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Impact of substance use on the onset and course of early psychosis

Identifieur interne : 001A03 ( PascalFrancis/Curation ); précédent : 001A02; suivant : 001A04

Impact of substance use on the onset and course of early psychosis

Auteurs : Hélène Verdoux [France] ; Marie Toumier [France] ; Audrey Cougnard [France]

Source :

RBID : Pascal:05-0468970

Descripteurs français

English descriptors

Abstract

The strong comorbidity between psychosis and substance use is already identifiable in early psychosis, raising the question of the direction of the association between substance use and psychosis onset. It has long been considered that this association was explained by the self-medication hypothesis. This hypothesis has been recently challenged by several prospective studies carried out in population-based samples, showing a dose-response relationship between cannabis exposure and risk of psychosis. This association was independent from potential confounding factors such as exposure to other drugs and preexistence of psychotic symptoms. As a large percentage of subjects from the general population is now exposed to this drug, even a small increase in the risk of adverse effects may have significant deleterious consequences for the health of the population. Hence, reducing exposure to cannabis may contribute to prevention of some incident cases of psychosis. Regarding prognosis, persistent substance misuse after the onset of psychosis has a deleterious impact on clinical outcome. Therapeutic programs for subjects with dual diagnosis should be implemented early in the course of psychosis to maximise their impact on the course of illness.
pA  
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A08 01  1  ENG  @1 Impact of substance use on the onset and course of early psychosis
A09 01  1  ENG  @1 Translating the evidence
A11 01  1    @1 VERDOUX (Hélène)
A11 02  1    @1 TOUMIER (Marie)
A11 03  1    @1 COUGNARD (Audrey)
A12 01  1    @1 ADDINGTON (Jean) @9 ed.
A14 01      @1 EA 3676, IFR of Public Health, University Victor Segalen Bordeaux 2 @2 Bordeaux @3 FRA @Z 1 aut. @Z 2 aut. @Z 3 aut.
A15 01      @1 University of Toronto, Psychiatry, CAMH, 250 College Street @2 Toronto, M5T 1R8 @3 CAN @Z 1 aut.
A18 01  1    @1 International Early Psychosis Association (IEPA) @2 Victoria @3 AUS @9 org-cong.
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A60       @1 P @2 C
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C01 01    ENG  @0 The strong comorbidity between psychosis and substance use is already identifiable in early psychosis, raising the question of the direction of the association between substance use and psychosis onset. It has long been considered that this association was explained by the self-medication hypothesis. This hypothesis has been recently challenged by several prospective studies carried out in population-based samples, showing a dose-response relationship between cannabis exposure and risk of psychosis. This association was independent from potential confounding factors such as exposure to other drugs and preexistence of psychotic symptoms. As a large percentage of subjects from the general population is now exposed to this drug, even a small increase in the risk of adverse effects may have significant deleterious consequences for the health of the population. Hence, reducing exposure to cannabis may contribute to prevention of some incident cases of psychosis. Regarding prognosis, persistent substance misuse after the onset of psychosis has a deleterious impact on clinical outcome. Therapeutic programs for subjects with dual diagnosis should be implemented early in the course of psychosis to maximise their impact on the course of illness.
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C03 01  X  ENG  @0 Drug addiction @5 01
C03 01  X  SPA  @0 Toxicomanía @5 01
C03 02  X  FRE  @0 Précoce @5 02
C03 02  X  ENG  @0 Early @5 02
C03 02  X  SPA  @0 Precoz @5 02
C03 03  X  FRE  @0 Psychose @5 03
C03 03  X  ENG  @0 Psychosis @5 03
C03 03  X  SPA  @0 Psicosis @5 03
C03 04  X  FRE  @0 Cannabis @2 NS @5 04
C03 04  X  ENG  @0 Cannabis @2 NS @5 04
C03 04  X  SPA  @0 Cannabis @2 NS @5 04
C03 05  X  FRE  @0 Facteur risque @5 05
C03 05  X  ENG  @0 Risk factor @5 05
C03 05  X  SPA  @0 Factor riesgo @5 05
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C03 06  X  ENG  @0 Schizophrenia @5 06
C03 06  X  SPA  @0 Esquizofrenia @5 06
C03 07  X  FRE  @0 Pronostic @5 07
C03 07  X  ENG  @0 Prognosis @5 07
C03 07  X  SPA  @0 Pronóstico @5 07
C03 08  X  FRE  @0 Association morbide @5 08
C03 08  X  ENG  @0 Concomitant disease @5 08
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C03 10  X  FRE  @0 Homme @5 18
C03 10  X  ENG  @0 Human @5 18
C03 10  X  SPA  @0 Hombre @5 18
C03 11  X  FRE  @0 Abus de substance @4 CD @5 96
C03 11  X  ENG  @0 Substance abuse @4 CD @5 96
C03 11  X  SPA  @0 Abuso de sustancias @4 CD @5 96
C07 01  X  FRE  @0 Cannabidaceae @2 NS
C07 01  X  ENG  @0 Cannabidaceae @2 NS
C07 01  X  SPA  @0 Cannabidaceae @2 NS
C07 02  X  FRE  @0 Dicotyledones @2 NS
C07 02  X  ENG  @0 Dicotyledones @2 NS
C07 02  X  SPA  @0 Dicotyledones @2 NS
C07 03  X  FRE  @0 Angiospermae @2 NS
C07 03  X  ENG  @0 Angiospermae @2 NS
C07 03  X  SPA  @0 Angiospermae @2 NS
C07 04  X  FRE  @0 Spermatophyta @2 NS
C07 04  X  ENG  @0 Spermatophyta @2 NS
C07 04  X  SPA  @0 Spermatophyta @2 NS
N21       @1 332
pR  
A30 01  1  ENG  @1 International conference on Early Psychosis @2 4 @3 Vancouver CAN @4 2004-09-28

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<s2>NS</s2>
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<s2>NS</s2>
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<s0>Spermatophyta</s0>
<s2>NS</s2>
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<s0>Spermatophyta</s0>
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<s1>332</s1>
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<fA30 i1="01" i2="1" l="ENG">
<s1>International conference on Early Psychosis</s1>
<s2>4</s2>
<s3>Vancouver CAN</s3>
<s4>2004-09-28</s4>
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