Weiss David M, Bernier Elizabeth, Robbins Douglas R, Elacqua Katherine M, Johnson Kelsey A, Powers Kate, Mesholam-Gately Raquelle I, Woodberry Kristen A
Maine Medical Center Research Institute, MaineHealth, Portland, ME, United States.
Department of Psychiatry, Tufts University School of Medicine, Boston, MA, United States.
Front Psychiatry. 2022 May 3;13:874246. doi: 10.3389/fpsyt.2022.874246. eCollection 2022.
Psychotic-spectrum disorders emerge during adolescence and early adulthood, which corresponds with the peak period for substance use initiation. Clinical and epidemiological data provide support that substance use is associated with psychotic symptom onset and severity. Experience-sampling methodology (ESM) data may provide additional insight into dynamic associations between substance use and psychotic symptoms. This is one of the first efforts to characterize substance use frequency and dynamic associations with psychotic symptoms and negative affect from ESM data in both clinical high risk (CHR) and early psychosis (EP) individuals.
Using ESM, 33 individuals, including 17 with CHR and 16 EP (age range: 15-24), provided information on substance use, negative affect, and psychotic symptoms 6 times a day across a 21-day data collection window. Psychotic symptoms and negative affect included multi-item variables rated on a seven-point Likert Scale. Participants reported recent substance use for 4 drug classes (nicotine, cannabis, depressants, stimulants) via a yes/no item. Descriptive information included data on substance use frequency, and momentary negative affect and psychotic symptoms. Exploratory analyses included multi-level and person-level dynamic structural equation models, which assessed contemporaneous and lagged associations between substance use and symptoms.
Twenty-seven individuals (82%) reported recurrent substance use including stimulants ( = 12, 46%), nicotine ( = 9, 27%), cannabis ( = 6, 18%), and depressants ( = 4, 12%). Individuals with any recurrent substance use indicated usage at 47.7% of answered prompts; stimulants at 23.6%; nicotine at 74.2%; cannabis at 39.1%; and depressants at 20.1%. A multi-level dynamic structural equation model reflected that substance use (any class) was associated with lagged negative affect (β = -0.02, CI: -0.06, < -0.00) but no significant contemporaneous or lagged associations between substance use and psychotic symptoms. Person-level models suggest potentially meaningful inter-individual variability.
CHR and EP individuals use a range of substances that may both reflect and influence other experiences in daily life experiences. Data reflected moderate to high rates of recurrent substance use with more consistent use within nicotine and cannabis classes. ESM data have the potential to increase our understanding of the dynamic relationships between substance use and symptoms and to inform treatment for individuals in early course psychosis.
精神病性谱系障碍在青少年期和成年早期出现，这与物质使用开始的高峰期相对应。临床和流行病学数据支持物质使用与精神病性症状的发作及严重程度相关。经验抽样法（ESM）数据可能会为物质使用与精神病性症状之间的动态关联提供更多见解。这是首批利用ESM数据对临床高危（CHR）和早期精神病（EP）个体的物质使用频率以及与精神病性症状和消极情绪的动态关联进行特征描述的研究之一。
使用ESM，33名个体，包括17名CHR个体和16名EP个体（年龄范围：15 - 24岁），在21天的数据收集窗口内每天报告6次关于物质使用、消极情绪和精神病性症状的信息。精神病性症状和消极情绪包括用七点李克特量表评分的多项目变量。参与者通过“是/否”项目报告最近4类药物（尼古丁、大麻、抑制剂、兴奋剂）的使用情况。描述性信息包括物质使用频率、瞬时消极情绪和精神病性症状的数据。探索性分析包括多层次和个体水平的动态结构方程模型，评估物质使用与症状之间的同期和滞后关联。
27名个体（82%）报告有复发性物质使用，包括兴奋剂（n = 12，46%）、尼古丁（n = 9，27%）、大麻（n = 6，18%）和抑制剂（n = 4，12%）。有任何复发性物质使用的个体在47.7%的回答提示中表明有使用；兴奋剂为23.6%；尼古丁为74.2%；大麻为39.1%；抑制剂为20.1%。一个多层次动态结构方程模型表明物质使用（任何类别）与滞后消极情绪相关（β = -0.02，CI：-0.06，p < -0.00），但物质使用与精神病性症状之间无显著的同期或滞后关联。个体水平模型显示出个体间潜在的有意义的变异性。
CHR和EP个体使用多种物质，这些物质可能既反映又影响日常生活经历中的其他体验。数据反映出复发性物质使用的发生率为中度到高度，尼古丁和大麻类物质的使用更为一致。ESM数据有可能增进我们对物质使用与症状之间动态关系的理解，并为早期精神病个体的治疗提供信息。
