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Substance use in individuals at clinical high risk of psychosis

Published online by Cambridge University Press:  02 March 2015

L. Buchy ,
K. S. Cadenhead ,
T. D. Cannon ,
B. A. Cornblatt ,
T. H. McGlashan ,
D. O. Perkins ,
L. J. Seidman ,
M. T. Tsuang ,
E. F. Walker  and
S. W. Woods
...Show all authors
L. Buchy
Affiliation:
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
K. S. Cadenhead
Affiliation:
Department of Psychiatry, UCSD, San Diego, CA, USA
T. D. Cannon
Affiliation:
Department of Psychology, Yale University, New Haven, CT, USA
B. A. Cornblatt
Affiliation:
Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, USA
T. H. McGlashan
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA
D. O. Perkins
Affiliation:
Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
L. J. Seidman
Affiliation:
Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
M. T. Tsuang
Affiliation:
Department of Psychology, Yale University, New Haven, CT, USA
E. F. Walker
Affiliation:
Departments of Psychology and Psychiatry, Emory University, Atlanta, GA, USA
S. W. Woods
Affiliation:
Department of Psychiatry, Yale University, New Haven, CT, USA
R. Heinssen
Affiliation:
Schizophrenia Spectrum Research Program, Division of Adult Translational Research, National Institute of Mental Health, Bethesda, MD, USA
C. E. Bearden
Affiliation:
Departments of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, USA
D. Mathalon
Affiliation:
Departments of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
J. Addington*
Affiliation:
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
*
* Address for correspondence: J. Addington, Mathison Centre for Mental Health Research and Education, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, CanadaT2N 4Z6. (Email: [email protected])
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Abstract

Background

A series of research reports has indicated that the use of substances such as cannabis, alcohol and tobacco are higher in youth at clinical high risk (CHR) of developing psychosis than in controls. Little is known about the longitudinal trajectory of substance use, and findings on the relationship between substance use and later transition to psychosis in CHR individuals are mixed.

Method

At baseline and 6- and 12-month follow-ups, 735 CHR and 278 control participants completed the Alcohol and Drug Use Scale and a cannabis use questionnaire. The longitudinal trajectory of substance use was evaluated with linear mixed models.

Results

CHR participants endorsed significantly higher cannabis and tobacco use severity, and lower alcohol use severity, at baseline and over a 1-year period compared with controls. CHR youth had higher lifetime prevalence and frequency of cannabis, and were significantly younger upon first use, and were more likely to use alone and during the day. Baseline substance use did not differentiate participants who later transitioned to psychosis (n = 90) from those who did not transition (n = 272). Controls had lower tobacco use than CHR participants with a prodromal progression clinical outcome and lower cannabis use than those with a psychotic clinical outcome at the 2-year assessment.

Conclusions

In CHR individuals cannabis and tobacco use is higher than in controls and this pattern persists across 1 year. Evaluation of clinical outcome may provide additional information on the longitudinal impact of substance use that cannot be detected through evaluation of transition/non-transition to psychosis alone.

Keywords

Alcoholcannabisprodromesubstance usetobacco
Type
Original Articles
Information
Psychological Medicine , Volume 45 , Issue 11 , August 2015 , pp. 2275 - 2284
Copyright
Copyright © Cambridge University Press 2015 

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