Hjorthøj Carsten, Arnfred Benjamin, Behrendt Silke, Møller Stine Bjerrum, Nordentoft Merete
Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15-4th floor, DK, 2900 Hellerup, Denmark; University of Copenhagen, Department of Public Health, Section of Epidemiology.
Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Gentofte Hospitalsvej 15-4th floor, DK, 2900 Hellerup, Denmark.
J Affect Disord. 2021 Dec 1;295:960-966. doi: 10.1016/j.jad.2021.09.004. Epub 2021 Sep 8.
Substance-induced psychosis has previously been linked to increased incidence of schizophrenia and bipolar disorder. We aimed to investigate if substance-induced psychosis is associated with increased risk of depression or anxiety.
We conducted a nationwide prospective register-based cohort study from 1994 to 2017, including all individuals with substance-induced psychosis, and age-and-sex matched controls without substance-induced psychosis. We investigated time to either depression or anxiety, as well as time to depression and time to anxiety, in stratified Cox regression models.
We included 5,557 individuals with substance-induced psychosis and 55,562 controls. Substance-induced psychosis was associated with increased risk of either depression or anxiety (HR=7.05, 95% CI 6.71-7.41), depression (HR=5.40, 95% CI 4.77-6.11), or anxiety (HR=7.05, 95% CI 5.99-8.31). Analyses of individual types of substance-induced psychosis revealed similar hazard ratios across substances. Associations between substance-induced psychosis and depression or anxiety were stronger in people without preceding alcohol or substance use disorders. While strongest shortly after incident substance-induced psychosis, the increased incidence of depression and anxiety remained more than double over the full period of follow-up.
Only psychiatric disorders treated either in psychiatric inpatient or outpatient units, supplemented with information on psychiatric medication, was available. Exact times of onset were similarly unknown, and only dates of first treatment were available.
Substance-induced psychosis is a strong predictor of later onset of depression or anxiety. Regardless of whether this association is causal, this highlights the need for increased monitoring and possibly improved treatment of patients with substance-induced psychosis.
物质所致精神病此前已被认为与精神分裂症和双相情感障碍的发病率增加有关。我们旨在调查物质所致精神病是否与抑郁或焦虑风险增加相关。
我们进行了一项基于全国前瞻性登记的队列研究，时间跨度为1994年至2017年，纳入了所有患有物质所致精神病的个体，以及年龄和性别匹配的无物质所致精神病的对照。我们在分层Cox回归模型中研究了发生抑郁或焦虑的时间，以及发生抑郁的时间和发生焦虑的时间。
我们纳入了5557名患有物质所致精神病的个体和5556,2名对照。物质所致精神病与抑郁或焦虑风险增加相关（风险比=7.05，95%置信区间6.71-7.41）、抑郁（风险比=5.40，95%置信区间4.77-6.11）或焦虑（风险比=7.05，95%置信区间5.99-8.31）。对个体类型的物质所致精神病的分析显示，不同物质间风险比相似。在无先前酒精或物质使用障碍的人群中，物质所致精神病与抑郁或焦虑之间的关联更强。虽然在物质所致精神病发病后不久关联最强，但在整个随访期间，抑郁和焦虑的发病率增加仍超过两倍。
仅可获得在精神科住院或门诊治疗的精神疾病，以及有关精神科药物的信息。发病的确切时间同样未知，仅可获得首次治疗日期。
物质所致精神病是后期发生抑郁或焦虑的有力预测因素。无论这种关联是否为因果关系，这都凸显了对物质所致精神病患者加强监测以及可能改善治疗的必要性。
