibell, Melissa A

AU - Hegelstad, Wenche Ten Velden

AU - Auestad, Bjørn

AU - Bramness, Jørgen

AU - Evensen, Julie

AU - Haahr, Ulrik

AU - Joa, Inge

AU - Johannessen, Jan Olav

AU - Larsen, Tor Ketil

AU - Melle, Ingrid

AU - Opjordsmoen, Stein

AU - Rund, Bjørn Rishovd

AU - Simonsen, Erik

AU - Vaglum, Per

AU - McGlashan, Thomas

AU - McGorry, Patrick

AU - Friis, Svein

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Substance use is common in first-episode psychosis (FEP) and has been linked to poorer outcomes with more severe psychopathology and higher relapse rates. Early substance discontinuation appears to improve symptoms and function. However, studies vary widely in their methodology, and few have examined patients longitudinally, making it difficult to draw conclusions for practice and treatment. We aimed to investigate the relationship between substance use and early abstinence and the long-term course of illness in a representative sample of FEP patients. Out of 301 included patients, 266 could be divided into 4 groups based on substance use patterns during the first 2 years of treatment: persistent users, episodic users, stop-users and nonusers. Differences in clinical and functional measures during the follow-up period were assessed using linear mixed effects models for the analysis of repeated measures data. Patients who stopped using substances within the first 2 years after diagnosis had outcomes similar to those who had never used with fewer symptoms than episodic or persistent users. Both episodic and persistent users had lower rates of symptom remission than nonusers, and persistent users also had more negative symptoms than those who stopped using. Our findings emerge from one of very few long-term longitudinal studies examining substance use cessation in FEP with 10-year follow-up. The results convey hope that the detrimental effects of substance abuse on mental health may be significantly reversed if one stops the abuse in time. This can help patients who struggle with addiction with their motivation to embrace abstinence.

AB - Substance use is common in first-episode psychosis (FEP) and has been linked to poorer outcomes with more severe psychopathology and higher relapse rates. Early substance discontinuation appears to improve symptoms and function. However, studies vary widely in their methodology, and few have examined patients longitudinally, making it difficult to draw conclusions for practice and treatment. We aimed to investigate the relationship between substance use and early abstinence and the long-term course of illness in a representative sample of FEP patients. Out of 301 included patients, 266 could be divided into 4 groups based on substance use patterns during the first 2 years of treatment: persistent users, episodic users, stop-users and nonusers. Differences in clinical and functional measures during the follow-up period were assessed using linear mixed effects models for the analysis of repeated measures data. Patients who stopped using substances within the first 2 years after diagnosis had outcomes similar to those who had never used with fewer symptoms than episodic or persistent users. Both episodic and persistent users had lower rates of symptom remission than nonusers, and persistent users also had more negative symptoms than those who stopped using. Our findings emerge from one of very few long-term longitudinal studies examining substance use cessation in FEP with 10-year follow-up. The results convey hope that the detrimental effects of substance abuse on mental health may be significantly reversed if one stops the abuse in time. This can help patients who struggle with addiction with their motivation to embrace abstinence.

KW - Journal Article

U2 - 10.1093/schbul/sbw179

DO - 10.1093/schbul/sbw179

M3 - Journal article

C2 - 28199703

SN - 0586-7614

VL - 43

SP - 843

EP - 851

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

IS - 4

ER -

The Effect of Substance Use on 10-Year Outcome in First-Episode Psychosis

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this