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Comorbid substance use and age at onset of schizophrenia

Department of Psychological Medicine, Imperial College Faculty of Medicine, London

SAM B. HUTTON, DPhil

Department of Psychology, University of Sussex, Brighton

HILARY C. WATT, MSc

Medical Statistics Unit, London School of Hygiene and Tropical Medicine, London

EILEEN M. JOYCE, FRCPsych

Institute of Neurology, University College London, National Hospital for Neurology and Neurosurgery, London, UK

Correspondence: Professor Thomas Barnes, Department of Psychological Medicine, Imperial College Faculty of Medicine, Charing Cross Campus, St Dunstan’s Road, London W6 8RP, UK. e-mail: t.r.barnes{at}imperial.ac.uk

Declaration of interest None. Funding detailed in the Acknowledgements.

Background Substance use may be a risk factor for the onset of schizophrenia.

Aims To examine the association between substance use and age at onset in substance use and age at onset in a UK, inner-city sample of people with recent-onset schizophrenia.

Method The study sample consisted of 152 people recruited to the West London First-Episode Schizophrenia Study. Self-reported data on drug and alcohol use, as well asinformation on age at onset of psychosis, were collected.Mental state, cognition (IQ, memory and executive function) and social function were also assessed.

Results Intotal, 60% ofthe participants were smokers, 27% reported a history of problems with alcohol use, 35% reported current substance use (not including alcohol), and 68% reported lifetime substance use (cannabis and psychostimulants were most commonly used).Cannabis use and gender had independent effects on age at onset of psychosis, after adjusting for alcohol misuse and use of other drugs.

Conclusions The strong association between self-reported cannabis use and earlier onset of psychosis provides further evidence that schizophrenia may be precipitated by cannabis use and/or that the early onset of symptoms is a risk factor for cannabis use.

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