Prevalence of substance use in first episode psychosis and its association with socio-demographic variants in Nepalese Patients

Abstract

Introduction: Substance use is common in first episode psychosis patients and has emerged as one of the greatest obstacle in the good prognosis of the illness. The high prevalence of substance use in patient with first episode psychosis and its association with socio-demographic variants found in the study signifies the importance of identifying and addressing these issues. The aim of the study was to estimate the prevalence of substance use in patients with first episode psychosis attending Department of Psychiatry and Mental Health, Tribhuvan University Teaching Hospital and to find out the association of socio-demographic variables in Nepalese population.

Materials and methods: All patients with first episode psychosis attending Department of Psychiatry were selected based on inclusion and exclusion criteria. A semi structured proforma was used to record the socio-demographic variables and psychiatric diagnosis was made according to ICD-10 DCR criteria by a consultant psychiatrist. A total of 80 patients meeting the inclusion criteria were selected.

Results: The result showed that 47.5% of first episode psychosis patient had a current or lifetime history of substance use. Alcohol was the most commonly used substance (52.6 %) followed by cannabinoids (26.3 %), opioids (5.3 %) and 15.8 % were multiple substance users. There was a statically significant association found in between socio-demographic profiles and substance use. When compared to non-substance users, substance using group were commonly from male gender, unemployed, educated up to secondary level and belonged to 15-25 years of age group. Cannabis use was associated with younger age and earlier onset of psychotic illness compared to alcohol use.

Conclusion: This study concluded that substance use is common among newly diagnosed first episode psychosis patients, alcohol being the most common. There was statically significant association with the socio- demographic variables for substance use. The study calls the need to develop services that address substance use in first episode psychosis. Profiles of substance use in psychosis shows demographic gradients that can inform treatment and preventive research for better management and help making treatment protocol for these subgroups of patients.

DOI: http://dx.doi.org/10.3126/jpan.v3i1.11347

J Psychiatrists’ Association of Nepal Vol .3, No.1, 2014: 16-22