Emergency department visits for substance use may be associated with an increased risk of developing a schizophrenia spectrum disorder, a study in JAMA Psychiatry has found. People who were seen in the emergency department for cannabis-induced psychosis had the highest risk of transitioning to a schizophrenia spectrum disorder within three years.
Daniel T. Myran, M.D., M.P.H., of the Ottawa Hospital Research Institute in Ontario and colleagues examined data from more than 9.8 million Ontaria residents aged 14 to 65 years between January 2008 and March 2022. Only those eligible for the province’s health coverage and without a history of a psychotic disorder were included.
Within three years, approximately 408,000 individuals had an emergency department visit for substance use; about 14,000 of the visits were for substance-induced psychosis. Compared with the general population, individuals with substance-induced psychosis had 163 times the risk of transitioning to a schizophrenia spectrum disorder. Individuals with an emergency department visit for substance use without psychosis had 9.8 times the risk of transitioning.
Other findings from the study include the following:
- Those seen for cannabis use and psychosis had 241.6 times the risk of transitioning to schizophrenia spectrum disorder compared with the general population.
- Those who did not have psychosis but were seen for amphetamine use, polysubstance use, and cannabis use had 28.4, 18.7, and 14.3 times the risk, respectively, of transitioning to a schizophrenia spectrum disorder compared with the general population.
- For all substance use visits, younger age and male sex were associated with a higher risk of transition to schizophrenia spectrum disorder compared with older age and female sex.
“Our findings … highlight the need for targeted secondary prevention providing early intervention and reducing substance use in the highest-risk groups, which may delay or prevent transition to schizophrenia spectrum disorders,” the researchers wrote. “Several prognostic factors, including cannabis use, younger age, and male sex, were associated with greater risk of transition, with clinical and policy implications.”
For related information, see The American Journal of Psychiatry article “Transition From Substance-Induced Psychosis to Schizophrenia Spectrum Disorder or Bipolar Disorder.”
(Image: iStock/MJ Felt)
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