The Impact of Substance Use on Treatment Outcomes among Patients Experiencing First-Episode Psychosis.

Poster A119, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Oladunni Oluwoye1,2,3, Maria Monroe-DeVita5, Ekaterina Burduli1,2,3, Lydia Chwastiak5, Sterling McPherson2,3,4, Jon M. McClellan5, Michael G. McDonell1,2,3; 1Initiative for Research and Education to Advance Community Health, Washington State University, Spokane WA, 2Elson S. Floyd College of Medicine, Washington State University, Spokane WA, 3Program of Excellence in Addictions Research, Washington State University, Spokane WA, 4Providence Medical Research Centre, Providence Health Care, Spokane WA, 5Department of Psychiatry and Behavioural Sciences, University of Washington School of Medicine, Seattle WA

Aim: The primary aim of this study was to examine the effect of recent tobacco, alcohol, and cannabis use on treatment outcomes among participants experiencing first episode psychosis (FEP). Methods: Secondary data analyses were conducted on 404 participants enrolled in the Recovery After an Initial Schizophrenia Episode – Early Treatment Program (RAISE-ETP) study. RAISE-ETP investigated the effectiveness of a coordinated specialty care (CSC) intervention for FEP in community mental health agencies in the U.S. Generalized estimating equations were used to examine whether recent tobacco smoking, alcohol, and cannabis use at baseline were associated with illness severity, number of antipsychotic pills missed, psychiatric symptoms, and quality of life during the 24-month treatment period, after controlling for duration of untreated psychosis and treatment group. Results: At baseline, roughly 50% (n=209) of participants reported recent tobacco, 28% (n=113) alcohol, and 24% (n=95) cannabis use. Tobacco smokers had higher levels of illness severity (β=0.24; p<0.005), a higher number of missed pills (β=2.89; p<0.05), higher psychiatric symptoms, and lower quality of life during treatment relative to non-smokers. Alcohol users had a higher number of missed pills (β=3.16; p<0.05) during treatment and cannabis users had higher levels of illness severity (β=0.18; p<0.05) and positive symptoms (β=1.56; p<0.05) relative to non-users. Conclusions: Tobacco, alcohol, and cannabis use are common in youth seeking treatment for FEP. Tobacco smoking was associated with more negative clinical outcomes. These findings have implications for including interventions targeting these areas of substance use within current CSC models.

Topic Area: Substance Use

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