Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis

C. L M Caton, Deborah S. Hasin, Patrick E. Shrout, Robert E. Drake, Boanerges Dominguez, Michael B. First, Sharon Samet, Bella Schanzer

Research output: Contribution to journalArticlepeer-review


Background: The stability of the diagnostic distinction between a substance-induced psychosis and a primary psychotic disorder co-occurring with substance use is not established. Aims: To describe DSM-IV diagnostic changes over I year and determine the predictive validity of baseline indicators of the substance-induced psychosis v. primary psychosis distinction. Method: We conducted a 1-year follow-up study of 319 psychiatric emergency department admissions with diagnoses of early-phase psychosis and substance use comorbidity. Results: Of those with a baseline DSM-IV diagnosis of substance-induced psychosis, 25% had a diagnosis of primary psychosis at follow-up. These patients had poorer premorbid functioning, less insight into psychosis and greater family mental illness than patients with a stable diagnosis of substance-induced psychosis. Reclassifying change cases to primary psychoses on follow-up, key baseline predictors of the primary/substance-induced distinction at I year also included greater family history of mental illness in the primary psychosis group. Conclusions: Further study of substance-induced psychoses should employ neuroscientific and behavioural approaches. Study findings can guide more accurate diagnoses at first treatment.

Original languageEnglish (US)
Pages (from-to)105-111
Number of pages7
JournalBritish Journal of Psychiatry
Issue numberFEB.
StatePublished - Feb 2007

ASJC Scopus subject areas

  • Psychiatry and Mental health


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