Differences between early-phase primary psychotic disorders with concurrrent substance use and substance-induced psychoses

Carol L M Caton, Robert E. Drake, Deborah S. Hasin, Boanerges Dominguez, Patrick E. Shrout, Sharon Samet, W. Bella Schanzer

Research output: Contribution to journalArticle

Abstract

Context: The distinction between a substance-induced psychosis and a primary psychotic disorder that co-occurs with the use of alcohol or other drugs is critical for understanding illness course and planning appropriate treatment, yet there has been little study and evaluation of the differences between these 2 diagnostic groups. Objective: To identify key demographic, family, and clinical differences in substance-induced psychosis and primary psychotic disorders diagnosed according to DSM-IV criteria using a research diagnostic instrument for psychiatric and substance use comorbidity. Design: Data on demographic, family, and clinical factors were gathered at baseline as part of a 3-year longitudinal study of early-phase psychosis and substance use comorbidity in New York, NY. Setting: Psychiatric emergency department admissions. Participants: The study is based on a referred sample of 400 subjects interviewed at baseline. Participants had at least 1 psychotic symptom assessed during administration of the research protocol, had used alcohol and/or other drugs within the past 30 days, and had no psychiatric inpatient history before the past 6 months. Subject race included 43.5% black, 42.0% Hispanic, and 14.5% white or other. Main Outcome Measure: Psychotic disorders defined by the DSM-IV. Results: Overall, 169 (44%) were diagnosed as having substance-induced psychosis and 217 (56%), as having primary psychosis. Significant differences were observed in all 3 domains. Multivariate analysis using logistic regression identified the following 3 key predictors as being greater in the substance-induced group: parental substance abuse (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.00-2.85), a diagnosis of dependence on any drug (OR, 9.41; 95% CI, 5.26-16.85), and visual hallucinations (OR, 2.13; 95% CI, 1.10-4.13). The key predictor of total positive and negative symptom score was greater in the primary psychosis group (OR, 0.96; 95% CI, 0.94-0.97). Conclusions: Differences in demographic, family, and clinical domains confirm substance-induced and primary psychotic disorders as distinct entities. Key predictors could help emergency clinicians to correctly classify early-phase psychotic disorders that co-occur with substance use.

Original languageEnglish (US)
Pages (from-to)137-145
Number of pages9
JournalArchives of General Psychiatry
Volume62
Issue number2
DOIs
StatePublished - Feb 2005

Fingerprint

Substance-Induced Psychoses
Psychotic Disorders
Odds Ratio
Confidence Intervals
Psychiatry
Demography
Diagnostic and Statistical Manual of Mental Disorders
Comorbidity
Alcohols
Pharmaceutical Preparations
Hallucinations
Hispanic Americans
Research
Critical Illness
Substance-Related Disorders
Longitudinal Studies
Hospital Emergency Service
Inpatients
Emergencies
Multivariate Analysis

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Differences between early-phase primary psychotic disorders with concurrrent substance use and substance-induced psychoses. / Caton, Carol L M; Drake, Robert E.; Hasin, Deborah S.; Dominguez, Boanerges; Shrout, Patrick E.; Samet, Sharon; Schanzer, W. Bella.

In: Archives of General Psychiatry, Vol. 62, No. 2, 02.2005, p. 137-145.

Research output: Contribution to journalArticle

Caton, Carol L M ; Drake, Robert E. ; Hasin, Deborah S. ; Dominguez, Boanerges ; Shrout, Patrick E. ; Samet, Sharon ; Schanzer, W. Bella. / Differences between early-phase primary psychotic disorders with concurrrent substance use and substance-induced psychoses. In: Archives of General Psychiatry. 2005 ; Vol. 62, No. 2. pp. 137-145.
@article{f7513e52ec7242208935ba801c522013,
title = "Differences between early-phase primary psychotic disorders with concurrrent substance use and substance-induced psychoses",
abstract = "Context: The distinction between a substance-induced psychosis and a primary psychotic disorder that co-occurs with the use of alcohol or other drugs is critical for understanding illness course and planning appropriate treatment, yet there has been little study and evaluation of the differences between these 2 diagnostic groups. Objective: To identify key demographic, family, and clinical differences in substance-induced psychosis and primary psychotic disorders diagnosed according to DSM-IV criteria using a research diagnostic instrument for psychiatric and substance use comorbidity. Design: Data on demographic, family, and clinical factors were gathered at baseline as part of a 3-year longitudinal study of early-phase psychosis and substance use comorbidity in New York, NY. Setting: Psychiatric emergency department admissions. Participants: The study is based on a referred sample of 400 subjects interviewed at baseline. Participants had at least 1 psychotic symptom assessed during administration of the research protocol, had used alcohol and/or other drugs within the past 30 days, and had no psychiatric inpatient history before the past 6 months. Subject race included 43.5{\%} black, 42.0{\%} Hispanic, and 14.5{\%} white or other. Main Outcome Measure: Psychotic disorders defined by the DSM-IV. Results: Overall, 169 (44{\%}) were diagnosed as having substance-induced psychosis and 217 (56{\%}), as having primary psychosis. Significant differences were observed in all 3 domains. Multivariate analysis using logistic regression identified the following 3 key predictors as being greater in the substance-induced group: parental substance abuse (odds ratio [OR], 1.69; 95{\%} confidence interval [CI], 1.00-2.85), a diagnosis of dependence on any drug (OR, 9.41; 95{\%} CI, 5.26-16.85), and visual hallucinations (OR, 2.13; 95{\%} CI, 1.10-4.13). The key predictor of total positive and negative symptom score was greater in the primary psychosis group (OR, 0.96; 95{\%} CI, 0.94-0.97). Conclusions: Differences in demographic, family, and clinical domains confirm substance-induced and primary psychotic disorders as distinct entities. Key predictors could help emergency clinicians to correctly classify early-phase psychotic disorders that co-occur with substance use.",
author = "Caton, {Carol L M} and Drake, {Robert E.} and Hasin, {Deborah S.} and Boanerges Dominguez and Shrout, {Patrick E.} and Sharon Samet and Schanzer, {W. Bella}",
year = "2005",
month = "2",
doi = "10.1001/archpsyc.62.2.137",
language = "English (US)",
volume = "62",
pages = "137--145",
journal = "JAMA Psychiatry",
issn = "2168-622X",
publisher = "American Medical Association",
number = "2",

}

TY - JOUR

T1 - Differences between early-phase primary psychotic disorders with concurrrent substance use and substance-induced psychoses

AU - Caton, Carol L M

AU - Drake, Robert E.

AU - Hasin, Deborah S.

AU - Dominguez, Boanerges

AU - Shrout, Patrick E.

AU - Samet, Sharon

AU - Schanzer, W. Bella

PY - 2005/2

Y1 - 2005/2

N2 - Context: The distinction between a substance-induced psychosis and a primary psychotic disorder that co-occurs with the use of alcohol or other drugs is critical for understanding illness course and planning appropriate treatment, yet there has been little study and evaluation of the differences between these 2 diagnostic groups. Objective: To identify key demographic, family, and clinical differences in substance-induced psychosis and primary psychotic disorders diagnosed according to DSM-IV criteria using a research diagnostic instrument for psychiatric and substance use comorbidity. Design: Data on demographic, family, and clinical factors were gathered at baseline as part of a 3-year longitudinal study of early-phase psychosis and substance use comorbidity in New York, NY. Setting: Psychiatric emergency department admissions. Participants: The study is based on a referred sample of 400 subjects interviewed at baseline. Participants had at least 1 psychotic symptom assessed during administration of the research protocol, had used alcohol and/or other drugs within the past 30 days, and had no psychiatric inpatient history before the past 6 months. Subject race included 43.5% black, 42.0% Hispanic, and 14.5% white or other. Main Outcome Measure: Psychotic disorders defined by the DSM-IV. Results: Overall, 169 (44%) were diagnosed as having substance-induced psychosis and 217 (56%), as having primary psychosis. Significant differences were observed in all 3 domains. Multivariate analysis using logistic regression identified the following 3 key predictors as being greater in the substance-induced group: parental substance abuse (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.00-2.85), a diagnosis of dependence on any drug (OR, 9.41; 95% CI, 5.26-16.85), and visual hallucinations (OR, 2.13; 95% CI, 1.10-4.13). The key predictor of total positive and negative symptom score was greater in the primary psychosis group (OR, 0.96; 95% CI, 0.94-0.97). Conclusions: Differences in demographic, family, and clinical domains confirm substance-induced and primary psychotic disorders as distinct entities. Key predictors could help emergency clinicians to correctly classify early-phase psychotic disorders that co-occur with substance use.

AB - Context: The distinction between a substance-induced psychosis and a primary psychotic disorder that co-occurs with the use of alcohol or other drugs is critical for understanding illness course and planning appropriate treatment, yet there has been little study and evaluation of the differences between these 2 diagnostic groups. Objective: To identify key demographic, family, and clinical differences in substance-induced psychosis and primary psychotic disorders diagnosed according to DSM-IV criteria using a research diagnostic instrument for psychiatric and substance use comorbidity. Design: Data on demographic, family, and clinical factors were gathered at baseline as part of a 3-year longitudinal study of early-phase psychosis and substance use comorbidity in New York, NY. Setting: Psychiatric emergency department admissions. Participants: The study is based on a referred sample of 400 subjects interviewed at baseline. Participants had at least 1 psychotic symptom assessed during administration of the research protocol, had used alcohol and/or other drugs within the past 30 days, and had no psychiatric inpatient history before the past 6 months. Subject race included 43.5% black, 42.0% Hispanic, and 14.5% white or other. Main Outcome Measure: Psychotic disorders defined by the DSM-IV. Results: Overall, 169 (44%) were diagnosed as having substance-induced psychosis and 217 (56%), as having primary psychosis. Significant differences were observed in all 3 domains. Multivariate analysis using logistic regression identified the following 3 key predictors as being greater in the substance-induced group: parental substance abuse (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.00-2.85), a diagnosis of dependence on any drug (OR, 9.41; 95% CI, 5.26-16.85), and visual hallucinations (OR, 2.13; 95% CI, 1.10-4.13). The key predictor of total positive and negative symptom score was greater in the primary psychosis group (OR, 0.96; 95% CI, 0.94-0.97). Conclusions: Differences in demographic, family, and clinical domains confirm substance-induced and primary psychotic disorders as distinct entities. Key predictors could help emergency clinicians to correctly classify early-phase psychotic disorders that co-occur with substance use.

UR - http://www.scopus.com/inward/record.url?scp=13244249917&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=13244249917&partnerID=8YFLogxK

U2 - 10.1001/archpsyc.62.2.137

DO - 10.1001/archpsyc.62.2.137

M3 - Article

C2 - 15699290

AN - SCOPUS:13244249917

VL - 62

SP - 137

EP - 145

JO - JAMA Psychiatry

JF - JAMA Psychiatry

SN - 2168-622X

IS - 2

ER -