First-episode psychosis and substance use in Nelson Mandela Bay: Findings from an acute mental health unit.

Journal: The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa

Volume: 25

Issue: 0

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry and Behavioural Sciences, Walter Sisulu University, Mthatha, South Africa.

Abstract summary 

Use of psychoactive substances is a common finding in studies on first-episode psychosis (FEP), and this has prognostic implications. We know very little about psychoactive substance use (SU) among patients with FEP in the Eastern Cape province (EC) of South Africa (SA).The study seeks to determine SU prevalence and associated features among inpatients with non-affective FEP in an acute mental health unit (MHU) in Nelson Mandela Bay, EC.Researchers conducted a retrospective clinical file review of a 12-month admission cohort of patients with FEP, without a concurrent mood episode, to the Dora Nginza Hospital MHU. Information collected included SU history, psychiatric diagnoses, and demographics. Data were then subjected to statistical analysis.Researchers conducted a retrospective clinical file review of a 12-month admission cohort of patients with FEP, without a concurrent mood episode, to the Dora Nginza Hospital MHU. Information collected included SU history, psychiatric diagnoses and demographics. Data were then subjected to statistical analysis.A total of 117 patients (86 [73.5%] males; 31 [26.5%] females) aged 18-60 years (mean 29 years) met the inclusion criteria. After controlling for missing information, 95 of 117 (81.2%) patients had a history of active or previous SU, 82 of 90 (91.1%) were single and 61 of 92 (66.3%) were unemployed. A significant association was found between SU and unemployment ( < 0.001), as well as male sex ( < 0.001). The most common substances used were cannabis (59.8%), followed by alcohol (57.3%) and stimulants (46.4%).In keeping with national and international literature, the results of this study showed a high prevalence of substance use in South African patients with first-episode psychosis. The high prevalence of lifetime substance use in this cohort compared to previous studies in South Africa requires further investigation and highlights the urgent need for dual diagnosis services in the Eastern Cape province.

Authors & Co-authors:  Thungana Yanga Y Zingela Zukiswa Z van Wyk Stephan S

Study Outcome 

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Statistics
Citations :  Archie S, Rush BR, Akhtar-Danesh N, et al. . Substance use and abuse in first-episode psychosis: Prevalence before and after early intervention. Schizophr Bull. 2007;33(6):1354–1363. 10.1093/schbul/sbm011
Authors :  3
Identifiers
Doi : 1372
SSN : 1608-9685
Study Population
Male
Mesh Terms
Other Terms
cannabis use;dual diagnosis;first-episode psychosis;polysubstance use;substance use
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
South Africa