Comparative Clinical and Sociodemographic Assessment of Substance Use in First Episode, Drug-naïve Psychosis and Schizophrenia Patients

Abstract

Objective: This study aims to compare recent-onset, drug-naïve patients with first-episode psychosis (FEP) and patients with schizophrenia in terms of substance and smoking history, and to explore their associations with sociodemographic and clinical characteristics. Methods: A total of 107 patients were included: 56 with drug-naïve FEP and 51 with schizophrenia. Standardized clinical instruments were used, including the Clinical Global Impression–Severity Scale (CGI-S), the Scale for the Assessment of Negative Symptoms (SANS), the Scale for the Assessment of Positive Symptoms (SAPS), and the Calgary Depression Scale for Schizophrenia (CDSS). Results: Substance use was more prevalent among schizophrenia patients (41.2%) compared to FEP patients (25.0%). In both groups, substance use was associated with increased smoking, alcohol consumption, and greater clinical severity. Specifically, FEP patients with substance use reported significantly higher depressive and negative symptoms, as well as greater illness severity. Among schizophrenia patients, substance use was correlated with elevated SAPS, SANS, and CGI-S scores, as well as higher rates of self-mutilation. Conclusion: Substance use contributes to greater symptom burden, behavioral dysregulation, and overall clinical severity in both FEP and schizophrenia. Early screening and the integration of dual-diagnosis treatment strategies are essential to mitigate adverse outcomes in psychotic disorders.

Keywords

• First-episode psychosis
• Drug-naïve
• Schizophrenia
• Substance Use
• Clinical features

İlk Atak, İlaç Kullanmamış Psikoz ve Şizofreni Hastalarında Madde Kullanımının Karşılaştırmalı Klinik ve Sosyodemografik Analizi

Öz

Amaç: Bu çalışmanın amacı, ilk atak psikoz (FEP) tanısı almış, ilaç-naif ve hastalığı yakın zamanda başlamış bireylerle şizofreni hastalarını madde ve sigara kullanımı açısından karşılaştırmak ve bu değişkenlerin sosyodemografik ve klinik özelliklerle ilişkisini incelemektir. Yöntem: Çalışmaya 56'sı ilaç-naif FEP, 51’i ise şizofreni olgusu olmak üzere toplam 107 hasta dahil edilmiştir. Klinik değerlendirme için Klinik Genel İzlenim - Şiddet Ölçeği (CGI-S), Negatif Belirti Değerlendirme Ölçeği (SANS), Pozitif Belirti Değerlendirme Ölçeği (SAPS) ve Şizofrenide Depresyon için Calgary Ölçeği (CDSS) gibi standart ölçekler kullanılmıştır. Bulgular: Madde kullanımı, şizofreni hastalarında (%41,2), FEP hastalarına (%25,0) göre daha yaygındı. Her iki grupta da madde kullanımı, artmış sigara ve alkol tüketimi ile birlikte daha yüksek klinik şiddet ile ilişkilidir. Özellikle, madde kullanan FEP hastalarında depresif ve negatif semptomlar anlamlı şekilde daha yüksektir ve hastalık şiddeti artmıştır. Şizofreni grubunda ise madde kullanımı, SAPS, SANS ve CGI-S skorlarının yüksekliği ile ve daha sık özkıyım davranışı ile ilişkilidir. Sonuç: Madde kullanımı, hem FEP hem de şizofreni hastalarında semptom yükünü, davranışsal düzensizlikleri ve genel klinik şiddeti artırmaktadır. Psikotik bozukluklarda olumsuz sonuçları azaltmak için erken dönemde tarama yapılması ve ikili tanıya yönelik tedavi stratejilerinin entegrasyonu büyük önem taşımaktadır.

Anahtar Kelimeler

• İlk epizod psikoz
• Tedavi almamış
• Madde Kullanımı
• Klinik özellikler
• Şizofreni

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