Demographic and Clinical Profiles of Drug-Induced Psychosis: Age, Gender, and Social Context in a German Cohort

Demographic and Clinical Profiles of Drug-Induced Psychosis: Age, Gender, and Social Context in a German Cohort | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Demographic and Clinical Profiles of Drug-Induced Psychosis: Age, Gender, and Social Context in a German Cohort Nadia Böss, Gabriele Koller, Kristina Adorjan, Bernhard Haller, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7943364/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 31 Mar, 2026 Read the published version in European Archives of Psychiatry and Clinical Neuroscience → Version 1 posted You are reading this latest preprint version Abstract Background: Drug-induced psychosis (DIP) represents a complex clinical challenge, particularly among younger substance-using populations. While DIP arises in the context of substance use, distinguishing transient episodes from emerging primary psychotic disorders remains difficult, and data on demographic and clinical variations are limited. Methods: We conducted a descriptive cohort study of 340 patients diagnosed with DIP (ICD-10: F1X.5) between 2010 and 2020 at two university hospitals in Germany. Equal numbers of cases (n=170) were included from the toxicology and psychiatry departments; all eligible cases at TUM were included, and the same number were randomly selected from the LMU cohort. Variables assessed included sociodemographic data, psychiatric symptoms, substance use (self-report and toxicology), comorbidities, and family history. Analyses included descriptive statistics, chi-square or Fisher’s exact tests, and Mann–Whitney U tests to examine group differences. Results: The cohort was predominantly male (77.4%) with a median age of 27 years. Migration background was present in 27.6%, with admissions peaking in 2015–2018. Psychotic symptoms were dominated by perceptual disturbances (62.3%) and thought disorder (76.3%). Women exhibited higher rates of tactile hallucinations, suicidal ideation, and depression (all p<0.05) and tended to have higher serum ethanol levels. Daily substance use was common (69.0%), with polysubstance use exceeding 75%. Cannabis and stimulants predominated in younger patients, while opiates, sedatives, and ethanol were more frequent in older groups. Conclusion: DIP showed clear gender- and age-related differences in psychotic symptom profiles and clinical presentation, alongside high rates of daily and polysubstance use, young male predominance, and migration-related patterns. These findings underscore the need for early, individualized, and demographically informed interventions. Drug-induced psychosis Substance use disorder Polysubstance use Age differences Gender differences Social determinants Psychotic symptoms Full Text Additional Declarations Competing interest reported. Professor Adorjan serves as an editor for the European Archives of Psychiatry and Clinical Neuroscience. She will have no involvement in the editorial handling or peer-review process for this manuscript. The remaining authors declare that they have no competing interests. Supplementary Files ClinicalAndDemographicProfilesOfDIPsupplement.zip Cite Share Download PDF Status: Published Journal Publication published 31 Mar, 2026 Read the published version in European Archives of Psychiatry and Clinical Neuroscience → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7943364","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":560264878,"identity":"609eab26-0587-4240-a33b-6832434f2d21","order_by":0,"name":"Nadia Böss","email":"","orcid":"","institution":"Technical University of Munich","correspondingAuthor":false,"prefix":"","firstName":"Nadia","middleName":"","lastName":"Böss","suffix":""},{"id":560264880,"identity":"72662acb-097a-4c01-88d5-eb00e8f69d13","order_by":1,"name":"Gabriele Koller","email":"","orcid":"","institution":"Ludwig-Maximilians-Universität 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Professor Adorjan serves as an editor for the European Archives of Psychiatry and Clinical Neuroscience. She will have no involvement in the editorial handling or peer-review process for this manuscript. The remaining authors declare that they have no competing interests.","formattedTitle":"Demographic and Clinical Profiles of Drug-Induced Psychosis: Age, Gender, and Social Context in a German Cohort","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Drug-induced psychosis, Substance use disorder, Polysubstance use, Age differences, Gender differences, Social determinants, Psychotic symptoms","lastPublishedDoi":"10.21203/rs.3.rs-7943364/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7943364/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eDrug-induced psychosis (DIP) represents a complex clinical challenge, particularly among younger substance-using populations. While DIP arises in the context of substance use, distinguishing transient episodes from emerging primary psychotic disorders remains difficult, and data on demographic and clinical variations are limited.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e We conducted a descriptive cohort study of 340 patients diagnosed with DIP (ICD-10: F1X.5) between 2010 and 2020 at two university hospitals in Germany. Equal numbers of cases (n=170) were included from the toxicology and psychiatry departments; all eligible cases at TUM were included, and the same number were randomly selected from the LMU cohort. Variables assessed included sociodemographic data, psychiatric symptoms, substance use (self-report and toxicology), comorbidities, and family history. Analyses included descriptive statistics, chi-square or Fisher’s exact tests, and Mann–Whitney U tests to examine group differences.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The cohort was predominantly male (77.4%) with a median age of 27 years. Migration background was present in 27.6%, with admissions peaking in 2015–2018. Psychotic symptoms were dominated by perceptual disturbances (62.3%) and thought disorder (76.3%). Women exhibited higher rates of tactile hallucinations, suicidal ideation, and depression (all p\u0026lt;0.05) and tended to have higher serum ethanol levels. Daily substance use was common (69.0%), with polysubstance use exceeding 75%. Cannabis and stimulants predominated in younger patients, while opiates, sedatives, and ethanol were more frequent in older groups.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e DIP showed clear gender- and age-related differences in psychotic symptom profiles and clinical presentation, alongside high rates of daily and polysubstance use, young male predominance, and migration-related patterns. These findings underscore the need for early, individualized, and demographically informed interventions.\u003c/p\u003e","manuscriptTitle":"Demographic and Clinical Profiles of Drug-Induced Psychosis: Age, Gender, and Social Context in a German Cohort","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-16 17:33:14","doi":"10.21203/rs.3.rs-7943364/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"8aeebedf-6415-45a4-aeae-9e4d7b35106e","owner":[],"postedDate":"December 16th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-07T16:07:51+00:00","versionOfRecord":{"articleIdentity":"rs-7943364","link":"https://doi.org/10.1007/s00406-026-02232-y","journal":{"identity":"european-archives-of-psychiatry-and-clinical-neuroscience","isVorOnly":false,"title":"European Archives of Psychiatry and Clinical Neuroscience"},"publishedOn":"2026-03-31 15:59:03","publishedOnDateReadable":"March 31st, 2026"},"versionCreatedAt":"2025-12-16 17:33:14","video":"","vorDoi":"10.1007/s00406-026-02232-y","vorDoiUrl":"https://doi.org/10.1007/s00406-026-02232-y","workflowStages":[]},"version":"v1","identity":"rs-7943364","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7943364","identity":"rs-7943364","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}