Mortality in substance-induced psychosis: a register-based national cohort study
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Mortality in substance-induced psychosis : a register-based national cohort study. / Hjorthoj, Carsten; Madsen, Trine; Starzer, Marie; Erlangsen, Annette; Nordentoft, Merete.
In: Addiction, Vol. 116, No. 12, 2021, p. 3515-3524.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Mortality in substance-induced psychosis
T2 - a register-based national cohort study
AU - Hjorthoj, Carsten
AU - Madsen, Trine
AU - Starzer, Marie
AU - Erlangsen, Annette
AU - Nordentoft, Merete
PY - 2021
Y1 - 2021
N2 - Aims We aimed to analyze whether people with substance-induced psychosis (SIP), both those who convert and do not convert to schizophrenia, have higher all-cause and cause-specific mortality when compared to the general population. Design Prospective cohort study. Setting Nationwide Danish registers. Participants/Cases We included all people born in Denmark, living in Denmark on their 15th birthday, and age 15 or more during the study period from January 1, 1994, and August 10, 2017. Measurements Exposure was categorized as: (i) neither SIP nor schizophrenia; (ii) SIP without preceding schizophrenia; (iii) SIP converted to schizophrenia; and (iv) schizophrenia without preceding SIP. Any SIP and substance-specific SIPS were examined regarding all-cause and cause-specific mortality. Findings The study included a total of 5 619 691 individuals. Compared to people with neither schizophrenia nor SIP, people with SIP without preceding schizophrenia had an increased risk of dying (hazard ratio [HR] = 6.23, 95% CI = 5.96-6.50), as had those with SIP converting to schizophrenia (HR = 9.77, 95% CI = 8.84-10.79) and those with only schizophrenia (HR = 3.07, 95% CI = 3.03-3.13). A similar pattern, albeit with higher HRs, was observed for suicides and accidental deaths. Other cause-specific-mortality groups also generally showed the same pattern, as did types of individual substances. Conclusions Substance-induced psychosis was strongly associated with an increased risk of both all-cause and cause-specific mortality, even among cases who did not convert to schizophrenia. This provides a strong rationale for monitoring people with previous diagnosis of substance-induced psychosis and developing and implementing interventions to reduce this excess mortality.
AB - Aims We aimed to analyze whether people with substance-induced psychosis (SIP), both those who convert and do not convert to schizophrenia, have higher all-cause and cause-specific mortality when compared to the general population. Design Prospective cohort study. Setting Nationwide Danish registers. Participants/Cases We included all people born in Denmark, living in Denmark on their 15th birthday, and age 15 or more during the study period from January 1, 1994, and August 10, 2017. Measurements Exposure was categorized as: (i) neither SIP nor schizophrenia; (ii) SIP without preceding schizophrenia; (iii) SIP converted to schizophrenia; and (iv) schizophrenia without preceding SIP. Any SIP and substance-specific SIPS were examined regarding all-cause and cause-specific mortality. Findings The study included a total of 5 619 691 individuals. Compared to people with neither schizophrenia nor SIP, people with SIP without preceding schizophrenia had an increased risk of dying (hazard ratio [HR] = 6.23, 95% CI = 5.96-6.50), as had those with SIP converting to schizophrenia (HR = 9.77, 95% CI = 8.84-10.79) and those with only schizophrenia (HR = 3.07, 95% CI = 3.03-3.13). A similar pattern, albeit with higher HRs, was observed for suicides and accidental deaths. Other cause-specific-mortality groups also generally showed the same pattern, as did types of individual substances. Conclusions Substance-induced psychosis was strongly associated with an increased risk of both all-cause and cause-specific mortality, even among cases who did not convert to schizophrenia. This provides a strong rationale for monitoring people with previous diagnosis of substance-induced psychosis and developing and implementing interventions to reduce this excess mortality.
KW - Alcohol use disorder
KW - alcoholism
KW - death
KW - mortality
KW - schizophrenia
KW - substance use disorder
KW - substance-induced psychosis
KW - suicide
KW - BIPOLAR DISORDER
KW - EXCESS MORTALITY
KW - MENTAL-DISORDERS
KW - LIFE EXPECTANCY
KW - SCHIZOPHRENIA
KW - CANCER
KW - RISK
KW - EPIDEMIOLOGY
KW - METAANALYSIS
KW - ALCOHOL
U2 - 10.1111/add.15598
DO - 10.1111/add.15598
M3 - Journal article
C2 - 34105214
VL - 116
SP - 3515
EP - 3524
JO - Addiction
JF - Addiction
SN - 0965-2140
IS - 12
ER -
ID: 273696970