Lifetime Adversity Among Individuals With Early Phase Psychosis and Comorbid Substance Misuse

Adverse events and substance misuse are rarely examined together among people in early phase psychosis, although both are frequently examined in isolation given their high prevalence in this population. As a result, the frequency of the three-way overlap is unclear. Moreover, adverse events are often limited to childhood abuse and rarely include illness-related events (e.g., threatening hallucinations). This study aims to explore the overlap between these variables and provide a more detailed understanding of adversity in this population and their desire to disclose experiences.

We surveyed 110 individuals aged 16-35 years with early phase psychosis about substance misuse, lifetime adverse events, disclosure of adverse events, and PTSD symptoms.

Nearly all participants (97.2%) had experienced at least 1 adverse event, recalling an average of 8 adverse events over lifetime (SD = 3.8). Over 22% met the cutoff for a probable PTSD diagnosis on a validated measure. Substance misuse was present in 67% of participants, often involving multiple substances (M = 2.7 substances, SD = 1.5), most commonly alcohol, cannabis, and tobacco. There was an overlap between early phase psychosis, substance misuse, and a history of at least 1 adverse event in 66.4% of the sample. Most participants (78.7%) had disclosed their adverse events to someone, and 72.7% expressed interest in speaking to a mental health professional about their experiences.

Adverse events and substance misuse commonly co-occur in early phase psychosis, and these results have important clinical ramifications for assessment and treatment in an early phase psychosis population.