Prior admissions with stimulant disorder, but not a prior cannabis disorder diagnosis, are a negative prognostic sign in first-episode psychosis according to new research in the British Journal of Psychiatry. “Young people with substance comorbidities may have both the best and worst of outcomes, depending on whether problematic substance use is discontinued,” the authors note.
Sara, G., Burgess, P., Malhi, G., Whiteford, H., Hall, W., Cannabis and stimulant disorders and readmission 2 years after first-episode psychosis. British Journal of Psychiatry. Online February 27, 2014. doi: 10.1192/bjp.bp.113.135145
Drug abuse does not always lead to psychosis readmission (Medwire News)
Conclusions
Prior admissions with stimulant disorder may be a negative prognostic sign in first-episode psychosis. Drug use diagnoses at baseline may be a good prognostic sign IF THEY ARE IDENTIFIED AND CONTROLLED.
This requires psych hospitals to accurately assess the patient’s actual drug history. Not just use the toxicology report as the gospel. But most p-docs do not want to thoroughly interview each pt, nor do they want to interview or contact the family members (despite the Hipaa waived so the designated family member(s) have that right). It’s instead rush to judge, label and medicate. Psych hospitals should employ Addiction Specialists to be on staff who have the expertise to help young patients to understand how even “recreational” use of substances ( for my son it was cannabis mostly) can alter their brain health . With the present paradigm of care, there is no interest in understanding the root cause(s) of the negative life experiences that lead people into substance use. So, there is no sincere interest in finding the trigger to the psychosis. These are the changes a compassionate MH system would do if true recovery and wellness were the goals. Sadly, IMO, having watched as a parent, the system needs a complete overhaul. Until then, more precious lives will be lost………………………………