To examine patterns of substance use in youth with psychotic disorders, researchers assessed 69 youths between the ages of 6 and 17 (mean age, 14.8 years) undergoing treatment for early onset psychosis. Subjects were assessed annually over 2 years using standardized diagnostic and symptom rating measures. Results were as follows:

• Forty-five percent of subjects met criteria for substance abuse or dependence. An additional 7% did not meet criteria for a diagnosis of substance use disorder but had used illicit drugs.
• Of these youths, only 26% had received substance abuse treatment.
• Youths diagnosed with schizophrenia had used substances prior to their first psychotic episode and were significantly older than other youths in the study at onset of psychotic symptoms.
• No significant associations were found between substance use disorder and other hypothesized risk factors such as attention deficit hyperactivity disorder, socioeconomic status, maltreatment, or family history of substance abuse.

Comments by Michael Boyle, MA
Youth experiencing a first episode of psychosis should be assessed for a substance use disorder and provided treatment for it when present. Unfortunately, research and development of evidence-based practices for treating co-occurring disorders have focused mainly on adults. Additional research is needed to develop effective practices for young persons with these dual problems.