Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study

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dc.contributor.advisorTemmingh, Hendrik
dc.contributor.authorde Vaal, Sybrand Johannes
dc.date.accessioned2022-02-18T05:09:19Z
dc.date.available2022-02-18T05:09:19Z
dc.date.issued2021
dc.date.updated2022-02-10T08:26:04Z
dc.description.abstractBackground: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation.
dc.identifier.apacitationde Vaal, S. J. (2021). <i>Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study</i>. (). ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health. Retrieved from http://hdl.handle.net/11427/35708en_ZA
dc.identifier.chicagocitationde Vaal, Sybrand Johannes. <i>"Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study."</i> ., ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health, 2021. http://hdl.handle.net/11427/35708en_ZA
dc.identifier.citationde Vaal, S.J. 2021. Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study. . ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health. http://hdl.handle.net/11427/35708en_ZA
dc.identifier.ris TY - Master Thesis AU - de Vaal, Sybrand Johannes AB - Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation. DA - 2021_ DB - OpenUCT DP - University of Cape Town KW - Psychiatry and Mental Health LK - https://open.uct.ac.za PY - 2021 T1 - Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study TI - Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study UR - http://hdl.handle.net/11427/35708 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35708
dc.identifier.vancouvercitationde Vaal SJ. Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study. []. ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/35708en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Psychiatry and Mental Health
dc.publisher.facultyFaculty of Health Sciences
dc.subjectPsychiatry and Mental Health
dc.titleDiagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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