O Oluwoye, M Monroe-DeVita, E Burduli, L Chwastiak, S McPherson, JM McClellan and MG McDonell,
Early intervention in psychiatry, Jan 22 2018
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).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 United States. 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.At baseline, roughly 50% (nā=ā209) of participants reported recent tobacco, 28% (nā=ā113) alcohol and 24% (nā=ā95) cannabis use. Tobacco smokers had higher levels of illness severity (Ī²ā=ā.24; Pā<ā.005), a higher number of missed pills (Ī²ā=ā2.89; Pā<ā.05), higher psychiatric symptoms and lower quality of life during treatment relative to non-smokers. Alcohol users had a higher number of missed pills (Ī²ā=ā3.16; Pā<ā.05) during treatment and cannabis users had higher levels of illness severity (Ī²ā=ā.18; Pā<ā.05) and positive symptoms (Ī²ā=ā1.56; Pā<ā.05) relative to non-users.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.