Substance Use in Young People with First Episode Psychosis in Adelaide

Abstract

Comorbid drug and alcohol use is frequently observed among young people with first episode psychosis (FEP). A case note audit was conducted of patients aged 18-30 years who presented for the first time with a psychotic disorder to the mental health services in Adelaide, South Australia. South Australia does not have dedicated first episode psychosis services so patients were assessed and treated at general adult inpatient and community facilities. The audit investigated the recording of information related to drug and alcohol use. We also looked at the recording of interventions offered to those patients who had significant drug and alcohol problems. The majority of FEP case notes did contain a drug and alcohol history, and high rates of drug use were noted. The most commonly used drugs were cannabis and amphetamines. The recorded information may underestimate the extent of substance use within young people with first episode psychosis, as clinicians may have failed to assess drug and alcohol use, or may have asked about this but not recorded their findings. The results of the current study support previous literature that has identified high levels of substance use (marijuana and amphetamine use in particular) in individuals during their first presentation with a psychotic disorder. It is likely that substance abuse is making a significant contribution to the clinical presentation of many young people with early psychosis in Adelaide.