Demographic and clinical correlates of substance use disorders in first episode psychosis.
BACKGROUND
We assessed the prevalence and correlates of lifetime substance use disorders in people with first episode psychosis using the baseline data from the Recovery After an Initial Schizophrenia Episode (RAISE) Early Treatment Program study.


METHODS
Research staff assessed 404 first episode patients at 34 community mental health centers across the United States with the Structured Clinical Interview for DSM-IV for diagnoses of psychotic and substance use disorders. Logistic regression was used to evaluate the relationships between participant characteristics and lifetime substance use disorders, followed with generalized linear mixed-effects regression models to identify unique predictors of lifetime substance use disorders.


RESULTS
Approximately one-third of participants reported recent alcohol use (36.6%) and cannabis use (30.7%), and one half (51.7%) met criteria for any lifetime alcohol or drug use disorder. Lifetime substance use disorders were associated with male gender, White race, higher excited (hyperactivity, mood lability, impulsivity, hostility, and uncooperativeness), psychotic and depressive symptoms, less impaired cognition, and greater perceived stigma. Gender, race, and excited symptoms were the most consistent unique predictors of lifetime substance use disorders found in multivariate analyses.


CONCLUSIONS
Half of first episode psychosis patients have co-occurring substance use disorders, which are associated with both more severe symptoms and greater perceptions of stigma. Programs aiming to serve these patients must have the skills and clinical strategies to help people with these unique characteristics.
['Brunette|Mary F|MF|', 'Mueser|Kim T|KT|', 'Babbin|Steven|S|', 'Meyer-Kalos|Piper|P|', 'Rosenheck|Robert|R|', 'Correll|Christoph U|CU|', 'Cather|Corrine|C|', 'Robinson|Delbert G|DG|', 'Schooler|Nina R|NR|', 'Penn|David L|DL|', 'Addington|Jean|J|', 'Estroff|Sue E|SE|', 'Gottlieb|Jennifer|J|', 'Glynn|Shirley M|SM|', 'Marcy|Patricia|P|', 'Robinson|James|J|', 'Kane|John M|JM|']
D000208:Acute Disease D015897:Comorbidity D005260:Female D006801:Humans D007406:Interview, Psychological D016015:Logistic Models D008297:Male D016017:Odds Ratio D011569:Psychiatric Status Rating Scales D011618:Psychotic Disorders D012559:Schizophrenia D012565:Schizophrenic Psychology D019966:Substance-Related Disorders D055815:Young Adult
Substance use disorder First episode Schizophrenia Alcohol Cannabis Drug