F55. CLINICAL OUTCOMES ASSOCIATED WITH ILLICIT SUBSTANCE USE IN FIRST EPISODE PSYCHOSIS (FEP): A TEXT MINING STUDY OF ELECTRONIC HEALTH RECORDS

TY - JOUR

T1 - F55. CLINICAL OUTCOMES ASSOCIATED WITH ILLICIT SUBSTANCE USE IN FIRST EPISODE PSYCHOSIS (FEP): A TEXT MINING STUDY OF ELECTRONIC HEALTH RECORDS

AU - Patel, Rashmi

AU - Colling, Craig

AU - Jyoti, Jyoti

AU - Jackson, Richard George

AU - Stewart, Robert James

AU - McGuire, Philip

PY - 2019/4/9

Y1 - 2019/4/9

N2 - BackgroundComorbid illicit substance use is associated with poor clinical outcomes in established psychotic disorders. However, less is known about the impact of substance misuse in first episode psychosis (FEP). We conducted a largescale electronic health record (EHR) study using text mining software to investigate the associations of cannabis, cocaine, amphetamines and MDMA with risk of psychiatric hospitalization.MethodsData were obtained from 1,835 people with FEP in South London using the Clinical Record Interactive Search tool (CRIS). TextHunter was used to identify exposure to cannabis, cocaine, amphetamines or MDMA documented in free text EHRs. Their relationship with number of psychiatric hospital admissions over a 5-year period was analyzed using multivariable negative binomial regression with age, gender and ethnicity as covariates.ResultsThe most frequently used illicit substance was cannabis (58.5%) followed by cocaine (24.4%), amphetamines (3.7%) and MDMA (3.1%). Cannabis (IRR 1.58, 95% CI 1.37 to 1.83) and cocaine (1.36, 1.17 to 1.59) were associated with increased frequency of psychiatric hospital admission. Amphetamines showed no significant association (1.05, 0.77 to 1.45) while MDMA was associated with a reduction in frequency of admissions (0.59, 0.40 to 0.86).DiscussionCannabis and cocaine are associated with a significant increase in frequency of psychiatric hospital admissions. These findings highlight the importance of addressing comorbid illicit substance use in people with FEP.

AB - BackgroundComorbid illicit substance use is associated with poor clinical outcomes in established psychotic disorders. However, less is known about the impact of substance misuse in first episode psychosis (FEP). We conducted a largescale electronic health record (EHR) study using text mining software to investigate the associations of cannabis, cocaine, amphetamines and MDMA with risk of psychiatric hospitalization.MethodsData were obtained from 1,835 people with FEP in South London using the Clinical Record Interactive Search tool (CRIS). TextHunter was used to identify exposure to cannabis, cocaine, amphetamines or MDMA documented in free text EHRs. Their relationship with number of psychiatric hospital admissions over a 5-year period was analyzed using multivariable negative binomial regression with age, gender and ethnicity as covariates.ResultsThe most frequently used illicit substance was cannabis (58.5%) followed by cocaine (24.4%), amphetamines (3.7%) and MDMA (3.1%). Cannabis (IRR 1.58, 95% CI 1.37 to 1.83) and cocaine (1.36, 1.17 to 1.59) were associated with increased frequency of psychiatric hospital admission. Amphetamines showed no significant association (1.05, 0.77 to 1.45) while MDMA was associated with a reduction in frequency of admissions (0.59, 0.40 to 0.86).DiscussionCannabis and cocaine are associated with a significant increase in frequency of psychiatric hospital admissions. These findings highlight the importance of addressing comorbid illicit substance use in people with FEP.

U2 - 10.1093/schbul/sbz018.467

DO - 10.1093/schbul/sbz018.467

M3 - Meeting abstract

SN - 0586-7614

VL - 45

SP - S276

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

IS - S2

ER -