Substance abuse in first-episode psychosis at Chris Hani Baragwanath Hospital

Background: In South Africa, the use of substances is associated with serious health challenges, exacerbated by limited health resources. Substance use is often associated with first-episode psychosis (FEP). Prevention and treatment protocols can be established by understanding the socio-demographic and clinical characteristics of patients with FEP. Aim: To determine the prevalence, patterns, socio-demographic and clinical factors associated with substance use in patients with FEP at Chris Hani Baragwanath Academic Hospital. Setting: The study was conducted at Chris Hani Baragwanath Academic Hospital, a tertiary healthcare facility in Soweto, South Africa. Methods: The study was a retrospective chart review analysis of clinical records of 200 patients presenting with FEP. The data were then statistically analysed, and patients with and without substance use in FEP were compared. Results: The prevalence of substance use was 73.6%. Most patients were male and between 21 years old and 30 years old (37.0%). Substance-induced psychotic disorder was the most common diagnosis. Cannabis (THC) (46.0%) was the most commonly used substance. Substance use was associated with aggression (45.0%), and only 34.0% of substance users were referred to social services. Conclusion: Substance use is a modifiable risk factor in the presentation of psychotic disorders. Integrated models of care, addressing both mental health and substance use and targeting early intervention, are essential to improve patient outcomes. Contribution: In this study, the focus was on the interrelationship between substance use and psychosis. It emphasised the need for integrated strategies for the treatment of mental health and substance use. It provides a crucial insight into the socio-demographic and clinical predictors of substance use in patients with FEP, which can inform clinical practice and intervention strategies.