Polysubstance use after remission in first-episode psychosis: Associations with positive symptoms and self-care.
Dunja M van der Velde, Lieuwe de Haan, Albert Batalla et al.
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In 30 seconds
This analysis of the HAMLETT randomized controlled trial examined substance-use patterns and their associations with symptoms, cognition, and functioning 3 to 6 months after remission in people with first-episode psychosis. Among 283 participants included in the analyses, 13 reported polysubstance use, defined as tobacco, cannabis, and other illicit drugs. Use patterns remained stable over six months. Polysubstance use was associated with more severe positive symptoms than other substance-use groups and poorer self-care than no substance use; positive-symptom differences were seen primarily among participants continuing antipsychotic medication.
Key findings
- Of 283 participants analysed, 13 reported polysubstance use; substance-use patterns remained stable over six months.
- Polysubstance use was associated with more severe positive symptoms than other substance-use groups.
- Compared with participants reporting no substance use, those reporting polysubstance use had poorer self-care.
- Positive-symptom differences were observed primarily among participants continuing antipsychotic medication.
Why it matters
The findings identify polysubstance use as a marker associated with positive symptoms and impaired self-care during the early post-remission period. Considering both substance-use patterns and everyday functioning may help clinicians recognise patients experiencing ongoing difficulties after remission. The results also highlight that symptom associations may differ by antipsychotic continuation status.
What to keep in mind
The analysis included only 13 participants reporting polysubstance use, limiting the evidence available for this group. Associations do not establish that substance use caused symptom or self-care differences.