title: Substance use and at-risk mental state for psychosis in 2102 prisoners: the case for early detection and early intervention in prison.
abstract: Prisoners exhibit high rates of substance use and mental health problems. In the present study, we sought to gain a detailed understanding of substance use amongst young prisoners to inform early detection and early intervention strategies in a prison setting.
  
  
  
  This is a cross-sectional study of 2102 prisoners who were screened by the London Early Detection and Prevention in Prison Team (LEAP). Data on the use of substances were collected including age of first use, recent use, duration of use and poly-drug use. The Prodromal Questionnaire - Brief Version was used to screen for the at-risk mental state.
  
  
  
  We found high rates of lifetime and recent use and low age of first use of a number of substances. We also found strong associations between substance use and screening positive for an at-risk mental state. Logistic regression analysis confirmed that use of any drug in the last year, poly-drug and early use, as well as heavy alcohol use, were related to an increased risk of screening positive.
  
  
  
  Substance use in the prison population is not only widespread and heavy but is also strongly linked with a higher risk of developing mental health problems. The need for early detection and early intervention in prison is discussed.
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Jemima
authors.initials: J
authors.lastname: Cooper
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Manuela
authors.initials: M
authors.lastname: Jarrett
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Forrester
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Marta
authors.initials: M
authors.lastname: di Forti
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Robin M
authors.initials: RM
authors.lastname: Murray
authors.affiliation: South London and Maudsley NHS Foundation Trust, London, UK.|University College London, London, UK.
authors.forename: Vyv
authors.initials: V
authors.lastname: Huddy
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Roberts
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Phillip
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Campbell
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Majella
authors.initials: M
authors.lastname: Byrne
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: McGuire
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Thomas
authors.identifier: 0000-0003-1442-0391
authors.initials: T
authors.lastname: Craig
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Lucia
authors.initials: L
authors.lastname: Valmaggia
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D061345:Early Medical Intervention; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D011329:Prisoners / Q000523:psychology*; D062706:Prodromal Symptoms; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult
keywords: early detection; prison; substance use; ultra high risk