{"id":3913,"date":"2024-03-12T11:43:25","date_gmt":"2024-03-12T00:43:25","guid":{"rendered":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/transition-to-schizophrenia-spectrum-disorder-following-emergency-department-visits-due-to-substance-use-with-and-without-psychosis-cannabis-tops-the-list-3\/"},"modified":"2024-03-12T11:43:25","modified_gmt":"2024-03-12T00:43:25","slug":"transition-to-schizophrenia-spectrum-disorder-following-emergency-department-visits-due-to-substance-use-with-and-without-psychosis-cannabis-tops-the-list-3","status":"publish","type":"post","link":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/transition-to-schizophrenia-spectrum-disorder-following-emergency-department-visits-due-to-substance-use-with-and-without-psychosis-cannabis-tops-the-list-3\/","title":{"rendered":"Transition to Schizophrenia Spectrum Disorder Following Emergency Department Visits Due to Substance Use With and Without Psychosis \u2013 Cannabis Tops the List"},"content":{"rendered":"<p><strong>Question:<\/strong>&nbsp;&nbsp;What is the risk of developing schizophrenia spectrum disorder following an emergency department (ED) visit caused by substance use with and without psychosis?<\/p>\n<p><strong>Findings:<\/strong>&nbsp;&nbsp;In this cohort study of 9.8 million people, individuals with an ED visit for substance-induced psychosis or substance use without psychosis were at increased risk of developing schizophrenia spectrum disorder within 3 years relative to the general population.<\/p>\n<p><strong>Meaning:<\/strong>&nbsp;&nbsp;These findings suggest that people who present to the ED for substance use, with or without psychosis, are at increased risk of developing schizophrenia spectrum disorder.<\/p>\n<p><strong>Abstract<\/strong><\/p>\n<p><strong>Importance:<\/strong>&nbsp;&nbsp;Episodes of substance-induced psychosis are associated with increased risk of developing a schizophrenia spectrum disorder. However, there are limited data on the transition risk for substance use without psychosis.<\/p>\n<p><strong>Objectives:<\/strong>&nbsp;&nbsp;To quantify the risk of transition to schizophrenia spectrum disorder following an incident emergency department (ED) visit for (1) substance-induced psychosis and (2) substance use without psychosis and to explore factors associated with transition.<\/p>\n<p><strong>Results:<\/strong>&nbsp;&nbsp;The study included 9\u202f844\u202f497 individuals, aged 14 to 65 years (mean [SD] age, 40.2 [14.7] years; 50.2% female) without a history of psychosis. There were 407\u202f737 individuals with an incident ED visit for substance use, of which 13\u202f784 (3.4%) ED visits were for substance-induced psychosis. Individuals with substance-induced psychosis were at a 163-fold (age- and sex-adjusted hazard ratio [aHR], 163.2; 95% CI, 156.1-170.5) increased risk of transitioning, relative to the general population (3-year risk, 18.5% vs 0.1%). Individuals with an ED visit for substance use without psychosis had a lower relative risk of transitioning (aHR, 9.8; 95% CI, 9.5-10.2; 3-year risk, 1.4%), but incurred more than 3 times the absolute number of transitions (9969 vs 3029).&nbsp;<strong><em>Cannabis use had the highest transition risk among visits with psychosis (aHR, 241.6; 95% CI, 225.5-258.9) and the third-highest risk among visits without psychosis (aHR, 14.3; 95% CI, 13.5-15.2).&nbsp;<\/em><\/strong>Younger age and male sex were associated with a higher risk of transition, and the risk of male sex was greater in younger compared with older individuals, particularly for cannabis use.<\/p>\n<p><strong>Conclusions and Relevance:<\/strong>&nbsp;&nbsp;The findings of this cohort study suggest that ED visits for substance use were associated with an increased risk of developing a schizophrenia spectrum disorder. Although substance-induced psychoses had a greater relative transition risk, substance use without psychosis was far more prevalent and resulted in a greater absolute number of transitions. Several factors were associated with higher transition risk, with implications for counseling and early intervention<\/p>\n<p>(Source:&nbsp;<a href=\"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/article-abstract\/2809870\" target=\"_blank\" rel=\"noopener\">&nbsp;JAMA Psychiatry | JAMA Network<\/a>&nbsp;2023)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Question:&nbsp;&nbsp;What is the risk of developing schizophrenia spectrum disorder following an emergency department (ED) visit caused by substance use with and without psychosis? Findings:&nbsp;&nbsp;In this cohort study of 9.8 million people, individuals with an ED visit for substance-induced psychosis or substance use without psychosis were at increased risk of developing schizophrenia spectrum disorder within 3 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":"","_wp_rev_ctl_limit":""},"categories":[19],"tags":[],"class_list":["post-3913","post","type-post","status-publish","format-standard","hentry","category-dalgarno-research-you-can-use"],"_links":{"self":[{"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/posts\/3913","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/comments?post=3913"}],"version-history":[{"count":0,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/posts\/3913\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/media?parent=3913"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/categories?post=3913"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.dalgarnoinstitute.org.au\/wp_site\/wp-json\/wp\/v2\/tags?post=3913"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}