Drug and alcohol misuse in first episode psychosis: An observational study

BACKGROUND: There have been very few observational studies of drug and alcohol misuse in first-episode psychosis in the UK. METHOD: Using an observational database of first episode psychosis in Northumberland, a county in Northern England, information on patients aged 16 to 36 years were collected at presentation and annual follow-up between October 1998 and October 2005. Patterns of drug and alcohol misuse were compared using hospitalization as an outcome measure, and violence rates were examined retrospectively. RESULTS: Drug misuse without alcohol misuse was associated with a highly significant increase in hospital days. An alcohol problem, either with or without coexisting drug misuse, was not predictive of increased hospital days. Drug and alcohol misuse together was associated with violence. CONCLUSIONS: This paper lends some support to those Early Intervention in Psychosis (EIP) teams currently advising patients that drug misuse may have a greater impact than alcohol use on the outcome of first-episode psychosis.