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Acta Psychiatr Scand. 2007 Apr;115(4):304-9.

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

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  • 1Department of Psychiatry, University of Toronto, Toronto, ON, Canada.



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.


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.


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.


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.

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