TY - JOUR
T1 - Differences in Patterns of Stimulant Use and Their Impact on First-Episode Psychosis Incidence
T2 - An Analysis of the EUGEI Study
AU - Rodríguez-Toscano, Elisa
AU - Alloza, Clara
AU - Fraguas, David
AU - Durán-Cutilla, Manuel
AU - Roldán, Laura
AU - Sánchez-Gutiérrez, Teresa
AU - López-Montoya, Gonzalo
AU - Parellada, Mara
AU - Moreno, Carmen
AU - Gayer-Anderson, Charlotte
AU - Jongsma, Hannah E
AU - Di Forti, Marta
AU - Quattrone, Diego
AU - Velthorst, Eva
AU - de Haan, Lieuwe
AU - Selten, Jean-Paul
AU - Szöke, Andrei
AU - Llorca, Pierre-Michel
AU - Tortelli, Andrea
AU - Bobes, Julio
AU - Bernardo, Miguel
AU - Sanjuán, Julio
AU - Luis Santos, José
AU - Arrojo, Manuel
AU - Tarricone, Ilaria
AU - Berardi, Domenico
AU - Ruggeri, Mirella
AU - Lasalvia, Antonio
AU - Ferraro, Laura
AU - La Cascia, Caterina
AU - La Barbera, Daniele
AU - Menezes, Paulo Rossi
AU - Del-Ben, Cristina Marta
AU - Rutten, Bart P
AU - van Os, Jim
AU - Jones, Peter B
AU - Murray, Robin M
AU - Kirkbride, James B
AU - Morgan, Craig
AU - Díaz-Caneja, Covadonga M
AU - Arango, Celso
AU - EU-GEI WP2 Group
PY - 2023/9/7
Y1 - 2023/9/7
N2 - BACKGROUND: Use of illegal stimulants is associated with an increased risk of psychotic disorder. However, the impact of stimulant use on odds of first-episode psychosis (FEP) remains unclear. Here, we aimed to describe the patterns of stimulant use and examine their impact on odds of FEP. METHODS: We included patients with FEP aged 18-64 years who attended psychiatric services at 17 sites across 5 European countries and Brazil, and recruited controls representative of each local population (FEP = 1130; controls = 1497). Patterns of stimulant use were described. We computed fully adjusted logistic regression models (controlling for age, sex, ethnicity, cannabis use, and education level) to estimate their association with odds of FEP. Assuming causality, we calculated the population-attributable fractions for stimulant use associated with the odds for FEP. FINDINGS: Prevalence of lifetime and recent stimulant use in the FEP sample were 14.50% and 7.88% and in controls 10.80% and 3.8%, respectively. Recent and lifetime stimulant use was associated with increased odds of FEP compared with abstainers [fully adjusted odds ratio 1.74,95% confidence interval (CI) 1.20-2.54, P = .004 and 1.62, 95% CI 1.25-2.09, P < .001, respectively]. According to PAFs, a substantial number of FEP cases (3.35% [95% CI 1.31-4.78] for recent use and 7.61% [95% CI 3.68-10.54] for lifetime use) could have been prevented if stimulants were no longer available and the odds of FEP and PAFs for lifetime and recent stimulant use varied across countries. INTERPRETATION: Illegal stimulant use has a significant and clinically relevant influence on FEP incidence, with varying impacts across countries.
AB - BACKGROUND: Use of illegal stimulants is associated with an increased risk of psychotic disorder. However, the impact of stimulant use on odds of first-episode psychosis (FEP) remains unclear. Here, we aimed to describe the patterns of stimulant use and examine their impact on odds of FEP. METHODS: We included patients with FEP aged 18-64 years who attended psychiatric services at 17 sites across 5 European countries and Brazil, and recruited controls representative of each local population (FEP = 1130; controls = 1497). Patterns of stimulant use were described. We computed fully adjusted logistic regression models (controlling for age, sex, ethnicity, cannabis use, and education level) to estimate their association with odds of FEP. Assuming causality, we calculated the population-attributable fractions for stimulant use associated with the odds for FEP. FINDINGS: Prevalence of lifetime and recent stimulant use in the FEP sample were 14.50% and 7.88% and in controls 10.80% and 3.8%, respectively. Recent and lifetime stimulant use was associated with increased odds of FEP compared with abstainers [fully adjusted odds ratio 1.74,95% confidence interval (CI) 1.20-2.54, P = .004 and 1.62, 95% CI 1.25-2.09, P < .001, respectively]. According to PAFs, a substantial number of FEP cases (3.35% [95% CI 1.31-4.78] for recent use and 7.61% [95% CI 3.68-10.54] for lifetime use) could have been prevented if stimulants were no longer available and the odds of FEP and PAFs for lifetime and recent stimulant use varied across countries. INTERPRETATION: Illegal stimulant use has a significant and clinically relevant influence on FEP incidence, with varying impacts across countries.
KW - amphetamines
KW - first episode psychosis
KW - methamphetamine
KW - population attributable fractions
KW - stimulant use
U2 - 10.1093/schbul/sbad013
DO - 10.1093/schbul/sbad013
M3 - Article
SN - 0586-7614
VL - 49
SP - 1269
EP - 1280
JO - Schizophrenia Bulletin
JF - Schizophrenia Bulletin
IS - 5
M1 - sbad013
ER -