Trends and Associated Factors in the Transition from Substance-Induced Psychotic Disorder to Schizophrenia: A Retrospective Study in Samutprakarn Hospital
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Abstract
Objective: To study the trends and factors associated with diagnostic changes from substance-induced psychosis to schizophrenia among patients treated at Samutprakarn hospital.
Methods: A retrospective descriptive study of patients initially diagnosed with substance-induced psychosis between 2014 and 2023. Data were collected from medical records, then continue to monitor data until the diagnosis is changed to schizophrenia or the patient discontinued treatment or the data collection period ends in December 2024. Data were analyzed using descriptive statistics, multiple logistic regression, and Kaplan-Meier method. To help provide an overview or trend in the change in psychiatric diagnosis from substance abuse to schizophrenia.
Results: Of all 193 patients with substance-induced psychosis, 80.3 percent were male, with a mean age of 30.4 years, and 53.9 percent were single. The main types of drugs that caused psychotic symptoms were amphetamine, alcohol, cannabis, and multiple drug use. The percentages were 47.2, 21.8, 20.7 and 9.3 percent, respectively. There were 55 cases (28.5%) that changed their diagnostic to schizophrenia, with a cumulative risk of 26.6% at 2 years. Significant factors associated with diagnostic conversion included single marital status, disorganized speech (disorganized thought), antipsychotic medication dosage (equivalent to haloperidol 5 - 15 mg/day), and persistent psychiatric symptoms or were referred.
Conclusion: The transition from substance-induced psychosis to schizophrenia occurred in 28.5% of patients. Continuous follow-up treatment during the first 2 years is crucial, especially in those with risk factors, for appropriate treatment planning and to reduce the chance of relapse of psychotic symptoms in the long term.
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