Screening for substance use disorders in first-episode psychosis: implications for readmission.
Screening for substance use disorders in first-episode psychosis: implications for readmission.
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DOI：
10.1016/j.schres.2013.02.031
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发表时间：
2013-05
影响因子：
4.5
通讯作者：
Bernardo M
中科院分区：
文献类型：
--
作者：
Batalla A;Garcia-Rizo C;Castellví P;Fernandez-Egea E;Yücel M;Parellada E;Kirkpatrick B;Martin-Santos R;Bernardo M
对药物使用情况的筛查可能有助于防止精神病第一次发作后再次入院。本研究的目的是在首发精神病样本中评估药物使用对再入院风险的影响，并确定达特茅斯生活方式问卷(DALI)中的大麻/可卡因分量表是否比尿液分析更好地预测工具。入院后，对首发精神病患者进行药物使用访谈，并用DALI量表进行评估。他们还接受了血液和尿液采样。重新入院的时间被作为一个独立的结果进行研究。生存曲线的估计采用Kaplan-Meier估计量进行双因素分析。为了控制潜在的混杂因素，对用于多变量分析的COX比例风险模型进行了评估。用ROC曲线和效度参数评估再入院检测的有效性。共纳入58名患者。达利大麻/可卡因分量表和尿检与生存曲线上的再入院风险增加有关，主要是在头五年的随访中。在控制了重新入院的潜在混杂变量后，只有达利大麻/可卡因分量表仍然是一个显著的危险因素。就效度而言，达利大麻/可卡因分量表比尿检更敏感。酒精评估与再次入院无关。结果表明，大麻/可卡因使用障碍的快速筛查自我报告量表在预测再次住院方面优于尿液分析。未来的研究应该考虑对简短有效的筛查试验的纵向评估，以评估它们在预防首发精神病患者早期再入院方面的益处。
Screening of substance use may prove useful to prevent readmission after the first episode of psychosis. The aim of the present study was to evaluate the influence of drug use on readmission risk in a first-episode psychosis sample, and to determine whether the cannabis/cocaine subscale of the Dartmouth Assessment of Lifestyle Inventory (DALI) is a better predictive instrument than urinary analysis. After admission, first-episode psychotic patients were interviewed for substance use and assessed with the DALI scale. They also underwent blood and urine sampling. Time to readmission was studied as a dependent outcome. The Kaplan–Meier estimator was applied to estimate the survival curves for bivariate analysis. The Cox proportional hazards model for multivariate analysis was assessed in order to control for potential confounders. ROC curve and validity parameters were used to assess validity to detect readmission. Fifty-eight patients were included. The DALI cannabis/cocaine subscale and urinalysis were associated with increased readmission risk in survival curves, mainly the first five years of follow-up. After controlling for potential confounding variables for readmission, only the DALI cannabis/cocaine subscale remained as a signifi-cant risk factor. In terms of validity, the DALI cannabis/cocaine subscale was more sensitive than urinalysis. Alcohol assessments were not related to readmission. The findings demonstrated that a quick screening self-report scale for cannabis/cocaine use disorders is superior to urinary analysis for predicting readmission. Future research should consider longitudinal assessments of brief validated screening tests in order to evaluate their benefits in preventing early readmission in first-episode psychosis.
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影响因子：
6
作者：
Ford, P
通讯作者：
Ford, P
影响因子：
4.5
作者：
Garcia-Rizo, Clemente;Fernandez-Egea, Emilio;Kirkpatrick, Brian
通讯作者：
Kirkpatrick, Brian
影响因子：
4.5
作者：
Bühler, B;Hambrecht, M;Häfner, H
通讯作者：
Häfner, H
影响因子：
3.8
作者：
Addington, Donald Emile;Beck, Cindy;McKenzie, Emily
通讯作者：
McKenzie, Emily
影响因子：
6.6
作者：
DRAKE, RE;OSHER, FC;BEAUDETT, MS
通讯作者：
BEAUDETT, MS