COMORBIDITY IN PSYCHOSIS AT 1ST HOSPITALIZATION

Objective: The authors sought to determine the prevalence and effects of medical and psychiatric comorbidity on initial outcome in a group o f patients experiencing a first episode of psychosis. Method: Patients with a first episode of psychosis who were consecutively admitted to a hospital (N=102) were examined for the presence of psychiatric and m edical disorders. Patients were given psychiatric diagnoses with the u se of the Structured Clinical Interview for DSM-III-R and were rated w eekly on symptom rating scales. Outcome variables at discharge were fi nal symptom rating scale scores, length of hospitalization, and recove ry on the basis of operationalized criteria. Results: Comorbid diagnos es were present in 52.0% (N=53) of the patients, and 37.7% (N=20) bad multiple comorbid diagnoses. The most common comorbid diagnosis was su bstance abuse. Patients with affective psychoses were significantly mo re likely than those with nonaffective psychoses to have a comorbid su bstance abuse diagnosis. Patients with psychiatric comorbidity bad poo rer initial outcomes, while those with medical comorbidity had fewer s ymptoms at discharge. Conclusions: Comorbidity is common and may be a useful predictor of the outcome of a first episode of psychosis.