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

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.