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Novel psychoactive substances (NPS) use in severe mental illness (SMI) patients: Potential changes in the phenomenology of psychiatric diseases

Giuseppe Bersani, Elisabeth Prevete

Human Psychopharmacology Clinical and Experimental May 1, 2017 DOI: 10.1002/hup.2591 (opens in new tab) via OpenAlex

Summary

AI-generated from the abstract

The clinical effects of novel psychoactive substances (NPS) in patients with severe mental illness (SMI) are poorly understood. This review found that NPS use in this population is probably underestimated, with only 14 studies identified, most of which are case reports. The main reported outcome is acute exacerbation of preexisting psychosis, with paranoid, mood, and aggression symptoms occurring more frequently. The authors conclude that NPS use could modify clinical features of SMI but that these findings cannot be generalized, and more evidence is needed to establish causal connections between NPS use and illness course, symptom type, and treatment outcomes.

Study at a glance

Characteristics Systematic review Case report Peer reviewed
Population Patients with severe mental illness (SMI), such as psychotic patients
Keywords Psychiatry Mental illness Phenomenology philosophy Medicine Psychology
Citations 15
Key finding NPS use in patients with SMI is probably underestimated, and most clinical results report acute symptom exacerbation of preexisting psychosis, with paranoid, mood, and aggression symptoms occurring more frequently.

Abstract

OBJECTIVE: Literature is quite poor about the clinical effects of novel psychoactive substances (NPS) and the long-term consequences of NPS use in psychiatric patients. Consequently, it is of the greatest interest to examine which effects NPS can exert in patients with previous severe mental illness (SMI), such as psychotic patients. The aim of this work was a comprehensive review about NPS use in patients with SMI. METHODS: We searched Medline or PubMed for relevant English-language citations and reviews describing relationships between NPS use and mental disorders, as well as for the main groups of substances and associated psychiatric manifestations. All studies reporting single case or case series of patients were selected. RESULTS: The NPS use in patients with SMI is probably underestimated. The one existing systematic review considers only 14 studies, 12 of which are case reports. Most clinical results report acute symptom exacerbation of preexisting psychosis. Paranoid, mood, and aggression symptoms occur more frequently. CONCLUSIONS: NPS use could modify clinical features of SMI, but these conclusions cannot be generalizable. More evidence is needed to establish the causal and effective connection between NPS use and course of illness, type of psychiatric symptoms, and outcome of treatment in terms of adherence or response.

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