{"id":{"repo_id":"varna","oai_identifier":"oai:repository.mu-varna.bg:nls/4377"},"canonical_url":"https://search.dev.ndltd.org/etd/varna/oai:repository.mu-varna.bg:nls/4377","repository":{"repo_id":"varna","name":"Medical University of Varna","base_url":"https://repository.mu-varna.bg/oai/request"},"display":{"title":"Dynamics of Diagnosis in Patients with a First Psychotic Episode Induced by the Use of Psychoactive Substances // Динамика на диагнозата при пациенти с първи психотичен епизод след употреба на психоактивни вещества","abstract":"The first psychotic episode marks a critical moment in the development of chronic psychotic disorders and carries substantial diagnostic and prognostic significance. In recent decades, a steady increase in the number of registered psychotic disorders induced by psychoactive substance use has been documented. The dynamics of diagnosis in these patients are a relevant yet insufficiently researched issue, thereby requiring investigation. The thesis aims to track the variability (dynamics) of diagnosis in patients with a first psychotic episode after psychoactive substance use within a two-year period. The study is designed as a longitudinal, prospective study, including a total sample of 81 patients aged 18 to 65 years, divided into two groups: the study group of 41 individuals with a diagnosis of first psychotic episode after psychoactive substance use and the control group of 40 individuals. To achieve the objectives, sociodemographic and clinical characteristics, severity of psychotic symptomatology, frequency of hospitalisations, level of functional recovery, and dynamics of initial diagnosis were studied. Applied research methods included clinical psychiatric examination, standardised assessment instruments (PANSS, GAF scales, and DAST 10 questionnaire), clinical laboratory tests, and combined urine tests for psychoactive substances. Data were processed with modern statistical methods, ensuring reliability and statistical significance of the obtained results. The analysis of results and conclusions confirms that psychoactive substance use is a substantial modifying factor in the development and course of psychotic disorders and exerts unfavourable influence on psychosis severity, number of hospitalisations, degree of recovery, and the quality of life. In patients in the study group, slower and partial improvement is observed, as well as a tendency toward chronification of psychosis, mainly with transition to diagnosis in the schizophrenia spectrum. Decrease in positive symptomatology remains the leading prognostic marker for early remission, while negative and cognitive impairments determine poorer long-term prognosis and social maladaptation. The study demonstrates the applicability of standardised psychometric instruments (PANSS, GAF, and DAST-10) in Bulgarian clinical practice and outlines the need for inclusion of neuropsychological assessments in future studies. The main limitations in the course of the study were the relatively small sample size (n ≈ 80) and an insufficiently prolonged follow-up period.","abstract_html":"The first psychotic episode marks a critical moment in the development of chronic psychotic disorders and carries substantial diagnostic and prognostic significance. In recent decades, a steady increase in the number of registered psychotic disorders induced by psychoactive substance use has been documented. The dynamics of diagnosis in these patients are a relevant yet insufficiently researched issue, thereby requiring investigation. The thesis aims to track the variability (dynamics) of diagnosis in patients with a first psychotic episode after psychoactive substance use within a two-year period. The study is designed as a longitudinal, prospective study, including a total sample of 81 patients aged 18 to 65 years, divided into two groups: the study group of 41 individuals with a diagnosis of first psychotic episode after psychoactive substance use and the control group of 40 individuals. To achieve the objectives, sociodemographic and clinical characteristics, severity of psychotic symptomatology, frequency of hospitalisations, level of functional recovery, and dynamics of initial diagnosis were studied. Applied research methods included clinical psychiatric examination, standardised assessment instruments (PANSS, GAF scales, and DAST 10 questionnaire), clinical laboratory tests, and combined urine tests for psychoactive substances. Data were processed with modern statistical methods, ensuring reliability and statistical significance of the obtained results. The analysis of results and conclusions confirms that psychoactive substance use is a substantial modifying factor in the development and course of psychotic disorders and exerts unfavourable influence on psychosis severity, number of hospitalisations, degree of recovery, and the quality of life. In patients in the study group, slower and partial improvement is observed, as well as a tendency toward chronification of psychosis, mainly with transition to diagnosis in the schizophrenia spectrum. Decrease in positive symptomatology remains the leading prognostic marker for early remission, while negative and cognitive impairments determine poorer long-term prognosis and social maladaptation. The study demonstrates the applicability of standardised psychometric instruments (PANSS, GAF, and DAST-10) in Bulgarian clinical practice and outlines the need for inclusion of neuropsychological assessments in future studies. The main limitations in the course of the study were the relatively small sample size (n ≈ 80) and an insufficiently prolonged follow-up period.","abstract_has_math":false,"creators":["Avramov, Danko","Аврамов, Данко"],"institution":"Medical University of Varna","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2026,"date_issued":"2026-04-02T12:55:23Z","date_published":"2026-04-02T12:55:23Z","updated_at":"2026-07-27T21:57:04Z","subjects":["psychotic episode","psychotic disorder","substances","Психиатрия и медицинска психология / Psychiatry and Medical Psychology"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://repository.mu-varna.bg/handle/nls/4377","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["Avramov, Danko","Аврамов, Данко"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2026-04-02T12:55:23Z","2025"]},{"key":"dc:publisher","label":"Institution","values":["Medical University of Varna"]},{"key":"dc:type","label":"Dc Type","values":["thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["psychotic episode","psychotic disorder","substances","Психиатрия и медицинска психология / Psychiatry and Medical Psychology"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://repository.mu-varna.bg/handle/nls/4377"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["The first psychotic episode marks a critical moment in the development of chronic psychotic disorders and carries substantial diagnostic and prognostic significance. In recent decades, a steady increase in the number of registered psychotic disorders induced by psychoactive substance use has been documented. The dynamics of diagnosis in these patients are a relevant yet insufficiently researched issue, thereby requiring investigation. The thesis aims to track the variability (dynamics) of diagnosis in patients with a first psychotic episode after psychoactive substance use within a two-year period. The study is designed as a longitudinal, prospective study, including a total sample of 81 patients aged 18 to 65 years, divided into two groups: the study group of 41 individuals with a diagnosis of first psychotic episode after psychoactive substance use and the control group of 40 individuals. To achieve the objectives, sociodemographic and clinical characteristics, severity of psychotic symptomatology, frequency of hospitalisations, level of functional recovery, and dynamics of initial diagnosis were studied. Applied research methods included clinical psychiatric examination, standardised assessment instruments (PANSS, GAF scales, and DAST 10 questionnaire), clinical laboratory tests, and combined urine tests for psychoactive substances. Data were processed with modern statistical methods, ensuring reliability and statistical significance of the obtained results. The analysis of results and conclusions confirms that psychoactive substance use is a substantial modifying factor in the development and course of psychotic disorders and exerts unfavourable influence on psychosis severity, number of hospitalisations, degree of recovery, and the quality of life. In patients in the study group, slower and partial improvement is observed, as well as a tendency toward chronification of psychosis, mainly with transition to diagnosis in the schizophrenia spectrum. Decrease in positive symptomatology remains the leading prognostic marker for early remission, while negative and cognitive impairments determine poorer long-term prognosis and social maladaptation. The study demonstrates the applicability of standardised psychometric instruments (PANSS, GAF, and DAST-10) in Bulgarian clinical practice and outlines the need for inclusion of neuropsychological assessments in future studies. The main limitations in the course of the study were the relatively small sample size (n ≈ 80) and an insufficiently prolonged follow-up period.","Първият психотичен епизод представлява ключов момент в развитието на хроничните психотични разстройства и е свързан с висока диагностична и прогностична значимост. През последните десетилетия се отбелязва устойчиво нарастване на броя на регистрираните психотични разстройства, индуцирани от употребата на психоактивни вещества. Динамиката на диагнозата при тези пациенти е актуален и недостатъчно проучен проблем в българската психиатрия, което обосновава и избора на темата. Целта на настоящото изследване е да се проследи изменчивостта (динамиката) на диагнозата при пациенти с първи психотичен епизод след употреба на психоактивни вещества в рамките на двугодишен период. Изследването е проектирано като надлъжно, проспективно проучване, включващо обща извадка от 81 пациенти на възраст от 18 до 65г., разделени на две групи – проучваната група от 41 лица с диагноза първи психотичен епизод след употреба на психоактивни вещества и контролната група от 40 лица. За постигане на целите бяха проучени социодемографските и клиничните характеристики, тежестта на психотичната симптоматика, честотата на хоспитализациите, нивото на функционално възстановяване и динамиката на началната диагноза. Приложените методи на изследване включваха клинично психиатрично изследване; стандартизирани оценъчни инструменти (скалите PANSS, GAF и въпросник DATS 10); клинико-лабораторни изследвания и комбинирани уринни тестове за психоактивни вещества. Данните бяха обработвани със съвременни статистически методи, осигуряващи надеждност и статистическа значимост на получените резултати. Анализът на резултатите и изводите потвърждават, че употребата на психоактивни вещества е съществен модифициращ фактор в развитието и протичането на психотичните разстройства и оказва неблагоприятно влияние върху тежестта на психозата, броят на хоспитализациите, степента на възстановяване и качеството на живот. При пациентите в проучваната група се наблюдава по-бавно и частично подобрение, както и тенденция към хронифициране на психозата, основно с преход към шизофренния спектър. Отзвучаването на позитивната симптоматика остава водещ прогностичен маркер за ранна ремисия, докато негативните и когнитивни нарушения определят по-лоша дългосрочната прогноза и социалната дезадаптация. Проучването демонстрира приложимостта на стандартизирани психометрични инструменти (PANSS, GAF, DAST-10) в българската клинична практика и очертава нуждата от включване на невропсихологични оценки при бъдещи изследвания. Основни ограничения в хода на изследването бяха относително малкият размер на извадката (n ≈ 80) и недостатъчно продължителният период на проследяване."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Dynamics of Diagnosis in Patients with a First Psychotic Episode Induced by the Use of Psychoactive Substances // Динамика на диагнозата при пациенти с първи психотичен епизод след употреба на психоактивни вещества"]}]}],"canonical_facts":{"dc:creator":["Avramov, Danko","Аврамов, Данко"],"dc:date":["2026-04-02T12:55:23Z","2025"],"dc:description":["The first psychotic episode marks a critical moment in the development of chronic psychotic disorders and carries substantial diagnostic and prognostic significance. In recent decades, a steady increase in the number of registered psychotic disorders induced by psychoactive substance use has been documented. The dynamics of diagnosis in these patients are a relevant yet insufficiently researched issue, thereby requiring investigation. The thesis aims to track the variability (dynamics) of diagnosis in patients with a first psychotic episode after psychoactive substance use within a two-year period. The study is designed as a longitudinal, prospective study, including a total sample of 81 patients aged 18 to 65 years, divided into two groups: the study group of 41 individuals with a diagnosis of first psychotic episode after psychoactive substance use and the control group of 40 individuals. To achieve the objectives, sociodemographic and clinical characteristics, severity of psychotic symptomatology, frequency of hospitalisations, level of functional recovery, and dynamics of initial diagnosis were studied. Applied research methods included clinical psychiatric examination, standardised assessment instruments (PANSS, GAF scales, and DAST 10 questionnaire), clinical laboratory tests, and combined urine tests for psychoactive substances. Data were processed with modern statistical methods, ensuring reliability and statistical significance of the obtained results. The analysis of results and conclusions confirms that psychoactive substance use is a substantial modifying factor in the development and course of psychotic disorders and exerts unfavourable influence on psychosis severity, number of hospitalisations, degree of recovery, and the quality of life. In patients in the study group, slower and partial improvement is observed, as well as a tendency toward chronification of psychosis, mainly with transition to diagnosis in the schizophrenia spectrum. Decrease in positive symptomatology remains the leading prognostic marker for early remission, while negative and cognitive impairments determine poorer long-term prognosis and social maladaptation. The study demonstrates the applicability of standardised psychometric instruments (PANSS, GAF, and DAST-10) in Bulgarian clinical practice and outlines the need for inclusion of neuropsychological assessments in future studies. The main limitations in the course of the study were the relatively small sample size (n ≈ 80) and an insufficiently prolonged follow-up period.","Първият психотичен епизод представлява ключов момент в развитието на хроничните психотични разстройства и е свързан с висока диагностична и прогностична значимост. През последните десетилетия се отбелязва устойчиво нарастване на броя на регистрираните психотични разстройства, индуцирани от употребата на психоактивни вещества. Динамиката на диагнозата при тези пациенти е актуален и недостатъчно проучен проблем в българската психиатрия, което обосновава и избора на темата. Целта на настоящото изследване е да се проследи изменчивостта (динамиката) на диагнозата при пациенти с първи психотичен епизод след употреба на психоактивни вещества в рамките на двугодишен период. Изследването е проектирано като надлъжно, проспективно проучване, включващо обща извадка от 81 пациенти на възраст от 18 до 65г., разделени на две групи – проучваната група от 41 лица с диагноза първи психотичен епизод след употреба на психоактивни вещества и контролната група от 40 лица. За постигане на целите бяха проучени социодемографските и клиничните характеристики, тежестта на психотичната симптоматика, честотата на хоспитализациите, нивото на функционално възстановяване и динамиката на началната диагноза. Приложените методи на изследване включваха клинично психиатрично изследване; стандартизирани оценъчни инструменти (скалите PANSS, GAF и въпросник DATS 10); клинико-лабораторни изследвания и комбинирани уринни тестове за психоактивни вещества. Данните бяха обработвани със съвременни статистически методи, осигуряващи надеждност и статистическа значимост на получените резултати. Анализът на резултатите и изводите потвърждават, че употребата на психоактивни вещества е съществен модифициращ фактор в развитието и протичането на психотичните разстройства и оказва неблагоприятно влияние върху тежестта на психозата, броят на хоспитализациите, степента на възстановяване и качеството на живот. При пациентите в проучваната група се наблюдава по-бавно и частично подобрение, както и тенденция към хронифициране на психозата, основно с преход към шизофренния спектър. Отзвучаването на позитивната симптоматика остава водещ прогностичен маркер за ранна ремисия, докато негативните и когнитивни нарушения определят по-лоша дългосрочната прогноза и социалната дезадаптация. Проучването демонстрира приложимостта на стандартизирани психометрични инструменти (PANSS, GAF, DAST-10) в българската клинична практика и очертава нуждата от включване на невропсихологични оценки при бъдещи изследвания. Основни ограничения в хода на изследването бяха относително малкият размер на извадката (n ≈ 80) и недостатъчно продължителният период на проследяване."],"dc:format":["application/pdf"],"dc:identifier":["http://repository.mu-varna.bg/handle/nls/4377"],"dc:publisher":["Medical University of Varna"],"dc:subject":["psychotic episode","psychotic disorder","substances","Психиатрия и медицинска психология / Psychiatry and Medical Psychology"],"dc:title":["Dynamics of Diagnosis in Patients with a First Psychotic Episode Induced by the Use of Psychoactive Substances // Динамика на диагнозата при пациенти с първи психотичен епизод след употреба на психоактивни вещества"],"dc:type":["thesis"]},"updated_at":"2026-07-27T21:57:04Z"}