Lambert Tchern Kuang Low and Kim Eng Wong
Causative Agents of Substance Induced Psychotic Disorder amongst Inpatients and Outpatients of a South East Asian Tertiary Addictions Management Service
Introduction: There is a paucity of local research on patients with substance induced psychotic disorder and their causative agents in South East Asia including Singapore. This study examines the main substances contributing to substance induced psychosis in patients receiving treatment at a tertiary addictions management service in Singapore. It also identifies factors predictive of subsequent conversion to a primary psychotic disorder. Methodology: Retrospective case-note analysis of 48 patients referred to the National Addictions Management Service between 01/04/2007-31/03/2012 with a diagnosis of substance induced psychotic disorder and no prior history of a primary psychotic disorder. Results: Amphetamine, alcohol, benzodiazepines and codeine were most commonly associated with substance induced psychosis. 10 (20.8%) of the patients were re-diagnosed to a primary psychotic disorder. The younger the age of onset of substance induced psychotic disorder, the higher the risk of conversion to a primary psychotic disorder. Conclusion: Illegal and so-called prescription drugs can cause SIPD or precipitate a primary psychosis in those with an underlying psychotic diathesis, and the risk of the latter is higher the younger the age of onset of the SIPD. This message should be used more often in primary and secondary prevention strategies.