Eline Borger Rognli, a researcher from the Department of Mental Health and Addiction at Oslo University Hospital in Norway, presented significant findings on psychosis at the European Psychiatric Association Congress 2025. Her research looked at First-Episode Psychosis (FEP), with participation of 1,820 patients. It showed important gaps in treatment, demographics, and outcomes, as well as the impact of substance use on those with psychotic disorders.
Well, it turned out that in our study, 84.7% of patients with first-episode psychosis (FEP) were male. In these patients, the mean age at presentation was 26.8 years. The researchers followed the participants for an average of almost six years. That gave them a spectacular bird’s-eye view of their treatment trajectory and results. Antipsychotic medication has overwhelming efficacy for preventing recurrence of major psychotic episodes and hospitalizations. This is renewing hope to the millions who suffer from this multifactorial and complex condition.
Gender and Age Demographics in FEP Patients
Rognli’s study highlighted the changing demographics of patients presenting with First-Episode Psychosis. Given 84.7% of participants were male, these results suggest a strong male-bias in the presentation of psychotic disorders. The mean age of the patients was 26.8 years, suggesting that FEP often emerges during early adulthood—a critical period for mental health interventions.
Young men in particular have been shown to be more vulnerable to developing a mental illness, such as psychosis. Photo by Julie Fimreite Rognli’s study opens the door for more research. Its goal is to figure out what’s making this demographic disproportionately worse and how we could develop targeted interventions.
“Just by the name, it’s assumed that the psychosis is caused by substance use, and that type of explanatory diagnostic terms is something that we’ve broadly left behind,” – Eline Borger Rognli
This insight underscores the need to move beyond outdated diagnostic labels and better understand the underlying mechanisms driving psychotic disorders.
Impact of Antipsychotic Medications
Perhaps the most interesting thing about Rognli’s study is how it challenges perceptions of antipsychotic medication efficacy. The study found that antipsychotic use reduces the risk of relapse into psychosis by 33%. In addition, it results in a 23% decrease in psychiatric hospitalizations. The analysis showed a significant 23% reduction in hospitalizations related to substance use disorders. This decrease owed mainly to people who were on antipsychotic medications.
The findings suggest that antipsychotic medications play a vital role in managing symptoms and preventing relapses in individuals diagnosed with FEP. Of all medications researched, clozapine was the most effective, with aripiprazole coming in a close second.
“What it says about cannabis-related psychosis is clearly that the mechanisms of what we think of in schizophrenia and cannabis-related psychosis mechanisms travel on the same road,” – Lena Palaniyappan
This declaration underscores the intricate relationship between substance use and emergent psychosis. It further illustrates the importance of well-rounded treatment plans that are able to address both mental health and substance use disorders together.
The Role of Substance Use in Psychotic Disorders
One of the most interesting aspects of Rognli’s research was its deeper look into substance use–especially cannabis. The remaining 25 patients studied were diagnosed with cannabis use disorder (CUD). At the same time, 36 patients were still without this diagnosis. Understanding this distinction is important in addressing questions about the connection between cannabis use and psychosis.
Lena Palaniyappan, another leader in the field echoed that understanding this relationship requires sophisticated thinking. She made a strong case for acknowledging cannabis as a potential trigger for psychotic episodes. She was quick to remind us not to attribute all of these episodes strictly to substance use.
“So, we still keep cannabis in our consciousness when we talk about this; we still know that this person needs an intervention for cannabis, but we’re not blaming all of their psychosis on cannabis,” – Lena Palaniyappan
This standpoint encourages a holistic viewpoint on care, focusing equally on mental health resources and substance use treatment.
Palaniyappan warned against downplaying the importance of tackling cannabis-related risks in psychotic disorders. She stated:
“If you’re not differentiating schizophrenia from cannabis-related problems, then you actually treat everything as schizophrenia, which should include some advice on drug addiction and detoxification.”
In order to get patients the care they need, healthcare professionals need to take an integrative approach to treatment. This means they know how to treat all components of a patient’s disease state.
Leave a Reply