Patterns, predictors and impact of substance use in early psychosis: a longitudinal study

Acta Psychiatr Scand. 2007 Apr;115(4):304-9. doi: 10.1111/j.1600-0447.2006.00900.x.


Objective: The purpose was to determine the prevalence of substance use and its impact on outcome 3 years after presentation for a first-episode of psychosis.

Method: Subjects were 203 consecutive admissions to an early psychosis program. Assessments included substance use, positive, negative and depressive symptoms and social functioning. Assessments occurred at baseline, and 1-, 2- and 3-year follow-ups.

Results: The prevalence of substance misuse was high with 51% having a substance use disorder (SUD), 33% with cannabis SUD and 35% with an alcohol SUD. Numbers with an alcohol SUD declined considerably by 1 year and for cannabis SUD by 2 years. Substance misuse was significantly associated with male gender, young age and age of onset and cannabis misuse with increased positive symptoms.

Conclusion: This study confirms the high rates of substance misuse, in particular cannabis, in first-episode psychosis. It further demonstrates that these rates can be reduced.

MeSH terms

  • Adult
  • Alberta
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Follow-Up Studies
  • Humans
  • Inpatients
  • Longitudinal Studies
  • Male
  • Outpatients
  • Patient Dropouts / statistics & numerical data
  • Predictive Value of Tests
  • Psychotic Disorders / classification
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / psychology*
  • Socioeconomic Factors
  • Substance-Related Disorders / classification
  • Substance-Related Disorders / psychology*
  • Urban Population