Original Research

First-episode psychosis and substance use in Nelson Mandela Bay: Findings from an acute mental health unit

Yanga Thungana, Zukiswa Zingela, Stephan van Wyk
South African Journal of Psychiatry | Vol 25 | a1372 | DOI: https://doi.org/10.4102/sajpsychiatry.v25i0.1372 | © 2019 Yanga Thungana, Zukiswa Zingela, Stephan van Wyk | This work is licensed under CC Attribution 4.0
Submitted: 04 January 2019 | Published: 24 October 2019

About the author(s)

Yanga Thungana, Department of Psychiatry and Behavioural Sciences, Walter Sisulu University, Mthatha, South Africa; and, Acute Mental Health Care Unit, Dora Nginza Hospital, Bethelsdorp, South Africa
Zukiswa Zingela, Department of Psychiatry and Behavioural Sciences, Walter Sisulu University, Mthatha, South Africa; and, Nelson Mandela Academic Hospital, Mthatha, South Africa
Stephan van Wyk, Department of Psychiatry and Behavioural Sciences, Walter Sisulu University, Mthatha, South Africa; and, Nelson Mandela Academic Hospital, Mthatha, South Africa


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Abstract

Background: Use of psychoactive substances is a common finding in studies on first-episode psychosis (FEP), and this has prognostic implications. We know very little about psychoactive substance use (SU) among patients with FEP in the Eastern Cape province (EC) of South Africa (SA).

Aim: The study seeks to determine SU prevalence and associated features among inpatients with non-affective FEP in an acute mental health unit (MHU) in Nelson Mandela Bay, EC.

Setting: Researchers conducted a retrospective clinical file review of a 12-month admission cohort of patients with FEP, without a concurrent mood episode, to the Dora Nginza Hospital MHU. Information collected included SU history, psychiatric diagnoses, and demographics. Data were then subjected to statistical analysis.

Methods: Researchers conducted a retrospective clinical file review of a 12-month admission cohort of patients with FEP, without a concurrent mood episode, to the Dora Nginza Hospital MHU. Information collected included SU history, psychiatric diagnoses and demographics. Data were then subjected to statistical analysis.

Results: A total of 117 patients (86 [73.5%] males; 31 [26.5%] females) aged 18–60 years (mean 29 years) met the inclusion criteria. After controlling for missing information, 95 of 117 (81.2%) patients had a history of active or previous SU, 82 of 90 (91.1%) were single and 61 of 92 (66.3%) were unemployed. A significant association was found between SU and unemployment (p < 0.001), as well as male sex (p < 0.001). The most common substances used were cannabis (59.8%), followed by alcohol (57.3%) and stimulants (46.4%).

Conclusion: In keeping with national and international literature, the results of this study showed a high prevalence of substance use in South African patients with first-episode psychosis. The high prevalence of lifetime substance use in this cohort compared to previous studies in South Africa requires further investigation and highlights the urgent need for dual diagnosis services in the Eastern Cape province.


Keywords

substance use; first-episode psychosis; dual diagnosis; cannabis use; polysubstance use

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