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The British Journal of Psychiatry (2002) 181: 393-398
© 2002 The Royal College of Psychiatrists

Psychosis and drug dependence: results from a national survey of prisoners

M. FARRELL, MRCPsych and A. BOYS, PhD

National Addiction Centre, London

P. BEBBINGTON, FRCPsych

Royal Free and University College Medical School, London

T. BRUGHA, MRCPsych

University of Leicester, Leicester

J. COID, FRCPsych

Forensic Psychiatry Research Unit, St Bartholomew's Hospital, London

R. JENKINS, FRCPsych

Institute of Psychiatry, London

G. LEWIS, FRCPsych

Division of Psychiatry, Cotham House, Bristol

H. MELTZER, PhD

Office for National Statistics, London

J. MARSDEN, PhD

National Addiction Centre, London

N. SINGLETON, MSc

Office for National Statistics, London

C. TAYLOR, MSc

National Addiction Centre, London

Correspondence: Michael Farrell, National Addiction Centre, 4 Windsor Walk, London SE5 8AF, UK. E-mail: m.farrell{at}iop.kcl.ac.uk

Declaration of interest None.

Funding detailed in Acknowledgements.

Background The links between drug use and psychosis are of major aetiological and prognostic significance. Psychosis and drug dependence frequently co-occur within the prison population, providing the opportunity to study this link more closely.

Aims To explore the relationship between psychosis and drug dependence in a sample of prisoners.

Method A total of 3142 prisoners were surveyed nationally, and structured clinical data were obtained from a subsample of 503 respondents. Psychiatric assessment was based on the Schedules for Clinical Assessment in Neuropsychiatry (version 1.0). Measures of amphetamine, cannabis, cocaine and heroin use and dependence were obtained through self-report.

Results Logistic regression analyses indicated that first use of amphetamines or cocaine before the age of 16 years and severe cannabis or cocaine dependence were related to an increased risk of psychosis. In contrast, severe dependence on heroin was associated with a reduced risk of this classification.

Conclusions Severe dependence on cannabis and psychostimulants is associated with a higher risk of psychosis and is in contrast to severe dependence on heroin, which has a negative relationship with psychosis.

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ELIZABETH WALSH
BJP 2002 181: 0. [Full Text]  

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