title: Substance use in people at clinical high-risk for psychosis.
abstract: BACKGROUND
  Some high-risk (HR) mental states for psychosis may lack diagnostic specificity and predictive value. Furthermore, psychotic-like experiences found in young populations may act not only as markers for psychosis but also for other non-psychotic psychiatric disorders. A neglected consideration in these populations is the effect of substance misuse and its role in the development of such mental states or its influence in the evolution toward full psychotic presentations. Therefore, the main aim of this study was to thoroughly describe past and current substance use profiles of HR individuals by comparing a consecutive cohort of young people at high risk referred to a population-based early intervention clinical service with a random sample of healthy volunteers (HV) recruited from the same geographical area.
  
  
  METHODS
  We compared alcohol and substance use profiles of sixty help-seeking HR individuals and 60 healthy volunteers (HV). In addition to identification of abuse/dependence and influence on psychotic-like experiences, differences between HR individuals and HV were assessed for gender, ethnicity, occupational status, age of lifetime first substance use, prevalence and frequency of substance use.
  
  
  RESULTS
  There were no cases of substance use disorder or dependence in either groups. HR individuals were significantly younger than HV when they first started to use substances (p = 0.014). The prevalence of overall HR substance use was similar to that of HV. Although HR individuals reported less cannabinoid use than HV currently (15% vs. 27%), and more in the past (40% vs. 30%), the differences were not statistically significant (p = 0.177 & 0.339 respectively). Current frequency of use was significantly higher for HR individuals than HV for alcohol (p = 0.001) and cannabinoids (p = 0.03). In this sample, only 5% of HR individuals converted to psychosis over a two-year follow-up.
  
  
  CONCLUSIONS
  Certain profiles of substance use could potentially play a significant part in the evolution of HR presentations. Therefore, substance use may well represent a clinical domain that requires further emphasis and more detailed consideration in future studies.
authors.affiliation: CAMEO Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK. dr335@medschl.cam.ac.uk.|Department of Psychiatry, University of Cambridge, Cambridge, UK. dr335@medschl.cam.ac.uk.|Block 7, Ida Darwin Site, Fulbourn Hospital, CB21 5EE, Fulbourn, Cambridge, UK. dr335@medschl.cam.ac.uk.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Russo
authors.affiliation: Department of Health Sciences, University of York, York, UK. jan.stochl@york.ac.uk.
authors.forename: Jan
authors.initials: J
authors.lastname: Stochl
authors.affiliation: CAMEO Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK. michelle.painter@cpft.nhs.uk.
authors.forename: Michelle
authors.initials: M
authors.lastname: Painter
authors.affiliation: CAMEO Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK. pbj21@cam.ac.uk.|Department of Psychiatry, University of Cambridge, Cambridge, UK. pbj21@cam.ac.uk.|NIHR Collaboration for Leadership in Applied Health Research & Care, Cambridge, UK. pbj21@cam.ac.uk.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Jones
authors.affiliation: CAMEO Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK. jp440@cam.ac.uk.|Department of Psychiatry, University of Cambridge, Cambridge, UK. jp440@cam.ac.uk.
authors.forename: Jesus
authors.initials: J
authors.lastname: Perez
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D001008:Anxiety Disorders / Q000150:complications; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology; D011605:Psychoses, Substance-Induced / Q000209:etiology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000523:psychology*; D055815:Young Adult