Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort study

Abstract Background Substance use may be associated with the onset of psychotic symptoms, necessitating treatment for individuals with comorbid mental health and substance use disorders (MHD/SUD). COVID-19 significantly impacted individuals with MHD/SUD, reducing access to appropriate care and tre...

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Main Authors: Marja Leonhardt, Jørgen G. Bramness, Eline Borger Rognli, Lars Lien
Format: Article
Language:English
Published: Cambridge University Press 2024-01-01
Series:European Psychiatry
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Online Access:https://www.cambridge.org/core/product/identifier/S0924933824017978/type/journal_article
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author Marja Leonhardt
Jørgen G. Bramness
Eline Borger Rognli
Lars Lien
author_facet Marja Leonhardt
Jørgen G. Bramness
Eline Borger Rognli
Lars Lien
author_sort Marja Leonhardt
collection DOAJ
description Abstract Background Substance use may be associated with the onset of psychotic symptoms, necessitating treatment for individuals with comorbid mental health and substance use disorders (MHD/SUD). COVID-19 significantly impacted individuals with MHD/SUD, reducing access to appropriate care and treatment. Changes in drug availability and prices during the pandemic may have influenced drug consumption. This study aimed to determine the frequency of substance-induced psychosis (SIP) during COVID-19 among individuals with MHD/SUD and to explore substance fidelity by following patterns of SIP over time. Method In this retrospective cohort study, we analyzed data from all individuals with MHD/SUD registered in 2019–2021 in the Norwegian Patient Register. We used graphical approaches, descriptives, and Poisson regression to study occurrence and risk of SIP episodes in the three-year observation period. Sankey diagrams were used to examine trajectories of psychotic episodes induced by various substances. Results Despite a decrease in individuals diagnosed with SIP during COVID-19, SIP episodes increased overall. We observed a decline in cannabis-induced psychosis, but a rise in SIP episodes involving amphetamines and multiple substances. Among individuals with recurrent SIP episodes, the psychosis was more often induced by different substances during COVID-19 (2020: RR, 1.50 [95% CI, 1.34–1.67]; 2021: RR, 1.30 [95% CI, 1.16–1.46]) than in 2019. Conclusion During COVID-19, fewer individuals were hospitalized with SIP, but those patients experienced more episodes. There were fewer cannabis-induced psychotic episodes, but more SIP hospitalizations caused by central stimulants and more SIP diagnoses caused by different substances, possibly reflecting changes in drug availability and pricing.
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spelling doaj-art-38d7f558d27b4945b26b0c1bfc6c38222025-08-20T01:56:25ZengCambridge University PressEuropean Psychiatry0924-93381778-35852024-01-016710.1192/j.eurpsy.2024.1797Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort studyMarja Leonhardt0https://orcid.org/0000-0002-0528-3949Jørgen G. Bramness1https://orcid.org/0000-0002-9250-3144Eline Borger Rognli2https://orcid.org/0000-0002-7248-3019Lars Lien3https://orcid.org/0000-0002-0480-9208Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway Faculty of Health Studies, VID Specialized University, Oslo, NorwayNorwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, NorwaySection for Clinical Addiction Research, Oslo University Hospital, Oslo, NorwayNorwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway Abstract Background Substance use may be associated with the onset of psychotic symptoms, necessitating treatment for individuals with comorbid mental health and substance use disorders (MHD/SUD). COVID-19 significantly impacted individuals with MHD/SUD, reducing access to appropriate care and treatment. Changes in drug availability and prices during the pandemic may have influenced drug consumption. This study aimed to determine the frequency of substance-induced psychosis (SIP) during COVID-19 among individuals with MHD/SUD and to explore substance fidelity by following patterns of SIP over time. Method In this retrospective cohort study, we analyzed data from all individuals with MHD/SUD registered in 2019–2021 in the Norwegian Patient Register. We used graphical approaches, descriptives, and Poisson regression to study occurrence and risk of SIP episodes in the three-year observation period. Sankey diagrams were used to examine trajectories of psychotic episodes induced by various substances. Results Despite a decrease in individuals diagnosed with SIP during COVID-19, SIP episodes increased overall. We observed a decline in cannabis-induced psychosis, but a rise in SIP episodes involving amphetamines and multiple substances. Among individuals with recurrent SIP episodes, the psychosis was more often induced by different substances during COVID-19 (2020: RR, 1.50 [95% CI, 1.34–1.67]; 2021: RR, 1.30 [95% CI, 1.16–1.46]) than in 2019. Conclusion During COVID-19, fewer individuals were hospitalized with SIP, but those patients experienced more episodes. There were fewer cannabis-induced psychotic episodes, but more SIP hospitalizations caused by central stimulants and more SIP diagnoses caused by different substances, possibly reflecting changes in drug availability and pricing. https://www.cambridge.org/core/product/identifier/S0924933824017978/type/journal_articlecomorbidityCOVID-19mental health disorderregister studysubstance use disorderSubstance-induced psychosis
spellingShingle Marja Leonhardt
Jørgen G. Bramness
Eline Borger Rognli
Lars Lien
Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort study
European Psychiatry
comorbidity
COVID-19
mental health disorder
register study
substance use disorder
Substance-induced psychosis
title Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort study
title_full Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort study
title_fullStr Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort study
title_full_unstemmed Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort study
title_short Frequency and patterns of substance-induced psychosis in persons with concurrent mental health and substance use disorders during the COVID-19 pandemic: A Norwegian register-based cohort study
title_sort frequency and patterns of substance induced psychosis in persons with concurrent mental health and substance use disorders during the covid 19 pandemic a norwegian register based cohort study
topic comorbidity
COVID-19
mental health disorder
register study
substance use disorder
Substance-induced psychosis
url https://www.cambridge.org/core/product/identifier/S0924933824017978/type/journal_article
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