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Home > Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis.

Murrie, Benjamin and Lappin, Julia and Large, Matthew and Sara, Grant . (2020) Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis. Schizophrenia Bulletin, 46 (3) 505-16. https://doi.org/10.1093/schbul/sbz102

URL: https://academic.oup.com/schizophreniabulletin/art...

Some people who experience substance-induced psychosis later develop an enduring psychotic disorder such as schizophrenia. This study examines the proportion of people with substance-induced psychoses who transition to schizophrenia, compares this to other brief and atypical psychoses, and examines moderators of this risk. A search of MEDLINE, PsychINFO, and Embase identified 50 eligible studies, providing 79 estimates of transition to schizophrenia among 40 783 people, including 25 studies providing 43 substance-specific estimates in 34 244 people. The pooled proportion of transition from substance-induced psychosis to schizophrenia was 25% (95% CI 18%-35%), compared with 36% (95% CI 30%-43%) for brief, atypical and not otherwise specified psychoses. Type of substance was the primary predictor of transition from drug-induced psychosis to schizophrenia, with highest rates associated with cannabis (6 studies, 34%, CI 25%-46%), hallucinogens (3 studies, 26%, CI 14%-43%) and amphetamines (5 studies, 22%, CI 14%-34%). Lower rates were reported for opioid (12%), alcohol (10%) and sedative (9%) induced psychoses. Transition rates were slightly lower in older cohorts but were not affected by sex, country of the study, hospital or community location, urban or rural setting, diagnostic methods, or duration of follow-up. Substance-induced psychoses associated with cannabis, hallucinogens, and amphetamines have a substantial risk of transition to schizophrenia and should be a focus for assertive psychiatric intervention.


Item Type
Evidence resource
Drug Type
Alcohol or other drugs in general, Cannabis, CNS stimulants, Opioid
Intervention Type
AOD disorder, AOD disorder harm reduction
Date
10 April 2020
Pages
505-16
Page Range
pp. 505-516
Volume
46
Number
3
EndNote

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