Baseline Substance Use as a Correlate of Symptom Severity and Medication Adherence in Naturalistic Psychiatric Treatment for Psychosis

Caroline Harris (1,2,3), Heather Muir (1,2,4,5), Madison Natarajan (1,2,5), Pegah Seif (1,2,3), Ananya Saluja (2), Kelsey Johnson (2), Iqra Imam (2), Nicolas Raymond (1,2,3), Oshin Kushwaha (1,2,3), Yusuf Sendil (1,2,3), Raquelle Mesholam-Gately (1,2), Margaret Guyer (5), Matcheri Keshavan (1,2,5), Sarah Herold (1,2),Paulo Lizano (1,2,3)

1. Advancing Services for Psychosis Integration and Recovery (ASPIRE) Clinic, Beth Israel Deaconess Medical Center
2 Department of Psychiatry, Harvard Medical School
3. Division of Translational Neuroscience, Beth Israel Deaconess Medical Center
4. Center for Early Detection Assessment and Response to Risk(CEDAR) Clinic, Brookline Center for Community Mental Health
5. Massachusetts Department of Mental Health

Abstract

Background: Recent studies have found that those with psychosis who have used substances are more likely to develop schizophrenia-spectrum disorders than those who avoid substance use. Additionally, substance use in psychosis patients is correlated with medication non-adherence and increases in symptom severity. Moreover, studies examining substance use, medication adherence, and symptom severity in psychosis have largely been conducted in the context of clinical trials, as opposed to naturalistic settings for the treatment of early psychosis. Thus, it is important to elucidate the associations between these variables in the naturalistic treatment of early psychosis patients. The present study aims to examine the substance use rates within an early course psychosis clinic, and whether baseline current substance use frequency, duration, and type of substance are associated with baseline symptom severity and medication adherence.
Methods: Data was collected from intake assessments used in support of naturalistic early psychosis treatment across multiple MAPNET clinics. Intake assessments include various measures including measures of substance use (WHO ASSIST 3.0, Abbreviated), symptom severity (i.e., COMPASS-10, Colorado Symptom Index, and the Global Assessment of Functioning), and medication adherence. Patients hold varying psychotic spectrum diagnoses, including schizophrenia spectrum disorders, affective psychoses, and substance-induced psychosis.
Results: As data collection is ongoing, analyses will be completed closer to the date of the conference. Means and standard deviations will be presented for both substance use and psychosis symptoms to answer questions regarding descriptives. A series of independent t-tests and chi-square analyses will be used to determine the associations between frequency, duration, type of substance use and baseline psychosis symptom severity and medication adherence.
Conclusions: Findings will help clarify the associations between substance use, symptom severity, and medication adherence in naturalistic treatment for early psychosis, and thus, could inform decisions regarding inclusion of substance-focused intervention in coordinated specialty care programs for psychosis.