The prevalence of substance-induced psychotic disorder in relation to psychoactive substance abuse in the Czech Republic
Abstract
This article aims to describe the prevalence of toxic psychosis (substance-induced psychotic disorders) based on data from the Institute of Health Information and Statistics of the Czech Republic including the development of psychoactive substances abuse.
This study mainly uses data from the Institute of Health Information and Statistics (ÚZIS) of the Czech Republic, processed by descriptive statistics into graphs and tables and described. The study focuses on the observed period from 2010 to 2020. Moreover, the study discusses data from World Drug Report 2021 issued by the United Nations Office on Drugs and Crime, European Drug Report 2021 and data from the Annual Report on Drug Situation in the Czech Republic in 2019.
The number of patients with toxic psychoses is low compared to patients with schizophrenia spectrum disorders - 4% in outpatient care, 8% in hospitalization (data based on 2020 comparing the number of patients diagnosed with toxic psychoses with the number of patients diagnosed with diagnosis F20-F29, i.e., schizophrenia, schizotypal disorder and delusional disorder), however, their number is constantly increasing.
The number of hospitalized patients with substance-induced psychotic disorder increased significantly from 2010 to 2020 (in a direct comparison of 2010 and 2020 the number increased by 88% for cannabis, 36% for stimulants and by 90% for polysubstance use). The overall trend in the number of hospitalized patients with toxic psychosis, apart from the F105 diagnosis (alcohol-induced psychotic disorder), is increasing. At the same time, when we focus in more detail on specific diagnoses in individual years, the F105 diagnosis fluctuates slightly in the monitored period and overall decreases, while the F125 (cannabis-induced psychotic disorder) diagnosis slightly increases in the monitored period, in the F155 (stimulant-induced psychotic disorder) diagnosis, despite fluctuations in the monitored period, there was an overall increase and in the F195 (multiple drug-induced psychotic disorder) diagnosis, despite a slight fluctuation in the monitored period, there was an overall significant increase.
In psychiatric outpatient clinics, there was a 76% increase in poly-substance-induced psychotic disorder, a 65% increase in cannabis-induced psychotic disorder and a 42% increase in stimulant-induced psychotic disorder in a direct comparison of 2010 and 2020. The overall trend in the number of patients treated in psychiatric outpatient clinics with toxic psychosis, apart from the F105 diagnosis, is increasing. At the same time, if we focus in more detail on specific diagnoses in individual years, we can see that there is an overall decrease in the F105 diagnosis in the monitored period, and in the F125 diagnosis in the monitored period there was a slight increase. With the F155 diagnosis there was a gradual increase and in the second part of the monitored period a slight decrease, overall there was an increase and with the F195 diagnosis there was a very significant increase in the first part of the monitored period, a slight increase in the second half of the monitored period.
The prevalence of cannabis and stimulant use in the Czech Republic fluctuates over the monitored period.
An exception to the group of diagnoses of substance-induced psychotic disorders are toxic psychoses caused by the use of alcohol. Their number has decreased significantly over the last decade. The number of hospitalized patients with alcohol-induced psychotic disorder decreased by 39% in a direct comparison of 2010 and 2020 and the number of outpatients treated with alcohol-induced psychotic disorder decreased by 36% in a direct comparison of 2010 and 2020. Similar trends in toxic psychoses are indicated by world studies.
In conclusion, this study of the prevalence of toxic psychosis suggests a significant increase in the number of toxic psychoses despite their relatively low share in the aetiology of psychoses and fluctuating drug use (especially cannabis and stimulants). These findings in the Czech Republic underline the importance of future research on diagnostics and differential psychology of toxic psychoses, including their aetiology.