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The association between substance misuse and first-episode psychosis in a defined UK geographical area during the 1990s

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Abstract

Objective

The aim of this study was to examine the prevalence of all substance use disorders (SUD) and cannabis-specific SUDs reported in two first-episode epidemiological studies, conducted in the same catchment area, 5 years apart.

Methods

The prevalence of schizophrenia in Nottingham and Aetiology and Ethnicity of Schizophrenia and Other Psychoses studies included all people with a first-episode of psychosis between 1992 and 1994 and 1997 and 1999, respectively. Those individuals with a comorbid diagnosis of a SUD (ICD-10 harmful use or dependence) were identified.

Results

An upward (but not statistically significant) trend in all SUDs was found for the first-episode study population as a whole, between the two cohorts (11.9–18.2%). When analysed by age, a significant increase in cannabis-specific SUDs was observed for all first-episode cases aged 16–29 between cohorts (3.2–10.6%). When analysed by age and gender, a significant increase in all SUDs was apparent for female first-episode patients aged 16–29 between cohorts (6.1–24.2%), this same increase was not seen in male patients.

Conclusions

Illegal drug misuse is common in patients with a first-episode of psychosis. However, most concerning is that when both age and gender are considered, females with a first-episode of psychosis aged 16–29 show a highly significant rise in the prevalence of all SUDs over the 1990s. More recent drug use data from England and Wales shows that the prevalence of drug use in the 21st century is declining; further epidemiological studies are required to determine whether this is also the case in young female first-episode psychosis populations.

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Authors and Affiliations

  1. Division of Psychiatry, Institute of Mental Health, The Sir Colin Campbell Building, University of Nottingham Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK

    Kim Donoghue & Gillian A. Doody

  2. The Mandala Centre, Gregory Boulevard, Nottingham, UK

    Ian Medley

  3. Nottinghamshire Healthcare NHS Trust, Duncan Macmillan House, Porchester Road, Mapperley, Nottingham, UK

    John Brewin

  4. Division of Psychiatry, University of Nottingham, A Floor, Queens Medical Centre, Nottingham, UK

    Cristine Glazebrook

  5. The Stein Centre, St Catherine’s Hospital, Derby Road, Birkenhead, UK

    Peter Mason

  6. Perinatal Mental Health Service, Department of Psychiatry, Southern General Hospital, 1345 Govan Road, Glasgow, Scotland, UK

    Roch Cantwell

  7. Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Box 789, Cambridge, UK

    Peter B. Jones

  8. Academic Unit of Psychiatry, University of Bristol, Cotham House, Cotham Hill, Bristol, UK

    Glynn Harrison

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  1. Kim Donoghue
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  2. Ian Medley
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  3. John Brewin
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  4. Cristine Glazebrook
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  8. Glynn Harrison
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Correspondence to Kim Donoghue.

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Donoghue, K., Medley, I., Brewin, J. et al. The association between substance misuse and first-episode psychosis in a defined UK geographical area during the 1990s. Soc Psychiatry Psychiatr Epidemiol 46, 137–142 (2011). https://doi.org/10.1007/s00127-009-0175-5

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  • DOI: https://doi.org/10.1007/s00127-009-0175-5

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