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El-Hage D, Gao CX, Bedi G, Guerin A, Francey S, Stavely H, Rickwood D, Telford N, McGorry P, Thompson A, Brown E. Correlates of substance use in a large naturalistic cohort of young people with early and emerging psychosis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1447-1456. [PMID: 36808500 PMCID: PMC10460356 DOI: 10.1007/s00127-023-02436-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/02/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Substance use remains a barrier to recovery for young people accessing early intervention services for psychosis. While correlates of use have been explored in populations experiencing a first episode of psychosis (FEP), sample sizes have been small and less research assesses cohorts at ultrahigh risk of psychosis (UHR). METHODS This study uses data from a naturalistic cohort including UHR and FEP participants (N = 1252) to elucidate clinical correlates of use in the past 3 months of any illicit substance, amphetamine-type stimulants (ATS), cannabis, and tobacco. Moreover, network analysis based on use of these substances and additionally alcohol, cocaine, hallucinogens, sedatives, inhalants, and opioids was completed. RESULTS Young people with FEP used substances at significantly higher rates than those at UHR. High concurrence of use was seen between substances. In the FEP group, participants who had used any illicit substance, ATS, and/or tobacco had increased positive symptoms and decreased negative symptoms. Young people with FEP who used cannabis had increased positive symptoms. In the UHR group, participants who had used any illicit substance, ATS, and/or cannabis in the past 3 months showed decreased negative symptoms compared to those who had not. CONCLUSION A distinct clinical picture of more florid positive symptoms and alleviated negative symptoms seen in those who use substances in the FEP group appears muted in the UHR cohort. Treating young people at UHR in early intervention services represents the earliest opportunity to address substance use early to improve outcomes.
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Affiliation(s)
- D El-Hage
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - C X Gao
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - G Bedi
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - A Guerin
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - S Francey
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - H Stavely
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - D Rickwood
- Headspace National, Melbourne City, VIC, Australia
- University of Canberra, Bruce, ACT, Australia
| | - N Telford
- Headspace National, Melbourne City, VIC, Australia
| | - P McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - A Thompson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - Ellie Brown
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
- Orygen, 35 Poplar Road, Parkville, VIC, Australia.
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