Substance use and psychotic-like experiences in young people: a systematic review and meta-analysis

Abstract

This study aimed to systematically review and synthesise the available evidence on the prevalence and associations between psychotic-like experiences (PLEs) and substance use in children and adolescents aged ⩽17 years, prior to the typical age of development of prodromal symptoms of psychosis. As substance use has been associated with earlier age of psychosis onset and more severe illness, identifying risk processes in the premorbid phase of the illness may offer opportunities to prevent the development of prodromal symptoms and psychotic illness. MEDLINE, PsycINFO, and CINAHL databases were searched for chart review, case-control, cohort, twin, and cross-sectional studies. Study reporting was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist, and pooled evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Searches identified 55 studies that met inclusion criteria. Around two-in-five substance users reported PLEs [rate = 0.41, 95% confidence interval (CI) 0.32–0.51; low quality evidence], and one-in-five with PLEs reported using substances (rate = 0.19, 95% CI 0.12–0.28; moderate-to-high quality evidence). Substance users were nearly twice as likely to report PLEs than non-users [odds ratio (OR) 1.77, 95% CI 1.55–2.02; moderate quality evidence], and those with PLEs were twice as likely to use substances than those not reporting PLEs (OR 1.93, 95% CI 1.55–2.41; very low quality evidence). Younger age was associated with greater odds of PLEs in substance users compared to non-users. Young substance users may represent a subclinical at-risk group for psychosis. Developing early detection and intervention for both substance use and PLEs may reduce long-term adverse outcomes.

Intensity of Psychoactive Substance Use Affects the Occurrence of Prodromal Symptoms of Psychosis

“…The age of initiation of drug use is also a variable that significantly modulates the risk of developing prodromal symptoms, but also influences higher distress scores. This has also been confirmed in other reports hypothesizing that younger individuals among psychoactive substance users may represent a subclinical risk group for psychosis [27]. Effective addiction prevention and psychoeducation among young people about the relationship between substance use and the possible occurrence of prodromal symptoms is a key element in the prevention of psychotic disorders.…”

Cognitive Biases and Socio-Occupational Functioning Mediate the Relationship between Executive Functions and the Severity of Psychopathology among Young Adults with Psychotic-like Experiences: 1-Year Follow-Up Study

“…Considering the correlation between PLEs and psychoactive substances (as outlined in the meta-analysis by Matheson et al [ 83 ]), we also gathered information regarding their usage among the subjects. It was revealed that the most commonly used substance was alcohol (88%), followed by marijuana or hashish (45.5%).…”

The relationship between internet gaming disorder and psychotic experiences: cyberbullying and insomnia severity as mediators

“…The 6-item paranoid ideation subscale and the 10-item psychoticism subscale of the BSI [107,108] were used to measure participants' PEs. The "paranoid ideation" and "psychoticism" dimensions have been largely used to assess PEs in the general population (e.g., [30,[109][110][111][112][113][114][115][116]), and have been included as measurement tools of PEs in previous meta-analyses (e.g., [117,118]). The paranoid ideation subscale detects paranoia symptoms that involve delusion of reference and suspicion; while the psychoticism subscale identifies psychotic symptoms such as auditory hallucination, experience of thought insertion, thought control, and thought being revealed.…”