Differential diagnosis of substance-induced psychosis and schizophrenia in patients with substance use disorders

Schizophrenia Bulletin
R N Rosenthal, C R Miner

Abstract

We derived a statistical model that discriminates between substance-induced psychosis (i.e., DSM-III-R organic delusional disorder or organic hallucinosis; ODD-OH) and DSM-III-R schizophrenia in patients who have both DSM-III-R psychoactive substance use disorders (PSUD) and prominent delusions or hallucinations. A sample of 211 PSUD inpatients was divided by year of admission into data sets A and B, each of which was divided between those with concurrent schizophrenia and those with concurrent ODD-OH. A six-predictor discriminant function correctly classified 76.2 percent of all set A patients, including 83.1 percent with schizophrenia. Formal thought disorder and bizarre delusions significantly predict a diagnosis of schizophrenia, with odds ratios (OR) of 3.55:1 and 6.09:1, respectively. Suicidal ideation (OR = 0.32:1), intravenous cocaine abuse (0.18:1), and a history of drug detoxification (0.26:1) or methadone maintenance (0.18:1) demonstrate inverse relationships with a schizophrenia diagnosis. The model was validated in set B, correctly predicting the diagnostic status of 70.4 percent of patients (72.5% with schizophrenia). The pattern of presenting symptoms and clinical history differs in patients with psychosis due to...Continue Reading

Citations

Dec 23, 2003·Progress in Neuro-psychopharmacology & Biological Psychiatry·Patricia A BroderickYueping Zhou
Jul 6, 2000·European Psychiatry : the Journal of the Association of European Psychiatrists·P Batel
Jun 9, 2007·Schizophrenia Bulletin·Bruce J Rounsaville
Dec 4, 2009·Schizophrenia Bulletin·Lisa B DixonUNKNOWN Schizophrenia Patient Outcomes Research Team (PORT)
Jun 1, 2012·Revista colombiana de psiquiatría·Óscar Medina Ortiz
Jun 11, 2002·Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie·C FleischhakerH Remschmidt
Feb 3, 2007·The British Journal of Psychiatry : the Journal of Mental Science·Carol L M CatonBella Schanzer

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