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RESEARCH PRODUCT
Substance use, medication adherence and outcome one year following a first episode of psychosis
Robin M. MurraySara FraiettaAnna KolliakouAntonella TrottaJames H. MaccabeValeria MondelliMarco ColizziPaola DazzanJohn LallyAnthony S. DavidDiego QuattroneMarta Di FortiOlesya AjnakinaStefania BonaccorsoLucia SideliMizanur KhondokerElena CarraFiona Gaughransubject
Nicotine dependenceAdultMalePsychosismedicine.medical_specialtyFirst episode psychosisRemissionSubstance-Related DisordersMedication adherenceSubstance useCannabis useMedication AdherenceCannabis use; First episode psychosis; Medication adherence; Nicotine dependence; Remission; Substance use; Acute Disease03 medical and health sciencesYoung Adult0302 clinical medicineSettore M-PSI/08 - Psicologia ClinicamedicineHumansYoung adultCannabis use; First episode psychosis; Medication adherence; Nicotine dependence; Remission; Substance use; Acute Disease; Adult; Antipsychotic Agents; Female; Follow-Up Studies; Humans; Male; Medication Adherence; Middle Aged; Psychotic Disorders; Substance-Related Disorders; Treatment Outcome; Young AdultNicotine dependencePsychiatryMedication adherenceSettore MED/25 - PsichiatriaBiological PsychiatryFirst episodebiologyCannabis useMiddle Agedmedicine.diseasebiology.organism_classificationFirst episode psychosi030227 psychiatryTreatment OutcomePsychotic DisordersPsychiatry and Mental HealthAcute DiseaseFemaleCannabisSubstance usePsychology030217 neurology & neurosurgeryAntipsychotic AgentsFollow-Up Studiesdescription
Both substance use and poor medication adherence are associated with poor outcome in psychosis. To clarify the contributions of substance use and poor medication adherence to poor outcome in the year following a first episode of psychosis, 205 patients were evaluated for use of tobacco, alcohol, cannabis and stimulants at their psychosis onset, and in a 1-year follow-up. Data on medication adherence and symptom remission were also collected. Patients had high rates of overall substance use before (37-65%) and after psychosis onset (45-66%). 44% showed poor medication adherence and 55% did not reach remission from psychosis. Nicotine dependence and cannabis use after psychosis onset significantly predicted both poor medication adherence and non-remission, and poor medication adherence mediated the effects of these substances on non-remission. In conclusion, medication adherence lies on the causal pathway between nicotine dependence and cannabis on the one hand and non-remission on the other.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-02-01 |