Cocaine and cannabis use impacts symptoms and functionality in a cohort of antipsychotic naive patients at first episode of psychosis

Poster A90, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Luccas Coutinho1, Daniel Cavalcante1, Cinthia Higuchi1, Quirino Cordeiro2, Hianna Honorato1, Sintia Belangeiro1, Rodrigo Bressan1, Cristiano Noto1, Ary Gadelha1; 1Federal University of São Paulo - UNIFESP, 2Faculdade de Ciências Médicas da Santa Casa de São Paulo

Cannabis and cocaine are the most common ilicit drugs used by psychotic patients. While cocaine did not show strong influence evidences on psychosis, cannabis is related to increased psychosis risk and lower age of first episode of psychosis (FEP). To verify the influence of this substances on psychosis, we investigated the impact of lifetime cannabis and cocaine use on symptoms and functionality in a Brazilian cohort of antipsychotic naive FEP individuals. Our sample comprised 175 FEP individuals diagnosed by the Structured Clinical Interview for DSM- IV (SCID) at a Brazilian emergency service. 99 of them were reassessed after 10 weeks. Symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS) considering five dimensions: positive, negative, depressive, disorganized and excitement. Functionality was obtained by the Global Assessment of Functioning (GAF). The substance use was measured by the Addiction Severity Index (ASI-6). We performed multivariated linear regressions between the substance abuse variables and outcomes controlling for sex, age, income and Duration of Untreated Psychosis (DUP). 39.8% of the individuals reported cannabis use lifetime and 14.3% cocaine. All the cocaine users also reported cannabis use. We have not found any association between the cannabis use and outcomes. But, we found that cocaine use predicted worst excitement (p=0.017, R²=0.150, β=5.159) and disorganized (p=0.023, R²=0.182, β=6.058) symptoms at follow up. Our findings indicate that cocaine lifetime use has a higher impact on psychotic symptoms than cannabis. The early intervention on this issue may help this patients to have a better prognostic.

Topic Area: First Episode Psychosis

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