Predictors of Substance Use Reduction in an Epidemiological First-Episode Psychosis Cohort

Early Interv Psychiatry. 2014 Nov;8(4):358-65. doi: 10.1111/eip.12067. Epub 2013 Jul 24.


Aim: To assess the predictors of a significant decrease or cessation of substance use (SU) in a treated epidemiological cohort of first-episode psychosis (FEP) patients.

Method: Participants were FEP patients of the Early Psychosis Prevention and Intervention Centre in Australia. Patients' medical files were reviewed using a standardized file audit. Data on 432 patients with FEP and baseline co-morbid substance use disorder (SUD) were available for analysis. Predictors of reduction/cessation of SU at follow up were examined using logistic regression analyses.

Results: In univariate analyses, a reduction/cessation of SU was predicted by baseline measures reflecting higher education, employment, accommodation with others, cannabis use disorder (CUD) only (rather than poly-SUDs), better global functioning and better premorbid social and occupational functioning, later age at onset of psychosis, and a diagnosis of non-affective psychosis. In multivariate analysis, CUD alone and better premorbid social and occupational functioning remained significant predictors.

Conclusions: Addressing SUDs and social and occupational goals in people with FEP may offer opportunities to prevent SUDs becoming more severe or entrenched. Further longitudinal research on recovery from SU and FEP is needed to disentangle directions of influence and identify key targets for intervention.

Keywords: first episode; psychosis; recovery; schizophrenia; substance use disorder.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological
  • Age of Onset
  • Australia / epidemiology
  • Cohort Studies
  • Diagnosis, Dual (Psychiatry)
  • Educational Status
  • Employment
  • Female
  • Humans
  • Male
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / epidemiology*
  • Psychotic Disorders / psychology
  • Risk Factors
  • Social Adjustment
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology*
  • Substance-Related Disorders / psychology
  • Young Adult