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Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study
Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associate...
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| Format: | Thesis |
| Language: | English |
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Department of Psychiatry and Mental Health
2022
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| _version_ | 1867614054947749888 |
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| access_status_str | Open Access |
| author | de Vaal, Sybrand Johannes |
| author2 | Temmingh, Hendrik |
| author_browse | Temmingh, Hendrik de Vaal, Sybrand Johannes |
| author_facet | Temmingh, Hendrik de Vaal, Sybrand Johannes |
| author_sort | de Vaal, Sybrand Johannes |
| collection | Thesis |
| description | Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/35708 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:45:57.163Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Psychiatry and Mental Health |
| publisherStr | Department of Psychiatry and Mental Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/35708 Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study de Vaal, Sybrand Johannes Temmingh, Hendrik Psychiatry and Mental Health Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation. 2022-02-18T05:09:19Z 2022-02-18T05:09:19Z 2021 2022-02-10T08:26:04Z Master Thesis Masters MMed http://hdl.handle.net/11427/35708 eng application/pdf Department of Psychiatry and Mental Health Faculty of Health Sciences |
| spellingShingle | Psychiatry and Mental Health de Vaal, Sybrand Johannes Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study |
| thesis_degree_str | Master's |
| title | Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study |
| title_full | Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study |
| title_fullStr | Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study |
| title_full_unstemmed | Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study |
| title_short | Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study |
| title_sort | diagnostic conversion following admission for a first episode substance induced psychosis a four year retrospective cohort study |
| topic | Psychiatry and Mental Health |
| url | http://hdl.handle.net/11427/35708 |
| work_keys_str_mv | AT devaalsybrandjohannes diagnosticconversionfollowingadmissionforafirstepisodesubstanceinducedpsychosisafouryearretrospectivecohortstudy |