{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/35708"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/35708","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study","abstract":"Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation.","abstract_html":"Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation.","abstract_has_math":false,"creators":["de Vaal, Sybrand Johannes"],"institution":"Department of Psychiatry and Mental Health","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Temmingh, Hendrik"],"committee_chairs":[],"committee_members":[],"year":2021,"date_issued":"2021","date_published":"2021","updated_at":"2026-07-22T22:23:39Z","subjects":["Psychiatry and Mental Health"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/35708","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Temmingh, Hendrik"]},{"key":"dc:creator","label":"Author","values":["de Vaal, Sybrand Johannes"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2022-02-18T05:09:19Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2022-02-18T05:09:19Z"]},{"key":"dc:date.issued","label":"Date","values":["2021"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Psychiatry and Mental Health"]},{"key":"dc:type","label":"Dc Type","values":["Master Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Psychiatry and Mental Health"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/35708"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation."]},{"key":"dc:title","label":"Title","values":["Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study"]}]}],"canonical_facts":{"dc:contributor.advisor":["Temmingh, Hendrik"],"dc:creator":["de Vaal, Sybrand Johannes"],"dc:date.accessioned":["2022-02-18T05:09:19Z"],"dc:date.available":["2022-02-18T05:09:19Z"],"dc:date.issued":["2021"],"dc:description.abstract":["Background: Substance-induced psychotic disorder (SIPD) is prevalent in South Africa, yet there is a paucity of research regarding its longitudinal course, with studies finding that diagnostic conversion occurs often, mostly to schizophrenia (SCZ). Aim: We examined the rate of, and factors associated with, diagnostic conversion in first-episode SIPD to primary, non-substance-related mental disorders. Setting: Adult inpatients with a diagnosis of first-episode SIPD discharged between 2012 to 2014 from Valkenberg psychiatric hospital, Cape Town. Methods: We conducted a retrospective cohort study of first-episode patients discharged from hospital, followed-up for a four-year period. We used survival analysis and Cox-proportional hazard regression to determine factors associated with diagnostic conversion to a primary mental disorder. Results: Of the sample of 225 patients, the majority were young, male and polysubstance users. Diagnostic conversion occurred in 26.2%, the majority within 3 years - 71.2% to SCZ-spectrum disorders and 28.8% to major affective disorders. In the adjusted analysis, diagnostic conversion remained significantly associated with male sex (HRadj=1.85, 95% CI=1.00– 3.42, p=0.045) and greater length of index admission (HRadj=1.02, 95% CI=1.01 – 1.04, p=0.006). Compared to nonconverters, significant associations with conversion to SCZ-spectrum disorders were male sex and length of index admission. Conversions to both SCZ-spectrum and major affective disorders were significantly associated with number of re-admissions during follow-up. Conclusion: Diagnostic conversion occurred in a substantial proportion of SIPD cases, often to SCZ. This warrants enhanced follow-up of high-risk cases, with attention to indicators such as sex and length of index hospitalisation."],"dc:identifier.uri":["http://hdl.handle.net/11427/35708"],"dc:publisher.department":["Department of Psychiatry and Mental Health"],"dc:subject":["Psychiatry and Mental Health"],"dc:title":["Diagnostic conversion following admission for a first-episode substance induced psychosis: A four-year retrospective cohort study"],"dc:type":["Master Thesis"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:39Z"}