Differences in the subjective effects of drugs in patients with a first psychotic episode. Preliminary results

Introduction. The study of the subjective effects of abuse substances may facilitate comprehension of the high prevalence of substance abuse in psychosis. Objective. To assess the subjective effects of psychoactive substances in psychotic patients with substance use disorder in a prospective open study with a 6 month evaluation. Methods. Thirty patients consecutively admitted for the first time to a psychiatric hospital because of a psychotic disorder (DSM-IV) were included. Sociodemographic data, substance use history, drug urine test, and severity of psychotic symptoms measured by BPRS, SANS and SAPS were evaluated. The subjective effects of drugs were assessed with the short form of the ARCI questionnaire. Patients were re-assessed at six months followup. Results. Sixty-three percent of patients were male, mean age 29.2 years. A total of 46.6% presented at least one substance use disorder. Differences between substance users group and non-substance users group were only related to sex (more male in substance user group), and no other sociodemographic and clinical differences were found. The main abuse drugs found were: 86% cannabis, 17% cocaine, 17% alcohol, 3% heroin and 3% hypnosedatives. Fifty percent only consumed cannabis. The psychotic patients with substance use disorder showed higher punctuation in MBG scale (euphoria scale); no differences in other ARCI scales were found. At six months follow-up, 83.3% patients were re-assessed and no differences were found. Conclusions. The psychotic patients with substance use disorder showed a higher subjective effect of euphoria than non-substance user psychotics, suggesting that drug use is mainly related to obtaining euphoria-like effects than sedatives in this group.